Objective: People of racial/ethnic minorities, particularly those of lower-income groups, have higher rates of obesity compared to whites. We examined racial/ethnic disparities in receipt of provider recommendations on weight loss, patient adherence, perception of weight, attempts at weight loss, and actual weight loss among overweight and obese patients of Health Resources and Services Administration-funded health centers (HC).

Methods: We used a 2014 nationally representative survey of adult HC patients who reported being overweight or obese the year before the survey and that the HC was their usual source of care (n=3,517). We used logistic regression models to assess the interaction of race/ethnicity and obesity in (1) provider recommendations of diet or (2) exercise, (3) patient adherence to diet or (4) exercise, (5) perceptions of weight, and (6) weight loss attempts. We used a multinomial regression model to examine (7) weight loss or gain vs. no change and a linear regression model to evaluate (8) percent weight change.

Results: We found non-Hispanic African Americans (OR=1.65) experienced greater odds of receiving diet recommendations compared to whites. We found limited racial disparities in adherence. Non-Hispanic African American (OR=0.41), Hispanic (OR=0.45), and non-Hispanic American Indian/Alaska Native (OR=0.40) patients had lower odds of perceiving themselves as overweight.

Conclusion: Disparities in provider diet recommendations indicate the importance of culturally competent and personalized weight management advice. Understanding underlying reasons for discordance between self-perception and observed weight among different groups is needed. The overall increase in weight, despite current interventions, should be addressed through novel culturally appropriate approaches.