Predictors of weight control advice in primary care practices: patient health and psychosocial characteristics

Simkin‐Silverman, Laurey R.; Gleason, K.; King, Wendy C.; Weissfeld, Lisa A.; Buhari, Alhaji M.; Boraz, Miriam A.; Wing, Rena R.

doi:10.1016/j.ypmed.2004.05.012

Cited by 99 publications

(100 citation statements)

References 18 publications

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“…But general practitioners may be more likely to give weight-control advice to their diabetic patients than to patients who are obese but without risk factors [37]. In the present study, doctors largely followed the recommendations given to them, supplying metformin to the most obese patients and sulfonylureas to patients with lower bodyweight (Fig.…”

Section: Weight Loss Due To Calorie Loss In Glucosuriamentioning

confidence: 77%

Changes in patient weight and the impact of antidiabetic therapy during the first 5 years after diagnosis of diabetes mellitus

et al. 2006

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Aims/hypothesis It is generally thought difficult for type 2 diabetic patients to lose weight. We monitored changes in patients' weight during the first 5 years after diabetes diagnosis in relation to initiation of antidiabetic treatment. Subjects and methods Data from 711 newly diagnosed diabetic patients aged 40 or over were analysed with a random-effect linear-regression model. Patients were included consecutively from a well-defined patient list in general practice. Results In 245 patients whose only treatment was advice on diet, an initial weight loss of 6 to 7 kg was largely maintained over 5 years. Patients receiving metformin (n=86) or sulfonylureas (n=330) maintained an average weight loss of 2 to 4 kg that was dependent on age and sex. Patients' weight did not change on initiation of treatment with sulfonylureas or metformin. Over 5 years, median HbA 1c increased from 7.0 to 7.8% (reference range 5.4-7.4%) in the diet-alone group. HbA 1c was approximately 1 percentage point higher for most of the other treatment groups. Conclusions/interpretation In newly diagnosed type 2 diabetic patients, long-term weight loss was common and weight loss was not affected by sulfonylurea treatment. The measurements in the study are taken from treatment results achieved in the general population of diabetic patients, who are rarely treated in secondary care and seldom the subject of research; the results thus indicate that weight reduction is a practicable treatment in diabetic patients.

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Section: Weight Loss Due To Calorie Loss In Glucosuriamentioning

confidence: 77%

Changes in patient weight and the impact of antidiabetic therapy during the first 5 years after diagnosis of diabetes mellitus

et al. 2006

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“…Limited evidence from observation studies has shown great variation in the frequency with which physicians discuss weight or provide direct counseling on weight related behaviors. 10,[12][13][14] Overall rates range from 17 to 25% of total primary care visits, with counseling occurring more frequently for new patients or those seeing the physician for health maintenance. 10,12,13 Studies also suggest that the presence of medical comorbidities such as diabetes and heart disease leads to increased attention to weight and weight-related behaviors in health care settings.…”

Section: Introductionmentioning

confidence: 99%

“…10,12,13 Studies also suggest that the presence of medical comorbidities such as diabetes and heart disease leads to increased attention to weight and weight-related behaviors in health care settings. 10,14,15 In addition, because of the brief nature of typical physician encounters, providers may report conducting behavioral counseling with patients when patients perceive that no counseling has occurred. 16 Little is known about whether providers and patients agree about weight-related discussions in outpatient clinical encounters.…”

Section: Introductionmentioning

confidence: 99%

Discussing Weight with Obese Primary Care Patients: Physician and Patient Perceptions

et al. 2008

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OBJECTIVE: To evaluate patient-provider agreement on whether weight and related behaviors were discussed during routine visits. DESIGN:Post-visit survey assessments of patients and providers. PARTICIPANTS:Obese patients make up the majority of all patients seen in primary care (PC). The patients and physicians were recruited at the time of PC visits. MEASUREMENTS AND MAIN RESULTS:Percent patient-physician agreement and patient, provider and practice characteristics associated with agreement. Patients (456) and physicians (30) agreed about whether or not they discussed weight, physical activity (PA), and diet for 61% of office visits. There was disagreement on one of the items (weight, PA, or diet) for 23% of office visits, and for 2 or more of the items for 16% of the visits. Agreement was relatively greater for discussing weight than for discussing diet or physical activity. Physicians reported discussing weight issues more often than did patients. Overall patient-physician agreement was 0.51-0.59 (weighted Kappa statistic). In a multivariate analyses of factors associated with patient-physician agreement, health insurance (odds ratio [OR]=3.67, p value= 0.002), physician description of patient weight status (OR=2.27, p value=0.002), patient report of how weight relates to health (OR=1.70, p value=0.04), and female patient gender (OR=1.62, p=value=0.02) were significantly related to agreement. CONCLUSIONS:Patients and providers disagreed about whether or not weight issues were discussed in a large number of primary care encounters in this study. Physicians may be able to improve care for their obese patients by focusing discussions on specific details of diet and physical activity behaviors, and by clarifying that patients perceive weight-related information has been shared.

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“…This area of research requires further investigation. Additionally, survey studies conducted among patients and physicians (33)(34)(35)(36) show that, in general, less than half of obese adults are being advised to lose weight by healthcare professionals. The low rates of treatment of obesity are …”

Section: Articlesmentioning

confidence: 99%

Prevalence of Unhealthy Lifestyle Patterns Among Overweight and Obese Adults

Kushner

Choi

2010

Obesity

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This study determined the prevalence of unhealthy eating, exercise, and coping pattern traits among a large sample of overweight and obese adults. We analyzed responses to a 53‐item lifestyle pattern questionnaire posted on a commercial weight loss program Web site collected from 2004 through 2008. Subjects included 446,608 healthy weight, overweight, and obese adults, 18–65 years old, average age 31.9 (s.d. = 11.8), average BMI 30.5 kg/m2 (s.d. = 7.5). Categorically, 25.5% were healthy weight, 29.0% were overweight, 33.7% were class I–II obesity, and 11.8% class III obesity. A stratified random sample was used to estimate the prevalence of the 21 lifestyle patterns (7 eating, 7 exercise, and 7 coping) in the general population, and the prevalence of patterns in the complete dataset was further analyzed by gender, age, and BMI. Finally, we analyzed the odds ratio of the pattern prevalence for each BMI category. We found that unhealthy lifestyle patterns in diet, exercise, and coping were highly prevalent among this population. In general, the prevalence of these patterns rose with increasing BMI and is correlated with advancing age. Gender differences were seen with many of the patterns, most noticeably among the coping patterns. The odds ratio for 18 of the 21 patterns was >1.0 and steadily increased with higher BMI categories. We conclude that unhealthy lifestyle patterns in diet, exercise, and coping are highly prevalent among the overweight and obese population. Pattern recognition represents a new method to analyze the cluster of behaviors, attitudes, and traits seen among this population.

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Predictors of weight control advice in primary care practices: patient health and psychosocial characteristics

Cited by 99 publications

References 18 publications

Changes in patient weight and the impact of antidiabetic therapy during the first 5 years after diagnosis of diabetes mellitus

Changes in patient weight and the impact of antidiabetic therapy during the first 5 years after diagnosis of diabetes mellitus

Discussing Weight with Obese Primary Care Patients: Physician and Patient Perceptions

Prevalence of Unhealthy Lifestyle Patterns Among Overweight and Obese Adults

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