Do Obese Patients Receive and Follow Dietary Advice?

Background: Despite evidence that being overweight is a risk factor for numerous conditions, including hypertension, diabetes, coronary heart disease and stroke, many overweight patients do not adhere to dietary recommendations. The purpose of the current study was to examine if receiving advice about their weight was associated with differences in diet adherence in patients who were overweight or obese.

Methods: We analyzed baseline data from 183 veterans with uncontrolled blood pressure who were part of a randomized controlled trial to improve hypertension control. Participants were asked to indicate whether they had ever received advice about their weight from a physician or other healthcare professional. Diet adherence was assessed using the Willett Food Frequency Questionnaire (FFQ). Results from the FFQ were used to calculate the Healthy Eating Index (HEI), a 100-point index of adherence with US dietary guidelines, for each patient. Body mass index (BMI) was also measured. Since BMI was not normally distributed, Wilcoxon rank sum tests were used to compare BMI between the participants who had received advice about their weight and those who had not. Robust regressions were used to determine whether receipt of dietary advice was predictive of dietary adherence, controlling for age and BMI.

Results: Approximately half of our sample (n=92) reported that they had received advice about their weight from their physicians (70/96 obese and 12/52 overweight). Participants who had received weight management advice had a significantly higher (p<.001) BMI (33.2, classified as obese) compared to those who had not received such advice (28.2, classified as overweight). Those who had received advice had a significantly higher overall diet adherence than those who had not received such advice (HEI=68.1 vs. 66.2, respectively; p<.03). Participants who were advised to manage their weight consumed significantly more servings of vegetables than those who were not provided with such advice (p<.05).

Conclusion: As expected, obese patients were more likely to receive advice about weight management than those who were overweight. When such advice was provided, it may have led to a healthier diet and an increase in vegetable consumption. Our results suggest that physicians, dieticians, and other healthcare professionals should provide advice about weight management to overweight patients, who are also at risk for health complications due to their weight, so they can benefit from this advice as well.