It’s time for doctors and nurses to take up arms against the sea of obesity, researchers involved in two studies reported.
Sometimes it can be a simple as a doctor’s frank discussion with a patient.
U.S. patients who had simply been told by their physicians that they were overweight or obese were more likely to have tried to lose weight in the previous year than patients whose doctors failed to you either of the “o” words, wrote Dr. Robert E. Post, of Medical University of South Carolina in Charleston, and colleagues in the Feb. 28 issue of the Archives of Internal Medicine.
In the study there were 7,790 participants from the 2005 to 2008 National Health and Nutrition Examination Survey.
Of these participants, BMI was 25 or higher in 5,474 and 30 or higher in 2,874.
Overweight patients were six times more likely to perceive themselves as overweight if their physician told them that they were and an obese patient was more than seven times more likely to accept the reality of their size if their doctor told them they were obese.
Yet only 45 percent of those who were overweight and 66 percent of those who were obese acknowledged having been told this by a physician, Post’s group found.
People who are overweight or obese today are more likely to consider themselves normal than people did 20 years ago, the researchers observed.
Fortunately, Post and co-authors noted, only 6 percent of participants who were overweight and 3 percent of the obese still considered they to be of normal weight after having been directly told of their weight problem by a physician.
“This speaks strongly to the influence that physicians’ words have on their patients,” the researchers wrote.
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Limitations of the study were its cross-sectional design and the inability of the investigators to assess the quality of the individual physician-patient weight-lossinteraction.
Advice on how to address the problem of obesity by physicians was offered in an invited commentary by Dr. Robert B. Baron, of the University of California San Francisco.
He advocated using a “five A’s approach” adapted from smoking cessation programs:
- Assess the patient’s risk for obesity
- Ask if the patient is ready to try losing weight
- Advise in developing a dietary program
- Assist in establishing the intervention
- Arrange for appropriate follow-up
“In addition to office-based approaches, we must advocate for population-based strategies to promote healthy eating and increased physical activity, such as listing calories on menus, more farmers’ markets, and more walking and bicycling trails,” Baron argued.