Context Implementation of the National Institutes of Health's 1998 guidelines,
which recommended that health care professionals advise obese patients to
lose weight, required baseline data for evaluation.
Objectives To describe the proportion and characteristics of obese persons advised
to lose weight by their health care professional during the previous 12 months
and to determine whether the advice was associated with reported attempts
to lose weight.
Design The Behavioral Risk Factor Surveillance System, a random-digit telephone
survey conducted in 1996 by state health departments.
Setting Population-based sample from 50 states and the District of Columbia.
Participants A total of 12,835 adults, 18 years and older, classified as obese (body
mass index ≥30 kg/m2), who had visited their physician for a
routine checkup during the previous 12 months.
Main Outcome Measures Reported advice from a health care professional to lose weight, and
reported attempts to lose weight.
Results Forty-two percent of participants reported that their health care professional
advised them to lose weight. Using multivariate logistic regression analysis,
we found that the persons who were more likely to receive advice were female,
middle aged, had higher levels of education, lived in the northeast, reported
poorer perceived health, were more obese, and had diabetes mellitus. Persons
who reported receiving advice to lose weight were significantly more likely
to report trying to lose weight than those who did not (OR, 2.79; 95% CI,
Conclusions Less than half of obese adults report being advised to lose weight by
health care professionals. Barriers to counseling need to be identified and