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Physician talks increase likelihood of patients slimming down

Physicians can play a crucial role in encouraging overweight and obese patients to adopt healthier habits, but too few doctors broach the subject, says a study in the Feb. 28 Archives of Internal Medicine. More than two-thirds of U.S. adults are overweight and about a third are obese, putting them at increased risk for chronic illnesses such as hypertension and cardiovascular disease, according to the latest statistics from the Centers for Disease Control and Prevention. With a larger proportion of the population overweight or obese, fewer people acknowledge their weight troubles, said Robert Post, MD, a family physician and study co-lead author ( "People don't think that they're overweight because overweight is the new normal," said Dr. Post, research director at Virtua Family Medicine Residency in Voorhees, N.J. "If you're going to have change, the first step is recognizing that there is a problem." Researchers analyzed data on 5,474 patients, ages 20 to 64, from the 2005-08 National Health and Nutrition Examination Survey. Among them, 2,874 were classified as obese with a body mass index of 30 or greater. The rest qualified as overweight with a body mass index between 25 and 29. Forty-five percent of overweight patients and 66% of obese patients said their physicians had discussed weight problems. Compared with those whose doctors had not addressed the issue, overweight patients were more than eight times as likely to classify themselves as overweight and obese patients were more than six times as likely to classify themselves as obese. Patients whose doctors talked about weight were twice as likely to have tried to shed pounds during the past year. Physicians may be reluctant to mention weight because they believe they don't have time to counsel patients or that overweight patients lack self-control to lose weight, the study said. "Weight is a sensitive issue. You don't want to offend your patients," said Dr. Post, who was a faculty development fellow at the Medical University of South Carolina in Charleston, S.C., when the study was conducted. Doctors should avoid words such as "obese," which patients may find insulting, Robert B. Baron, MD, wrote in a commentary on the study. "Expressing concern rather than judgment and normalizing the conversation by simply comparing measured weight with standard definitions is likely to be effective," wrote Dr. Baron, a professor at the University of California at San Francisco. The full and original article can be found at:
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