Physician Weight Counseling for Adolescents

Abstract

Adolescent obesity prevalence is increasing, with minimal study of physician weight counseling with youth. This study examines adolescents' (n=110) perceptions of physicians weight counseling. Overweight adolescents (>85th percentile for body mass index, BMI) report receiving counseling more than nonoverweight adolescents. Physicians more often have counseled obese (>95th BMI percentile) than overweight but not obese adolescents (85th-94th BMI percentile). Prior counseling and adolescents' ethnicity were related to greater perceived physician concern and adolescent receptivity to future counseling. Overweight adolescents report attempting weight loss strategies at rates similar to recommendations, but recommendations for specific weight control behaviors do not increase the likelihood of adolescent attempts.

Physician weight loss advice and patient weight loss behavior change: a literature review and meta-analysis of survey data

“…The overall random effects mean weighted effect size for weight loss efforts including all studies was OR ¼ 3.85 (95% CI 2.71, 5.49; Z ¼ 7.47, Po0.01), indicating a statistically significant impact of weight loss advice on efforts at weight loss. Removal of studies with different populations such as children 20,29 and removal of the study with the outlying OR size for the outcome 22 did not change the results significantly. (1) PCP weight loss advice, either for general health or to improve a specific comorbidity; (2) specific PCP advice related to weight loss; (3) information or communication from the PCP regarding overweight; (4) PCP use of MI to promote weight loss.…”

“…Only one did not find a positive association. 29 The BRFSS is a standardized, nationwide telephone survey of adults X18 years of age to which states can attach separate modules asking questions focusing on specific comorbidities. These studies focused on questions regarding weight management.…”

“…In all, 11 studies examined the association between provider weight loss advice and attempts by patients at specific behavior changes related to weight. Of these 11, 8 studies 29,34,38,40,41,48,50,51 found a positive association between physician weight loss advice and dietary change. All studies, except those of Himmel et al 38 and Rodondi et al, 39 examined the association between weight loss advice and physical activity, but only three found a positive association.…”

“…All studies were conducted in the United States. Excluding two articles that did not give demographic information on gender 29,31 and one that did not give demographic information on race, 31 60% of patients were female and 37% were white. Two studies evaluated a pediatric population.…”

“…Two studies evaluated a pediatric population. 20,29 There were 39 310 (19%) patients who reported receiving advice to lose weight or being told that they were overweight. Two studies 18,31 looked only at an obese population, whereas the rest included overweight patients; two studies 22,41 included normal-weight patients in their sample.…”