Simkin-Silverman Laurey R, Gleason Katharine A, King Wendy C, Weissfeld Lisa A, Buhari Alhaji, Boraz Miriam A, Wing Rena R
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA.
Prev Med. 2005 Jan;40(1):71-82. doi: 10.1016/j.ypmed.2004.05.012.
Past research has surveyed primary care physicians (PCP) about their attitudes and practices towards obese patients, yet less is known about the patients receiving advice.
The Primary Care Weight Control Project (PCWC) enrolled 18 PCPs in a randomized clinical trial and asked 255 of their patients who were either overweight or obese at baseline about past weight control advice.
At baseline, 66.4% of patients reported that their physician previously told them they were overweight. Body mass index (BMI) was a strong predictor of being identified as obese. While 65.1% received information on the health benefits of weight loss, only 36.6% of patients were ever given specific weight control advice, and 28.2% were advised to increase their physical activity. A history of type 2 diabetes, high cholesterol, or hypertension was associated with physician-delivered weight control advice. Stages of change and number of prior visits with the PCP were also associated with physician advice.
Patients were more likely to receive education about weight loss than specific behavioral advice on how to lose weight. Physicians were more likely to provide weight control advice to their patients who had obesity-related comorbidities than to patients who were overweight or obese and without risk factors.
过去的研究调查了初级保健医生（PCP）对肥胖患者的态度和做法，但对于接受建议的患者了解较少。
初级保健体重控制项目（PCWC）在一项随机临床试验中招募了18名初级保健医生，并询问了他们255名在基线时超重或肥胖的患者过去的体重控制建议。
在基线时，66.4%的患者报告称他们的医生此前告知他们超重。体重指数（BMI）是被认定为肥胖的一个有力预测指标。虽然65.1%的患者收到了关于减肥对健康有益的信息，但只有36.6%的患者曾得到过具体的体重控制建议，28.2%的患者被建议增加体育活动。2型糖尿病、高胆固醇或高血压病史与医生提供的体重控制建议相关。行为改变阶段以及与初级保健医生之前就诊的次数也与医生的建议相关。
患者更有可能接受关于减肥的教育，而非关于如何减肥的具体行为建议。与超重或肥胖且无风险因素的患者相比，医生更有可能向患有肥胖相关合并症的患者提供体重控制建议。
