US Department of Health and Human Services, Health Resources and Services Administration, Bureau of Primary Health Care, Rockville, MD, USA.
Obes Res Clin Pract. 2013 Sep-Oct;7(5):e377-90. doi: 10.1016/j.orcp.2012.04.001.
We obtained the prevalence of overweight/obesity, weight-loss attempts, and weight-related counseling and treatment among U.S. adults who sought care in federally funded community health centers. We investigated whether racial/ethnic and gender disparities existed for these measures.
Data came from the 2009 Health Center Patient Survey. Measures included body mass index (BMI), self-perceived weight, weight-loss attempts, being told of a weight problem, receipt of weight-related counseling, nutritionist referrals, weight-loss prescriptions, and cholesterol checks. We conducted bivariate analyses to determine distributions by race/ethnicity and gender, then ran logistic regressions to examine the effects of several sociodemographic factors on weight-loss attempts and on being told of a weight problem.
Overall, 76% of adult patients seen in health centers were overweight or obese (BMI ≥ 25.0 kg/m(2)); 55% of overweight patients, and 87% of obese patients correctly perceived themselves as overweight. There were no racial/ethnic differences in BMI categories or self-perceptions of weight. Females were more likely than males to be obese and also more likely to perceive themselves as overweight. About 60% of overweight/obese patients reported trying to lose weight in the past year. There were no racial/ethnic disparities favoring non-Hispanic White patients in weight-related treatment. Women were more likely than men to receive referrals to a nutritionist or weight-loss prescriptions. Overweight/obese patients had higher adjusted odds of a past-year weight-loss attempt if they perceived themselves as overweight (OR = 3.30, p < 0.0001), were female (OR = 1.95, p < 0.05), African American (OR = 3.34, p < 0.05), or Hispanic/Latino (OR = 2.14, p < 0.05). Overweight/obese patients had higher odds of being told they had a weight problem if they were Hispanic/Latino (OR = 2.56, p < 0.05) or if they had two or more chronic conditions (OR = 2.77, p < 0.01).
Patients seen in community health centers have high rates of overweight and obesity, even higher than the general U.S. population. Efforts to address weight problems during primary care visits are needed to reduce the burden of obesity and its sequellae among health center patients.
我们在美国寻求联邦政府资助的社区卫生中心医疗服务的成年人中，发现了超重/肥胖、减肥尝试以及与体重相关的咨询和治疗的流行情况。我们调查了这些措施是否存在种族/民族和性别差异。
数据来自 2009 年的“健康中心患者调查”。衡量标准包括体重指数（BMI）、自我感知体重、减肥尝试、被告知体重有问题、接受与体重相关的咨询、营养师转介、减肥处方和胆固醇检查。我们进行了双变量分析，以确定种族/民族和性别分布，然后运行逻辑回归检查几个社会人口因素对减肥尝试和被告知体重有问题的影响。
总体而言，在卫生中心就诊的成年患者中有 76%超重或肥胖（BMI≥25.0kg/m2）；55%超重患者和 87%肥胖患者正确地认为自己超重。BMI 类别或自我体重感知方面没有种族/民族差异。女性比男性更有可能肥胖，也更有可能认为自己超重。约 60%的超重/肥胖患者报告在过去一年中尝试减肥。在与体重相关的治疗方面，没有任何种族/民族偏向非西班牙裔白人患者的情况。女性比男性更有可能获得营养师转介或减肥处方。如果超重/肥胖患者认为自己超重（OR=3.30，p<0.0001）、是女性（OR=1.95，p<0.05）、非裔美国人（OR=3.34，p<0.05）或西班牙裔/拉丁裔（OR=2.14，p<0.05），则他们过去一年减肥尝试的调整后几率更高。如果超重/肥胖患者是西班牙裔/拉丁裔（OR=2.56，p<0.05）或有两种或两种以上慢性疾病（OR=2.77，p<0.01），他们被告知有体重问题的几率更高。
在社区卫生中心就诊的患者超重和肥胖率很高，甚至高于美国一般人群。需要在初级保健就诊期间努力解决体重问题，以减轻卫生中心患者肥胖及其后果的负担。
