Who reports receiving advice to lose weight?: Results from a multistate survey

Background: Overweight and obesity are increasingly prevalent in the United States. The prevalence of health care provider advice to lose weight is not clear. Methods: We examined the percentage of individuals who reported being advised to lose weight by a health care practitioner in the past year by population subgroup. Participants were individuals in the 10 states participating in the 1996 Behavioral Risk Factor Surveillance System, which assessed advice to lose weight, hypertension awareness, and cholesterol awareness. Results: The prevalence of reporting advice to lose weight was most strongly associated with body mass index (BMI) (calculated as weight in kilograms divided by the square of height in meters) and weight-related comorbidities. In individuals with a BMI of 25 to 27, only 5.6% of those with no comorbidities and 13.6% of those with comorbidities received advice. These rates were increased to 32.4% and 47.3%, respectively, in those with a BMI greater than 30. Middle-aged individuals, those with more education, and those living in the northeast were also more likely to receive advice. Receiving advice to maintain weight was reported by only 2.5% of respondents. Receiving advice to lose weight was strongly associated with trying to lose weight, especially in those with a BMI of 25 to 27, where 77.5% who received advice reported trying to lose weight vs 33.4% of those who did not receive advice. Conclusions: Advice to lose weight is uncommon and is given primarily to those who are already obese, are middle-aged, and have comorbidities. Practitioners may be missing important opportunities to counsel mildly overweight individuals to lose weight or to maintain their weight and thereby prevent comorbidities.