Elsevier

Preventive Medicine

Volume 49, Issue 6, December 2009, Pages 482-486
Preventive Medicine

Weight management advice: What do doctors recommend to their patients?

https://doi.org/10.1016/j.ypmed.2009.09.015Get rights and content

Abstract

Objective.

To examine the weight management interventions that a broad population of adults reported receiving from physicians and assess what drug-related and behavioral information physicians provided when they prescribe weight loss medications.

Methods.

A random-digit dialed telephone survey was conducted in 2005–2006 with a representative sample of 3,500 American adults.

Results.

The most frequently reported interventions were having a doctor tell them about the health problems associated with being overweight (48.0%), or suggesting diet and exercise (46.5%). Few respondents reported having been referred to a formal diet program (5.2%), prescribed a weight loss medication (4.0%), recommended a non-prescription weight loss product (1.8%), or recommended stomach bypass surgery (1.5%). The proportion of individuals who reported each intervention increased across levels of body mass index (p < 0.001). Of those who reported being prescribed a weight loss medication (n = 155), only 29.5% (n = 44) reported receiving all six counseling interventions that were assessed.

Conclusions.

Many overweight patients have not been advised to lose weight, diet, or exercise, and physicians have been particularly reluctant to recommend medications. When physicians do prescribe medications, appropriate counseling too often fails to accompany the prescription. Efforts are needed to increase the involvement of physicians in guiding patients to effective weight management approaches.

Introduction

Two-thirds of American adults are overweight or obese, making excess weight a top health concern (Ogden et al., 2006). Primary care physicians are in a key position to assess the weight status of their patients and offer sound advice on effective weight management approaches. Yet, studies suggest that obesity is often not addressed during physician–patient encounters (Galuska et al., 1999, Sciamanna et al., 2000, Abid et al., 2005, Bish et al., 2005, Ford et al., 2005, Jackson et al., 2005, Loureiro and Nayga, 2006, Ko et al., 2008).

Research to date has largely focused on assessing whether or not physicians provided advice to lose weight and characterizing those most likely to receive advice. Less has been done examining the specific weight management approaches recommended by physicians. In their survey of family physicians, Phelan et al. (2009) found that that the most frequently recommended weight loss strategies were increasing physical activity, reducing fast food consumption, reducing portion sizes, and reducing soda consumption. Wadden et al. (2000), analyzing patient reports, found that prescription of a diet plan, a commercial weight loss program, medications, and readings were the most commonly prescribed interventions, though reported by only a minority of patients. This study examined a specialized population in a specialized setting, so the generalizability of the results is limited. As part of a large national survey, we examined the weight management interventions that a broad population of adults reported receiving from their physicians. We also assessed what drug-related and behavioral information physicians provided when they did prescribe weight loss medications.

Section snippets

Subjects

A total of 3,500 American adults, ≥ 18 years of age, consented to and completed a random digit-dial telephone survey conducted by the Center for Survey Research and Analysis at the University of Connecticut. Respondents were inhabitants of the 48 contiguous United States. Stratified sampling (by US Census Bureau geographic regions) was used to ensure proportional regional representation.

Procedure

We have previously reported details of the procedure used for this study (see Pillitteri et al., 2008).

Results

Characteristics of respondents are shown in Table 1. Overall, 50.3% of respondents were women, and 69.9% were Caucasian. The mean age was 45.7 years. Based on BMI, 41.6% of respondents were normal weight, 35.9% overweight, and 22.5% obese at the time of the survey.

Overall, 28.2% of respondents (38.0% of normal weight, 25.8% of overweight, and 14.1% of obese respondents) reported never having been offered any of the listed interventions (Table 2). The most frequently reported interventions were

Conclusions

This survey offered insights into weight management interventions occurring in clinical practice. Recommendations for diet and physical activity and discussion of health problems associated with being overweight were the most frequently endorsed items, reported by approximately 50% of respondents. Furthermore, these interventions were more often reported by those who were obese at the time of the survey (67.2% for suggestion of diet and exercise and 70.9% for discussion of health problems). Ko

Conflict of interest statement

This survey was conducted by the Center for Survey Research and Analysis at the University of Connecticut. Dr. Shiffman, Dr. Sweeney, Dr. Pillitteri and Mr. Sembower perform consulting services for GlaxoSmithKline Consumer Healthcare. Ms. Harkins is employed by GlaxoSmithKline Consumer Healthcare. Dr. Wadden has no financial interest related to the manuscript.

Acknowledgments

This study was supported by GlaxoSmithKline Consumer Healthcare, which markets the over-the-counter weight loss drug, orlistat (brand name alli®).

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