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Background <p>Obesity prevention guidelines have stressed the importance of utilizing each patient-physician encounter towards delivering effective weight reduction, exercise, and dietary counseling during patient encounters. The objective of this study was to understand the prevalence and predictors of weight, exercise, and dietary counseling for obese adults using a nationally representative data.</p> Methods <p>We conducted a retrospective cross-sectional analysis of the National Ambulatory Medical Care Survey (2011–2018), of obese patients aged ≥ 18&#xa0;years who had an office visit. Outcomes were receipt of weight reduction, exercise, dietary, any, and all counseling. Descriptive statistics and multivariable logistic regression were used to identify demographic, clinical, and practice-related predictors. Sampling weights were used to generate national estimates.</p> Results <p>An estimated 289,667,549 office visits were found among obese adults during the study period. Nearly 21.5% of these office visits had weight reduction advice, 24.5% exercise counseling, 33.9% dietary counseling, 40.1% any counseling, and 12.2% all three counseling. Logistic regression analysis showed that the odds of receiving any type of advice were significantly higher among Blacks (OR 1.43, 95% CI 1.11–1.85), Hispanics (OR 1.48, 95% CI 1.03–2.14), those with hyperlipidemia (OR 1.82, 95% CI 1.45–2.29), chronic problems (OR 1.84, 95% CI 1.44–2.35), and those seeking preventive care (OR 1.67, 95% CI 1.28–2.18), whereas lower among those who were ≥ 65&#xa0;years (OR 0.68, 95% CI 0.49–0.95). The odds of receiving all types of advice were significantly higher among Hispanics (OR 2.02, 95% CI 1.09–3.73), those with chronic problems (OR 2.00, 95% CI 1.41–2.84), and those seeking preventive care (OR 1.76, 95% CI 1.21–2.56), and those whose physicians were also their primary care providers (OR 1.06, 95% CI 1.21–3.53).</p> Conclusions <p>Weight-related counseling remains infrequent in US primary care settings, particularly for older adults and those with comorbidities. Strengthening patient-provider relationships and targeting identified gaps could improve obesity management.</p>

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Weight Reduction Advice by Physicians for Obese Patients in Office-Based Settings in the USA: An Observational Study

  • 期刊论文

  • 发表日期：

    2026年5月7日

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  • Muni Rubens,
  • Venkataraghavan Ramamoorthy,
  • Anshul Saxena,
  • Ashley Rodriguez,
  • Brian Murillo,
  • Krimal Shah,
  • Charlotte Tudela,
  • Elise McCormack-Granja

摘要

Background

Obesity prevention guidelines have stressed the importance of utilizing each patient-physician encounter towards delivering effective weight reduction, exercise, and dietary counseling during patient encounters. The objective of this study was to understand the prevalence and predictors of weight, exercise, and dietary counseling for obese adults using a nationally representative data.

Methods

We conducted a retrospective cross-sectional analysis of the National Ambulatory Medical Care Survey (2011–2018), of obese patients aged ≥ 18 years who had an office visit. Outcomes were receipt of weight reduction, exercise, dietary, any, and all counseling. Descriptive statistics and multivariable logistic regression were used to identify demographic, clinical, and practice-related predictors. Sampling weights were used to generate national estimates.

Results

An estimated 289,667,549 office visits were found among obese adults during the study period. Nearly 21.5% of these office visits had weight reduction advice, 24.5% exercise counseling, 33.9% dietary counseling, 40.1% any counseling, and 12.2% all three counseling. Logistic regression analysis showed that the odds of receiving any type of advice were significantly higher among Blacks (OR 1.43, 95% CI 1.11–1.85), Hispanics (OR 1.48, 95% CI 1.03–2.14), those with hyperlipidemia (OR 1.82, 95% CI 1.45–2.29), chronic problems (OR 1.84, 95% CI 1.44–2.35), and those seeking preventive care (OR 1.67, 95% CI 1.28–2.18), whereas lower among those who were ≥ 65 years (OR 0.68, 95% CI 0.49–0.95). The odds of receiving all types of advice were significantly higher among Hispanics (OR 2.02, 95% CI 1.09–3.73), those with chronic problems (OR 2.00, 95% CI 1.41–2.84), and those seeking preventive care (OR 1.76, 95% CI 1.21–2.56), and those whose physicians were also their primary care providers (OR 1.06, 95% CI 1.21–3.53).

Conclusions

Weight-related counseling remains infrequent in US primary care settings, particularly for older adults and those with comorbidities. Strengthening patient-provider relationships and targeting identified gaps could improve obesity management.