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LetterCorrespondence

Re: Primary Care Patients' Willingness to Participate in Comprehensive Weight Loss Programs: From the WWAMI Region Practice and Research Network

Denny Fe Garcia Agana
The Journal of the American Board of Family Medicine March 2017, 30 (2) 264; DOI: https://doi.org/10.3122/jabfm.2017.02.160353
Denny Fe Garcia Agana
Department of Epidemiology University of Florida College of Public Health and Health Professions H. James Free Center for Primary Care Education & Innovation University of Florida College of Medicine Department of Community Health and Family Medicine University of Florida College of Medicine Gainesville, FL
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To the Editor: The article by Cole et al1 about primary care patients' willingness to participate in comprehensive weight loss programs is progressive in addressing a major health problem, yet some areas need improvement. One objective of this study was to determine patient characteristics associated with willingness to participate in these programs. The investigators failed to include 2 important factors in their survey: income and educational level. According to the Centers for Disease Control and Prevention, (1) among Mexican American and non-Hispanic black men, those with higher incomes are more likely to be obese than those with lower incomes, (2) women with higher incomes are less likely to be obese than women with lower incomes, and (3) women with college degrees are less likely to be obese than women with lower educational levels.2

Another issue is the single delivery method of the survey, that is, article format. Investigators may have lost a population of patients who may not be able to read or write well (eg, less educated people, older adults) as a result of the lack of assistance in reading the survey. They also may have lost those who are more technologically advanced. Also, clinical staff offered the surveys to patients, which may have made patients feel obliged to take the survey. Some patients may have felt that the quality of their clinical care would be affected by not participating in the clinic-offered survey.

Next, the investigators aimed to identify potential facilitators and barriers to participation in comprehensive weight loss programs, but identified only the facilitators. They asked patients to mark the top 3 of 8 listed potential factors, yet these factors were all positive and did not identify barriers to participation.

In the discussion, the investigators explained that the Patient Protection and Affordable Care Act requires insurance companies to provide coverage for obesity treatment. This study included participants who were overweight, obese, and extremely obese. Yet, the sample included participants who were considered “at risk” but not obese. Therefore, this group should be excluded from the analysis in order for the results to pertain to patients who qualify for obesity treatment.

While this article was an advancement in the understanding of primary care patients' willingness to participate in comprehensive weight loss programs, all associated factors in the health outcomes were not assessed. These factors are necessary to tailor parsimonious and appropriate comprehensive weight loss programs for primary care patients.

Notes

  • To see this article online, please go to: http://jabfm.org/content/30/2/264.full.

  • The above letter was referred to the author of the article in question, who offers the following reply.

References

  1. 1.↵
    1. Cole AM,
    2. Keppel GA,
    3. Andrilla HA,
    4. Cox CM,
    5. Baldwin LM
    ; WWAMI (Washington, Wyoming, Alaska, Montana, and Idaho) Region Practice and Research Network (WPRN) Patient Preferences for Weight Loss in Primary Care Development Group; The WPRN Practice Champions. Primary care patients' willingness to participate in comprehensive weight loss programs: from the WWAMI Region Practice and Research Network. J Am Board Fam Med 2016;29:572–80.
    OpenUrlAbstract/FREE Full Text
  2. 2.↵
    Centers for Disease Control and Prevention. Adult obesity facts. Available from https://www.cdc.gov/obesity/data/adult.html. Updated September 1, 2016. Accessed October 27, 2016.
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The Journal of the American Board of Family     Medicine: 30 (2)
The Journal of the American Board of Family Medicine
Vol. 30, Issue 2
March-April 2017
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Re: Primary Care Patients' Willingness to Participate in Comprehensive Weight Loss Programs: From the WWAMI Region Practice and Research Network
Denny Fe Garcia Agana
The Journal of the American Board of Family Medicine Mar 2017, 30 (2) 264; DOI: 10.3122/jabfm.2017.02.160353

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Re: Primary Care Patients' Willingness to Participate in Comprehensive Weight Loss Programs: From the WWAMI Region Practice and Research Network
Denny Fe Garcia Agana
The Journal of the American Board of Family Medicine Mar 2017, 30 (2) 264; DOI: 10.3122/jabfm.2017.02.160353
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