Original Article

Receptivity to Weight Management Interventions Among Hospitalized Obese Patients An Untapped Opportunity

Authors: Ché Matthew Harris MD, Rebeca Rios, PhD, Regina Landis, BA, Waseem Khaliq, MD, MPH, Scott Wright, MD

Abstract

Objectives: Hospitalized obese patients rarely receive counseling about weight loss. Specific patient preferences regarding inpatient weight loss interventions have not been systematically investigated. The objective of the study was to describe the preferences of hospitalized obese patients for weight loss interventions and to identify predictors of receptivity to such offerings.

Methods: A total of 204 individuals with a body mass index (BMI) ≥30 kg/m2 (mean BMI 38.1 kg/m2) admitted to the hospital medicine service in spring 2011 were surveyed at bedside for this cross-sectional study. The study population was predominantly white (67%) and women (62%), and their mean age was 55 years.

Results: Although 82% expressed a desire for providers to discuss weight loss during hospitalization, nearly all (92%) of the patients reported that providers did not address this subject. Logistic regression analysis tested demographic variables and obesity-related health beliefs as predictors of receptivity to inpatient weight loss interventions. The recognition of their own obesity and belief that weight loss would prolong life were significantly associated with receptivity to specific interventions, over and above objectively measured BMI in adjusted models.

Conclusions: Receptivity to inpatient weight loss interventions varies considerably among hospitalized obese patients. The most important determinants that predict the level of receptivity were related to weight-related beliefs and perceptions. Future inpatient weight loss interventions could be targeted to patients with truthful health beliefs and perceptions about obesity.

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. Elixhauser A, Steiner C. Obese patients in U.S. hospitals, 2004. http://www.hcup-us.ahrq.gov/reports/statbriefs/sb20.pdf. Published December 2006. Accessed November 18, 2012.
 
2. Henry SL, Barzel B, Wood-Bradley RJ, et al. The developmental origins of obesity-related hypertension. Clin Exp Pharmacol Physiol. 2012; 39: 799–806.
 
3. van den Brandt PA, Spiegelman D, Yuan SS, et al. Pooled analysis of prospective cohort studies on height, weight, and breast cancer risk. Am J Epidemiol. 2000; 152: 514–527.
 
4. Research on obesity and overweight. AHRQ-supported research and recent findings. http://www.ahrq.gov/research/obesitybrf.pdf. Published April 2006. Accessed November 18, 2012.
 
5. Finkelstein EA, Trogdon JG, Cohen JW, et al. Annual medical spending attributable to obesity: payer- and service-specific estimates. Health Aff (Millwood). 2009; 28: w822–w831.
 
6. Wang Y, Beydou MA, Liang L, et al. Will all Americans become overweight or obese? Estimating the progression and cost of the US obesity epidemic. Obesity (Silver Spring). 2008; 16: 2323–2330.
 
7. Booth CM, Moore CE, Eddleston J, et al. Patient safety incidents associated with obesity: a review of reports to the National Patient Safety Agency and recommendations for hospital practice. Postgrad Med J. 2011; 88: 694–699.
 
8. Wachsberg K, Feinglass J, Williams MV, et al. Willingness for weight loss intervention among overweight and obese inpatients. South Med J. 2011; 104: 397–400.
 
9. Schafer MH, Ferraro KF. Obesity and hospitalization over the adult life course: does duration of exposure increase use? J Health Soc Behav. 2007; 48: 434–449.
 
10. Zizza C, Herring AH, Stevens J, et al. Length of hospital stays among obese individuals. Am J Public. Health. 2004; 94: 1587–1591.
 
11. Smith PM, Corso L, Brown KS, et al. Nurse case-managed tobacco cessation interventions for general hospital patients: results of a randomized clinical trial. Can J Nurs Res. 2011; 43: 98–117.
 
12. Duffy SA, Karvonen-Gutierrez CA, Ewing LA, et al. Implementation of the Tobacco Tactics program in the Department of Veterans Affairs. J Gen Intern Med. 2010; 25: 3–10.
 
13. National Heart, Lung, and Blood Institute. Obesity guidelines. http://www.nhlbi.nih.gov/guidelines/obesity/ob_home.htm. Accessed November 18, 2012.
 
14. Kirk SF, Penney TL, McHugh T, et al. Effective weight management practice: a review of the lifestyle intervention evidence. Int J Obes (Lond). 2012; 36: 178–185.
 
15. Howe EE, Wright SM, Landis R, et al. Addressing obesity in the hospitalized patient: a
 
16. Schuster RJ, Tasosa J, Terwoord NA. Translational research—implementation of NHLBI Obesity Guidelines in a primary care community setting: the Physician Obesity Awareness Project. J Nutr Health Aging. 2008; 12: 764S–769S.
 
17. Chang VW, Asch DA, Werner RM. Quality of care among obese patients. JAMA. 2010; 303: 1274–1281.
 
18. Post RE, Mainous AG 3rd, Gregorie SH, et al. The influence of physician acknowledgment of patients’ weight status on patient perceptions of overweight and obesity in the United States. Arch Intern Med. 2011; 171: 316–321.
 
19. Villareal DT, Chode S, Parimi N, et al. Weight loss, exercise, or both and physical function in obese older adults. N Engl J Med. 2011; 364: 1218–1229.
 
20. US Department of Health and Human Services, Office of Minority Health. Obesity data/statistics. http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=3&lvlid=537. Published September 6, 2012. Accessed November 18, 2012.
 
21. Liao Y, Tucker P, Okoro CA, et al. REACH 2010 Surveillance for Health Status in Minority Communities—United States, 2001–2002. MMWR Surveill Summ. 2004; 53: 1–36.
 
22. Sivalingam SK, Ashraf J, Vallurupalli N, et al. Ethnic differences in the self-recognition of obesity and obesity-related comorbidities: a cross-sectional analysis. J Gen Intern Med. 2011; 26: 616–620.
 
23. Champion VL, Sugg Skinner C. The health belief model. , in Glanz K, Rimer K, Viswanath K. (eds): Health Behavior and Health Education: Theory, Research, and Practice. San Francisco, CA, Jossey-Bass, 2008;, 4th ed, pp 41–62.
 
24. Saldalamacchia G, Massaro P, Pacioni D, et al. Weight loss in obese type 2 diabetic patients on an intensive therapeutic programme: importance of an initial short hospitalization period. Nutr Metab Cardiovasc Dis. 2008; 18: e1–e2.
 
25. Coleman EA, Fox PD., HMO Care Management Workgroup. One patient, many places: managing health care transitions. Ann Longterm Care. 2004; 12: 25–32,34–39, 14–16
 
26. Hruby M, Pantilat SZ, Lo B. How do patients view the role of the primary care physician in inpatient care? Dis Mon. 2002; 48: 230–238.
 
27. Sinclair J, Haynes C, Lee D. Development of a health promotion care pathway for adult hospital-based patients. Int J Care Pathway. 2010; 12: 155–160.
 
28. Webb TL, Sheeran P. Does changing behavioral intentions engender behavior change? A meta-analysis of the experimental evidence. Psychol Bull. 2006; 132: 249–268.