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Many doctors are not talking to their patients about
weight control during routine check-ups, unless the patient is already
obese and experiencing weight-related health problems, unfortunately missing
out on an excellent opportunity to have a significant positive impact
on their health, a new study suggests.
Researchers looked at survey data regarding obesity
that had been collected by the health departments of 10 states and the
Centers for Disease Control and Prevention (CDC).
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Study participants were considered "obese"
if they had a body mass index (BMI) over 30 and considered "overweight"
if their BMI was between 25 and 30
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Fewer than 15% of all patients were advised
by their healthcare provider to lose weight.
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Among patients considered "overweight",
those with BMIs between 25 and 27 were advised to lose weight less
than 10% of the time, and those between 27 and 30 were advised to
do so just under 20% of the time.
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For patients considered "obese" (BMI
30+), the number rose to over 40%.
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Researchers found that patients with weight-related
health concerns, such as elevated cholesterol and high blood pressure,
were twice as likely to be advised to lose weight than those without
such conditions.
One of the researchers said, in comments to Reuters
Health, that doctors are missing out on opportunities to help patients
manage their weight before it gets out of control and causes severe health
problems. The problem may stem from a lack of physician training regarding
one-on-one patient counseling and a medical culture that focuses on quick
testing and high-tech intervention rather than talking and advising.
According to one of the authors, "In many cases,
patients come only for tests and procedures. Simple things like discussing
health behavior fall off the radar screen easily. And most doctors report
they don't feel comfortable counseling patients, and if you don't feel
confident and comfortable in it, you're less likely to do it."
Archives of Internal Medicine
August 14/28, 2000;160:2334-2339.
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