Physicians can influence people to try to lose weight

People who were overweight were less likely to have tried to lose weight if their primary care provider had not talked with them about weight loss, a Kaiser Permanente study found.

“By delivering factual information on weight status, primary care providers may motivate their patients to consider weight management strategies,” said Deborah Rohm Young, PhD, the study’s lead author and director of Behavioral Research at the Kaiser Permanente Southern California Department of Research & Evaluation.

“Because most adults in the United States are overweight and obese, being larger may seem ‘normal’ and people may not realize that their weight may have a big detrimental effect on their health, such as a higher risk for cardiovascular diseases and diabetes,” Dr. Young said. “In addition, research has shown that being overweight and obese also puts some people at greater risk of severe complications from COVID-19.”

The study Dr. Young led was published on August 24, 2020, in Obesity Research & Clinical Practice. Study participants were randomly selected from the group of patients who are overweight or obese in the Patient Outcome Research to Advance Learning (PORTAL) network, a clinical data research network funded by the Patient-Centered Outcomes Research Institute.

The study aimed to understand characteristics of adults who were overweight or obese but did not attempt to lose weight over the previous year. It found that those who were overweight or obese, but not aware of it, or whose primary care provider had not talked with them about weight, were less likely to have attempted weight loss in the past year.

A total of 2,811 patients who were overweight or obese completed the 10-minute survey for the study. The respondents were from across the country.

  • 24% reported not attempting weight loss in the previous 12 months.
  • Patients who reported that their health care provider never talked about weight were 45% more likely to not attempt weight loss in the previous 12 months compared with those who reported providers frequently brought up weight.
  • Patients who perceived themselves as normal weight or underweight were 4.22 times more likely to not attempt weight loss compared with respondents who perceived themselves as overweight.
  • People who reported not attempting weight loss were less likely to report regular physical activity and regularly eating of fruits and vegetables. Specifically, respondents were less likely to attempt weight loss if they:
    • only exercised 0 to 29 minutes a week, as opposed to those who exercised more, and
    • only ate 0 to 2 servings of fruits and vegetables daily, as opposed to those who ate more fruits and vegetables.
  • Those who did not know how much they weighed were more likely to have not attempted weight loss in the prior 12 months compared with those who knew the most they ever weighed.

The study has important relevance for physicians, said Michael Horberg, MD, of Kaiser Permanente’s Mid-Atlantic Permanente Research Institute in Rockville, Maryland, and the senior author on the study.

“What this study shows is that if we are really to combat the obesity epidemic in the United States, we need to make a much more concentrated effort to improve the diet of our patients and have active, ongoing conversations with them about weight, physical activity, and dietary patterns.”

The PORTAL overweight/obesity cohort, which was used to determine who to send the surveys to, combines information from multiple managed care systems including all Kaiser Permanente health systems (Hawaii, Washington, Northwest, Northern California, Southern California, Colorado, Mid-Atlantic States [Maryland, Northern Virginia, District of Columbia], and Georgia), HealthPartners in Minnesota, and Denver Health in Colorado. The survey was sent to patients from Hawaii, Northern California, Southern California, Colorado, Mid-Atlantic States, Georgia, and Denver.

In addition to Dr. Young and Dr. Horberg, authors on the study were Margo A.Sidell, ScD, MSPH; Corinna Koebnick, PhD, MSc; and Claudia L. Nau, PhD, of the Department of Research & Evaluation in Pasadena, Calif; Stephanie Fitzpatrick, PhD, of the Kaiser Permanente Center for Health Research in Portland, Ore;  and Caryn Oshiro, PhD, RD, of the Center for Health Research, Kaiser Permanente Hawaii, Honolulu, Hawaii.