In another article in this issue of Archives, Robert E. Post, M.D., M.S., from the Medical University of South Carolina, Charleston, analyzed data from the 2005 – 2008 National Health and Nutrition Examination Survey (NHANES) on adults ages 20 to 64 years with a body mass index (BMI) of at least 25. The researchers were evaluating patient perceptions of overweight and obesity. And they also examined reports of physician acknowledgement of patients’ weight status and whether that was associated with a difference in perceptions and behaviors, such as desire or attempts to lose weight.

“In participants with BMIs of 25 or greater, 45.2 percent reported that they had been told by their physician that they were overweight. In participants with BMIs of 30 or greater, 66.4 percent reported that they had been told by their physician that they were overweight,” the authors write. “Telling an overweight patient that they are overweight was associated with a greater than eight-fold increase in the odds that the patient will classify themselves as overweight compared with a patient who has not been told they are overweight. For those who are obese, there was more than a six-fold increase.” In addition, having been told that they were overweight or obese, resulted in the participants having a greater desire to lose weight and, for some, attempting to lose weight.

“In conclusion, patient reports of being told by a physician that one is overweight were associated with major increases in the odds that overweight and obese participants had realistic perceptions of their own weight, had a desire to lose weight, and had made recent attempts to lose weight. However, fewer than one-half of overweight and fewer than two-thirds of obese participants had been told by their physicians that they are overweight. This is an important intervention point that is being missed by many physicians. Physicians need to tell more overweight and obese patients that they are overweight because this may help encourage them to change their behavior to lose weight and lower their risk for many diseases.”

(Arch Intern Med. 2011;171[4]:316-321. Available pre-embargo to the media at http://www.jamamedia.org)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Commentary: Telling Patients They Are Overweight or Obese

In an invited commentary on the article, Robert B. Baron, M.D., M.S. from the University of California, San Francisco, suggests “implementing a simple office based strategy for initiating weight management. First, all patients should have weight and height measured and BMI calculated at each visit, treating BMI as a routine vital sign.” … “Physicians should then straightforwardly inform patients of their abnormal weight in a manner analogous to telling patients that their blood pressure or blood cholesterol level is elevated.”

“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. Without increased individual and population-based interventions, it is likely that obesity and obesity-related conditions will only increase in the coming years.”

(Arch Intern Med. 2011; 171[4]:321-322. Available to the media pre-embargo at http://www.jamamedia.org)

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