Underassessment of weight and weight management in patients with diabetes: one more reason in support of weight management advice

A Retrospective Cross-sectional Analysis of Health Education Disparities in Patients With Diabetes Using Data From the National Ambulatory Medical Care Survey

Purpose

The purpose of this study was to determine if there was an association between receipt of diet/nutrition, exercise, and weight loss education in adult patients with a primary diagnosis of diabetes with various demographic and socioeconomic variables using data from the National Ambulatory Medical Care Survey (NAMCS) for the years 2008 to 2011.

Methods

This retrospective, cross-sectional, observational study design included patients ≥ 18 years of age with diabetes in the NAMCS between 2008 and 2011, inclusive. A series of weighted multivariable logistic regression models was constructed to evaluate predictors of diet/nutrition, exercise, and weight loss education. Odds ratios and 95% confidence intervals were reported.

Results

Among patients included in this study (n = 3027), 35.6% received diet/nutrition education, 21.8% received exercise education, and 13.6% received weight loss education. From the multivariable analyses, visits using “other” payment type, visits with Medicaid, and visits occurring in non-Metropolitan Statistical Areas were significantly less likely to receive diet/nutrition education; visits using other payment type, visits in non-Metropolitan Statistical Areas, and visits by those ≥ 65 and 45-64 years of age were significantly less likely to receive exercise education. No significant disparities in the receipt of weight loss education were found.

Conclusion

These findings indicate that although only approximately one third or fewer patients diagnosed with diabetes were receiving diet/nutrition, exercise, or weight loss education, there appeared to be limited disparities among the groups studied. Education rates appear to be trending upward over time, to be slightly improved as compared with previous studies, and to include fewer disparities.

Self-reported receipt of healthcare professional's weight management counselling is associated with self-reported weight management behaviours of type 2 diabetes mellitus patients

BACKGROUND

Weight loss has been shown to influence the health outcomes of type 2 diabetes patients. Providing weight management counselling to diabetes patients may help them adopt appropriate weight management behaviours to lose weight. This study determined the association between self-reported receipt of healthcare professional's weight management counselling and the weight management behaviours of type 2 diabetes patients.

METHODS

This cross-sectional study was conducted among 378 type 2 diabetes mellitus patients seeking care from two hospitals. Using a questionnaire, participants' weight management behaviours were assessed as well as receipt of healthcare professional's weight management counselling.

RESULTS

Half (51.3 %) of the participants reported receipt of healthcare professional's weight management counselling in the last 12 months. Half of the participants ever tried to lose weight. Fewer than half of the participants reported modifying their dietary habits (45.5 %) or engaging in exercise (48.7 %) to lose weight. Those who reported receipt of weight management counselling were more likely to report ever trying to lose weight (AOR 43.0, 95 % CI 23.0-81.6; p < 0.001), modifying their dietary habits (AOR 22.5, 95 % CI 13.0-39.19; p < 0.001), and engaging in exercise (AOR 13.0, 95 % CI 7.8-21.7; p < 0.001) to lose weight.

CONCLUSION

Participants engaged in varied weight management behaviours. Receipt of health care professionals' weight management counselling was associated to participants' reported participation in weight management behaviours. Weight management counselling from health care professionals may support the adoption of weight management behaviours in type 2 diabetes mellitus patients.

Demographic factors, weight management behaviours, receipt of healthcare professional's counselling and having knowledge in basic anthropometric measurements associated with underassessment of weight status in overweight and obese type 2 diabetes patients

OBJECTIVES

To describe the prevalence of underassessment of weight status and weight management behaviours and to evaluate how underassessment of weight status is associated with demographic factors, receipt of healthcare professional's weight management counselling, weight management behaviours and having knowledge in basic anthropometric measurements.

METHODS

This cross-sectional study included 222 overweight and obese type 2 diabetes patients. Participants' weight and height were determined using appropriate tools. Demographic characteristics, knowledge in basic anthropometric measurements and self-assessment of weight status were determined using a questionnaire.

RESULTS

They were more overweight (65.8%) than obese (34.2%) participants. Sixty percent reported receipt of weight management counselling from health care professionals. The majority (50.5%) of the participants did not know which category of weight status they were, 30.6% assessed themselves as normal weight and 18.0% assessed themselves as overweight/obese. Prevalence of underassessment was 63.6%. Participants underassessing (2.9% vs. 20%; p=0.004) their weight status were less likely to be able to measure their weight and calculate BMI than their counterparts who accurately self-assessed their weight status. Overweight participants were 3 times more likely to underassess their weight status than obese participants. Underassessment of weight status was less likely in females and in participants who reported receipt of weight management counselling than in those who did not receive weight management counselling.

CONCLUSION

Underassessment of weight status was more common in overweight than in obese participants. Receipt of weight management counselling was associated with having accurate assessment of weight status. Lack of knowledge in anthropometric measurements was widespread.

Body mass index self-perception and weight management behaviors during late adolescence

BACKGROUND

This study examined the relationship between actual body weight and self-perceived weight, and how perception of one's weight affects weight management behaviors among US adolescents.

METHODS

Adolescents ages 16-19 years with objectively-measured weight and height and self-reported perception of weight, weight-loss efforts, and health-related behaviors (N = 642) from the 2009-2010 National Health and Nutritional Examination Survey (NHANES) were included. Sociodemographic variables, body mass index percentile, weight perception, weight-loss efforts, and health-related behaviors were examined using Wald chi-square, Student's t test, analysis of variance, and logistic regression.

RESULTS

Approximately 15% were overweight, and 20% were obese; 26% inaccurately perceived their weight. Ethnic minority groups displayed higher rates of overweight and obesity. Overweight adolescents had a higher rate of inaccurate weight perception than obese adolescents. More girls correctly perceived their weight status than boys. Nearly 25% had tried to lose weight during the past year. Among overweight and obese adolescents, accurate weight perception was significantly and positively related to weight-loss efforts after controlling for sociodemographic variables and actual weight.

CONCLUSIONS

Accurate body weight perception is a significant factor in adolescents' weight-loss efforts. Targeting counseling for body weight perception and weight management toward boys and overweight adolescents may impact obesity in this age group.