A Silent Response to the Obesity Epidemic

Kraschnewski, Jennifer L.; Sciamanna, Christopher N.; Stuckey, Heather L.; Chuang, Cynthia H.; Lehman, Erik; Hwang, Kevin O.; Sherwood, Lisa L.; Nembhard, Harriet Black

doi:10.1097/mlr.0b013e3182726c33

Cited by 148 publications

(77 citation statements)

References 31 publications

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“…This may imply that having a primary care visit alone, without proper obesity counseling or referral to a bariatric specialist, may not be sufficient for increasing appropriate utilization of surgical obesity treatment. This is consistent with prior literature showing low rates of obesity counseling and weight loss treatment in the primary care setting [10].…”

Section: Resultssupporting

confidence: 92%

An Exploration of System-Level Factors and the Geographic Variation in Bariatric Surgery Utilization

et al. 2016

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There is wide geographic variation in bariatric surgery rates, although higher regional rates of obesity are not correlated with higher rates of surgery. In this study, four system-level factors were explored as contributors to this geographic variation. Geographic utilization rates of bariatric surgery showed no correlation to the number of bariatric surgeons, number of accredited centers, and the percentage of patients with a recent primary care visit. The total number of surgical discharges was weakly correlated with bariatric surgery rates (r = 0.26, p = <0.001). As surgeon supply, accredited bariatric centers, overall surgical volume, and access to primary care do not appear to heavily influence bariatric surgery rates, future studies are needed to identify additional factors that may explain the underutilization of bariatric surgery.

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Section: Resultssupporting

confidence: 92%

An Exploration of System-Level Factors and the Geographic Variation in Bariatric Surgery Utilization

et al. 2016

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“…This is likely due to the fact that our obesity indicator specified identification by a healthcare provider. Physician counseling regarding obesity is inadequate (Kraschnewski et al 2013); therefore, the slightly lower obesity prevalence in our sample likely reflects inadequate physician identification, or physician reluctance to use the potentially stigmatizing term “obesity,” rather than lower than average rates of obesity in this sample. However, as the cases of obesity in our sample were identified by a health care provider, these were likely to be clinically relevant cases of obesity (Dallman 2010; Kushner 2012).…”

Section: Limitationsmentioning

confidence: 85%

Association of intimate partner violence and health-care provider-identified obesity

et al. 2015

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We examined the association of physical and non-physical IPV (intimate partner violence) with obesity. Women (n=1,179) were surveyed regarding demographics, obesity, and IPV exposure using HARK (humiliate-afraid-rape-kick), an IPV screening tool. A three-level lifetime IPV exposure variable measured physical, non-physical or no IPV. Healthcare provider-identified obesity was defined if participants were told by a medical provider within the past 5 years that they were obese. Bivariate analyses examined obesity by IPV and demographics. Multivariable logistic regression assessed odds of obesity by IPV type, adjusting for age, race/ethnicity, education and marital status. Among participants, 44% reported lifetime IPV (25% physical, 19% non-physical), and 24% reported healthcare provider-identified obesity. In unadjusted analyses, obesity was more prevalent among women exposed to physical IPV (30%) and non-physical IPV (27%), compared to women without IPV (20%, p=0.002). In multivariable models, women reporting physical IPV had 1.67 times greater odds of obesity (95% confidence interval [CI] 1.20, 2.33), and women reporting non-physical IPV had 1.46 times greater odds of obesity (95% CI 1.01, 2.10) compared to women reporting never exposure. This study extends prior data by showing not only an association between physical IPV and obesity, but also an association between obesity and non-physical IPV.

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“…Further, these organizations launched the “Exercise is Medicine” initiative, in which physicians are encouraged to recommend physical activity to their patients as they would recommend any other effective treatment or preventive service (ACSM & AMA 2007). Despite these recommendations, only 21.7% of adults over 65 meet ST guidelines and physicians provide exercise counseling during a mere 11.3% of primary care visits (Centers for Disease and Prevention 2013; Kraschnewski 2013). …”

Section: Introductionmentioning

confidence: 99%

Is exercise used as medicine? Association of meeting strength training guidelines and functional limitations among older US adults

Kraschnewski

Sciamanna

Ciccolo

et al. 2014

Preventive Medicine

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OBJECTIVE To determine the association between meeting strength training (ST) guidelines (≥ 2 times per week) and the presence of functional limitations among older adults. METHODS This cross-sectional study used data from older adult participants (n=6,763) of the National Health Interview Survey conducted in 2011 in the United States. RESULTS Overall, 16.1% of older adults reported meeting ST guidelines. For each of nine functional limitations, those with the limitation were less likely to meet ST recommendations than those without the limitation. For example, 20.0% of those who reported no difficulty walking one-quarter mile met ST guidelines, versus only 10.1% of those who reported difficulty (p<.001). In sum, 21.7% of those with no limitations (33.7% of sample) met ST guidelines, versus only 15.9% of those reporting 1–4 limitations (38.5% of sample) and 9.8% of those reporting 5–9 limitations (27.8% of sample) (p<.001). CONCLUSION Strength training is uncommon among older adults and even less common among those who need it the most. The potential for ST to improve the public’s health is therefore substantial, as those who have the most to gain from ST participate the least.

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A Silent Response to the Obesity Epidemic

Cited by 148 publications

References 31 publications

An Exploration of System-Level Factors and the Geographic Variation in Bariatric Surgery Utilization

An Exploration of System-Level Factors and the Geographic Variation in Bariatric Surgery Utilization

Association of intimate partner violence and health-care provider-identified obesity

Is exercise used as medicine? Association of meeting strength training guidelines and functional limitations among older US adults

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