Objectives: To determine whether overweight and obese inpatients are receptive to weight-loss interventions while hospitalized and whether interest in weight-loss intervention correlates with accurate self-perception of weight.
Methods: We conducted a cross-sectional survey of overweight and obese patients admitted to the general medicine service at a large urban academic medical center from September 17, 2007 through October 16, 2007. Subjects were identified based on body mass index (BMI) on admission ≥25 and surveyed using a 14-question instrument. The main outcome measure was patient willingness to consider weight-loss intervention.
Results: Of 67 eligible patients, 64 (95.5%) agreed to be interviewed. BMI ranged from 25 to 50. Overall, 52.6% (10 of 19) of overweight patients did not believe they were overweight and 46.7% (21 of 45) of those with a BMI over 30 were unaware that they met criteria for obesity. Among all patients surveyed, 56.3% stated they would be interested in weight-loss intervention while hospitalized. In obese patients specifically, 68.9% expressed interest. Interest correlated with BMI (Pearson correlation coefficient (r) = 0.261, P = 0.04), accurate self-perception of weight (P = 0.03), diagnostic delays related to weight (P = 0.01) and a history of past weight-loss attempts (P = 0.04). None of the patients we interviewed received weight-loss intervention of any kind while hospitalized.
Conclusion: Inpatients who recognize that they are overweight or obese are interested in pursuing weight-loss initiatives. Despite their interest, most do not receive weight-loss interventions while hospitalized.
1. Flegal KM, Carroll MD, Ogden CL, et al. Prevalence and trends in obesity among US adults, 1999-2008. JAMA 2010;303:235-241.
2. 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.
3. Ma J, Xiao L, Stafford RS. Adult obesity and office-based quality of care in the United States. Obesity (Silver Spring) 2009;17:1077-1085.
4. McBride CM, Emmons KM, Lipkus IM. Understanding the potential of teachable moments: the case of smoking cessation. Health Educ Res 2003;18:156-170.
5. Fonarow GC, Gheorghiade M, Abraham WT. Importance of in-hospital initiation of evidence-based medical therapies for heart failure-a review. Am J Cardiol 2004;94:1155-1160.
6. Fonarow GC. In-hospital initiation of statins: taking advantage of the 'teachable moment'. Cleve Clin J Med 2003;70:502, 504-506.
7. Houston TK, Allison JJ, Person S, et al. Post-myocardial infarction smoking cessation counseling: associations with immediate and late mortality in older Medicare patients. Am J Med 2005;118:269-275.
8. Mohiuddin SM, Mooss AN, Hunter CB, et al. Intensive smoking cessation intervention reduces mortality in high-risk smokers with cardiovascular disease. Chest 2007;131:446-452.
9. Van Spall HG, Chong A, Tu JV. Inpatient smoking-cessation counseling and all-cause mortality in patients with acute myocardial infarction. Am Heart J 2007;154:213-220.
10. Dawood N, Vaccarino V, Reid KJ, et al. Predictors of smoking cessation after a myocardial infarction: the role of institutional smoking cessation programs in improving success. Arch Intern Med 2008;168:1961-1967.
11. Theobald M, Jaen CR. An update on tobacco cessation reimbursement. Fam Pract Manag 2006;13:75-76, 78.
12. Dorsey RR, Eberhardt MS, Ogden CL. Racial/ethnic differences in weight perception. Obesity (Silver Spring) 2009;17:790-795.
13. Ver Ploeg ML, Chang HH, Lin BH. Over, under, or about right: misperceptions of body weight among food stamp participants. Obesity (Silver Spring) 2008;16:2120-2125.
14. Yan AF, Zhang G, Wang MQ, et al. Weight perception and weight control practice in a multiethnic sample of US adolescents. South Med J 2009;102:354-360.
15. Chang VW, Christakis NA. Self-perception of weight appropriateness in the United States. Am J Prev Med 2003;24:332-339.
16. Paeratakul S, White MA, Williamson DA, et al. Sex, race/ethnicity, socioeconomic status, and BMI in relation to self-perception of overweight. Obes Res 2002;10:345-350.
17. Lemon SC, Rosal MC, Zapka J, et al. Contributions of weight perceptions to weight loss attempts: differences by body mass index and gender. Body Image 2009;6:90-96.
18. Edwards NM, Pettingell S, Borowsky IW. Where perception meets reality: self-perception of weight in overweight adolescents. Pediatrics 2010;125:e452-e458.
19. Howe EE, Wright SM, Landis R, et al. Addressing obesity in the hospitalized patient: a needs assessment. South Med J 2010;103:500-504.