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Keywords:

  • physician behavior;
  • health care delivery;
  • obesity;
  • weight management;
  • socioeconomic status

Context: Obesity is a fast-growing threat to public health in the U.S., but information on trends in professional advice to lose weight is limited.

Objective: We studied whether rising obesity prevalence in the U.S. was accompanied by an increasing trend in professional advice to lose weight among obese adults.

Design and Participants: We used the Behavioral Risk Factor Surveillance System, a cross-sectional prevalence study, from 1994 (n=10,705), 1996 (n=13,800), 1998 (n=18,816), and 2000 (n=26,454) to examine changes in advice reported by obese adults seen for primary care.

Measurements: Self-reported advice from a health care professional to lose weight.

Results: From 1994 to 2000, the proportion of obese persons receiving advice to lose weight fell from 44.0% to 40.0%. Among obese persons not graduating from high school, advice declined from 41.4% to 31.8%; and for those with annual household incomes below $25,000, advice dropped from 44.3% to 38.1%. In contrast, the prevalence of advice among obese persons with a college degree or in the highest income group remained relatively stable and high (>45%) over the study period.

Conclusions: Disparities in professional advice to lose weight associated with income and educational attainment increased from 1994 to 2000. There is a need for mechanisms that allow health care professionals to devote sufficient attention to weight control and to link with evidence-based weight loss interventions, especially those that target groups most at risk for obesity.