The Influence of Physician Acknowledgment of Patients' Weight Status on Patient Perceptions of Overweight and Obesity in the United States

Background: Physician counseling is effective in promoting healthy behavior. We evaluated whether patient reports of physician acknowledgment of overweight patients' weight status are associated with the patients' perceptions of their own weight and desire to lose weight. Methods: We analyzed the 2005-2008 National Health and Nutrition Examination Survey data on adults aged 20 to 64 years with a body mass index (BMI) of at least 25.0 (calculated as weight in kilograms divided by height in meters squared). Logistic regressions were computed to evaluate the impact of reports of physician acknowledgment of patients' weight status on patients' perceptions of their weight, desire to weigh less, and attempts to lose weight. Results: In logistic regressions controlling for relevant confounding variables, participants with a BMI of 25 or greater (odds ratio [OR], 6.11; 95% confidence interval [CI], 4.38-8.53) and those with a BMI of 30 or greater (OR, 7.58; 95% CI, 5.83-9.84) both had an increased likelihood to perceive themselves as overweight if they were told by their physician that they were overweight. Similarly, participants with a BMI of 25 or greater (OR, 2.51; 95% CI, 2.15-2.94) and those with a BMI of 30 or greater (OR, 2.24; 95% CI, 1.74-2.88) had an increased likelihood to have attempted to lose weight in the previous 12 months if they had reported being told they were overweight. However, only 45.2% of individuals with a BMI of 25 or greater and 66.4% of those with a BMI of 30 or greater reported being told by a physician that they were overweight. Conclusion: Among patients who were overweight or obese, patient reports of being told by a physician that they were overweight were associated with more realistic perceptions of the patients' own weight, desire to lose weight, and recent attempts to lose weight.