Patient perception matters in weight management (original) (raw)
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Provider Advice and Patient Perceptions on Weight Across Five Health Systems
American Journal of Preventive Medicine, 2020
Introduction: To improve the management of overweight and obesity in the primary care setting, an analysis of patient perceptions of weight status and predictors of weight loss attempts for those with overweight and obesity is needed. Methods: Primary care patients (n=949) across 5 health systems in the Mid-Atlantic region of the U.S. were surveyed in 2015; data analysis was performed in 2018. Survey data was combined with data via the electronic health record to understand patients' perceptions of weight, factors associated with weight loss efforts, and provider counseling practices. Results: Most participants with overweight or obesity perceived themselves as weighing too much and reported trying to lose weight. Furthermore, most participants with obesity reported receiving advice to lose weight by a provider in the past 12 months. However, less than half of patients with overweight reported receiving advice to lose weight, maintain weight, or develop healthy eating and physical activity patterns from a health professional in the past 12 months. Among participants with overweight and obesity, multivariable logistic regression analysis demonstrated that the perception of being overweight and receiving healthcare advice to lose weight had the highest odds of reporting attempted weight loss (OR=5.
European Journal of Internal Medicine, 2021
Background: People with obesity (PwO) often struggle to achieve and maintain weight loss. This can perpetuate and/or be influenced by feelings of low motivation. This analysis from ACTION-IO data identified factors associated with PwO motivation to lose weight. Methods: PwO completed an online survey in 11 countries. Exploratory multinomial logistic regression analyses identified independent variables associated with self-report of feeling motivated versus not motivated to lose weight. Results: Data from 10,854 PwO were included (5,369 motivated; 3,312 neutral; 2,173 not motivated). Variables associated with feeling motivated versus not motivated included (odds ratio [95% confidence interval]): acknowledgement of healthcare professional (HCP) responsibility to contribute to weight loss (2.32 [1.86-2.88]), comfort in talking to their HCP about weight (1.46 [1.24-1.72), agreement that it is easy to lose weight (1.73 [1.30-2.31]), and a goal of reducing risks from excess weight (1.45 [1.22-1.73]). Conversely, if PwO considered obesity less important than other diseases they were less likely to report feeling motivated (0.49
Preventive Medicine, 2005
Background. Past research has surveyed primary care physicians (PCP) about their attitudes and practices towards obese patients, yet less is known about the patients receiving advice. Methods. The Primary Care Weight Control Project (PCWC) enrolled 18 PCPs in a randomized clinical trial and asked 255 of their patients who were either overweight or obese at baseline about past weight control advice. Results. At baseline, 66.4% of patients reported that their physician previously told them they were overweight. Body mass index (BMI) was a strong predictor of being identified as obese. While 65.1% received information on the health benefits of weight loss, only 36.6% of patients were ever given specific weight control advice, and 28.2% were advised to increase their physical activity. A history of type 2 diabetes, high cholesterol, or hypertension was associated with physician-delivered weight control advice. Stages of change and number of prior visits with the PCP were also associated with physician advice. Conclusions. Patients were more likely to receive education about weight loss than specific behavioral advice on how to lose weight. Physicians were more likely to provide weight control advice to their patients who had obesity-related comorbidities than to patients who were overweight or obese and without risk factors.
BMC public health, 2014
Background: The prevalence of obesity is growing worldwide. Obesity guidelines recommend increasing the level of weight-related care for persons with elevated levels of weight-related health risk (WRHR). However, there seems to be a discrepancy between need for and use of weight-related care. The primary aim of this study is to examine predisposing factors that may influence readiness to lose weight and intention to use weight-related care in an overweight population. Methods: A population-based, cross-sectional survey was conducted. Data were collected using an online self-administered questionnaire sent to a population-representative sample of 1,500 Dutch adults on the Health Care Consumer Panel (n = 861 responded). Data were used from individuals (n = 445) with a mildly, moderately or severely elevated level of WRHR. WRHR status was based on self-reported data on Body Mass Index, risk assessment for diabetes mellitus type 2 (DM2) and cardiovascular disease (CVD), or co-morbidities. Results: 55.1% of persons with increased WRHR were ready to lose weight (n = 245). Depending on level of WRHR; educational level, marital status, individuals with an accurate perception of their weight and better perceptions and expectations of dietitians were significantly related to readiness to lose weight. Most of them preferred individual weight-loss methods (82.0% of n = 245). 11% (n = 26 of n = 245) intended to use weight-related care. Weight-related care seeking was higher for those with moderate or severe WRHR. Expectations and trust in dietitians did not seem to influence care seeking. Conclusions: Many Dutch adults who are medically in need of weight-related care are ready to lose weight. Most intend to lose weight individually, and only a few intend to use weight-related care. Therefore, obesity prevention initiatives should focus on monitoring weight change and weight-loss plans, and timely referral to obesity management. However, many people are not ready to lose weight. For this group, strategies for behaviour change may depend on WRHR, perceptions of weight and dietitians, educational level and marital status. Obesity prevention initiatives should focus on increasing the awareness of the seriousness of their condition and offering individually appropriate weight management programmes.
Predictors of weight loss communication in primary care encounters
Patient Education and Counseling
Objective-Evidence suggests that physicians' use of Motivational Interviewing (MI) techniques helps patients lose weight. We assessed patient, physician, relationship, and systems predictors of length of weight-loss discussions and whether physicians' used MI techniques.
Beliefs and practices of healthcare providers regarding obesity: a systematic review
Despite the implementation of various intervention measures, the number of obese individuals remain high; thus, it is important to consider what is contributing to this scenario. Authors have been striving to understand the role healthcare providers, especially in primary healthcare, seem to play in this context. The present review aims to synthesize the main investigation results regarding beliefs, attitudes, and practices of healthcare providers, as they seem to negatively influence the practitioner’s actions. The words “obesity”, “beliefs”, “healthcare professionals”, “general practitioners”, “attitudes”, “practices”, “health physicians”, and “family practitioners” were entered into databases, such as EBSCOHost, ScienceDirect, PsychInfo, PubMed, and SciELO. Thirteen studies from 1991 to 2011 were reviewed. The data indicate a lack of appropriate understanding and adequate competence regarding obesity, which likely contributes to ambivalent belief development and negative attitudes toward obese individuals, who are described as unmotivated, lazy, and lacking self-control. These professionals consider it hard to deal with obesity, manifesting low expectations of success regarding weight loss, thus considering themselves unsuccessful. Their practices are inconsistent, mirroring a certain skepticism towards the efficacy of available interventions. Either during graduation or as active practitioners, it is imperative to make healthcare providers aware of the impact their beliefs regarding obesity can exert on their practices, as these may impair appropriate and effective treatment delivery to obese individuals.
Provider and patient intervention to improve weight loss: A pilot study in a public hospital clinic
Patient Education and Counseling, 2008
Objective: To assess the efficacy of a literacy-appropriate weight loss intervention targeting providers and patients in improving physicians' weight loss counseling and patients' self-reported beliefs, and self-efficacy. Methods: The study took place in a public hospital nephrology clinic. The intervention included two physician workshops and a small group patient education. Physician-patient communication was observed and coded. Structured interviews assessed patient recall of weight loss recommendations, weight-related beliefs, and self-efficacy. Results: 64 patient visits were observed before and after the intervention. 75% of patients were African American, 96% lacked private insurance, 71% had low literacy skills; mean body mass index (BMI) of 35 kg/m 2 . Physician counseling improved significantly post-intervention, particularly in assessing, supporting and advising patients about weight loss and exercise. Patients reported increases in recall of weight loss recommendations and were more likely to report greater confidence about losing weight (52% vs. 70%, p < 0.01).