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Doctors Can Influence Patients to Lose Weight: Studies

By Amanda Gardner
HealthDay Reporter

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 less-informed counterparts.

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 general practitioner.

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 sign."

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 wrote.

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."

More information

For more on overweight and obesity, visit the U.S. Centers for Disease Control and Prevention.

SOURCES: Robert E. Post, M.D., family physician, Virtua Family Medicine, Voorhees, N.J.; John Simmons, M.D., assistant professor of family and community medicine and physician, Texas A&M Physicians, Texas A&M Health Science Center College of Medicine, Bryan-College Station; Feb. 28, 2011, Archives of Internal Medicine

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