MONDAY, Feb. 28 (HealthDay News) -- The battle of the bulge is
not lost, and health-care providers could be major players in the
fight to reduce waistlines, two new studies report.
One of the studies found that if patients are told by their
doctors that they are overweight or obese, they are more likely to
see themselves that way and are more likely to want to lose weight
and to try to lose weight.
The study did not track whether these patients actually lost
weight after this realistic assessment, compared to their
The second study found that counseling by a nurse practitioner
or "usual care" from a family physician helped overweight patients
maintain their existing weight, without gaining more weight.
"Maybe the doctor can be another person on the team pushing for weight loss," said Dr. John Simmons, assistant professor of family and community medicine at Texas A& M Health Science Center College of Medicine in Bryan-College Station.
Simmons was not involved with the studies, which appear in the
Feb. 28 issue of
Archives of Internal Medicine.
The first study was led by family physician Dr. Robert E. Post,
who said he "noticed in my own practice that there are a lot of
patients who are not aware of their own weight status."
Post's observation has been borne out by previous research.
"I wanted to see what would possibly change these perceptions," said Post, who currently practices medicine in Voorhees, N.J., but conducted the study while a faculty development fellow at the Medical University of South Carolina in Charleston.
In looking at national data on a large group of U.S. adults,
Post and his colleagues determined that patients who were told by
their doctors that they were overweight were eight times more
likely to perceive themselves this way, compared with patients who
were not informed of their weight status. Obese patients were six
times more likely to make the connection, the study found.
What's more, overweight patients were eight times more likely
and obese patients five times more likely to state that they wanted
to lose weight, and more than twice as likely to have tried to shed
pounds if their physician had talked to them about the issue.
"There are big jumps in people recognizing their weight and wanting to lose," said Post.
The bad news was that fewer than half of people with a body mass
index (BMI) of 25 or more (25 is the low end of overweight) said
their physician had talked to them about their weight.
Why do doctors seem so reluctant to do so, especially since
obesity is linked to such health problems as heart disease, type 2
diabetes and some cancers?
In addition to well-known time constraints, "there may be some
issues with not wanting to offend people," Post said.
"It's not the most comfortable topic," Simmons agreed. He does think more doctors are talking to their patients about their weight, however -- something he believes will eventually slow the tide of obesity.
For the second study, 457 patients in the Netherlands with a
body mass index of 25 to 40 were randomly picked to get lifestyle
counseling from a nurse practitioner (involving both in-person
visits and telephone consultations) or "usual" care from their
Sixty percent of participants in both groups stayed at a steady
weight over a follow-up period of three years.
"If you do bring it up, people are more likely to take that first step towards change, which is recognizing that there's a problem," Post said.
In a commentary accompanying the articles, Dr. Robert B. Baron
of the University of California, San Francisco, suggests a new
office strategy for doctors: measuring weight and height and
calculating BMI at every visit, with BMI as "a routine vital
Physicians "should then straightforwardly inform patients of
their abnormal weight" in the same way they would tell them their
blood pressure or blood cholesterol level is elevated, Baron
Simmons added that the obesity epidemic has grown so large that
"I don't think doctors have the luxury of ignoring it. And
non-doctor approaches just haven't really worked."
For more on overweight and obesity, visit the
Centers for Disease Control and Prevention.