OBESITY PERSONS COUNSELING

Obesity Persons Counseling

Obesity Persons Counseling

Background

Clinical guidelines for obesity call for assessment (e.g., diagnosis) and management (e.g., dietary and exercise therapy). In addition, the U.S. Preventive Task Force recommends that clinicians screen all patients for obesity and offer intensive counseling and behavioral interventions to promote sustained weight loss. Despite these guidelines, physician obesity care is sub-optimal and varies by patient characteristics. There is also evidence pointing to low rates of physician screening and advice for behavioral health risk factors related to obesity (e.g., physical inactivity.

Discussion

The prevalence of obesity has increased among older adults and will likely continue to increase. Regular physical activity is beneficial for the physical capacity of the obese person (Graff-Iversen et al., 2008), and thus physical activity needs to be increased among them. Obese people are a challenging group for physical activity promotion as they have more comorbidities and physical impairments and they report more unpleasant symptoms compared to their non-obese age peers, such as diabetes, cardiovascular diseases and osteoarthritis, smaller muscle strength relative to body mass, pain and tiredness. Therefore, a good starting point for developing an intervention could derive from identifying perceived constraints to physical activity among older obese people.

Among older people with a broad range of body mass indices, poor health and lack of interest are commonly mentioned as constraints on physical activity. However, only limited knowledge is available about the perceived constraints on physical activity among older obese people. Moreover, there is no information whether perceived constraints can explain an increased risk for physical inactivity among heavier older people. The word constraints is suggested to capture the wide range of explanations for physically inactivity including internal and external, intrapersonal and interpersonal, intervening and antecedent, blocking and inhibiting as well as permanent or temporary dimensions (Brawley et al., 1998). Minimizing of personal and environmental constraints on physical activity may help to increase physical activity participation among obese seniors (Sims et al., 2006).

The purpose of this study was to study the differences in constraints on physical exercise between community-dwelling obese and non-obese older people and to determine whether perceived constraints would explain the increased risk of physical inactivity among older obese people. This information will serve as basis for future studies aiming to test strategies for physical activity promotion for older obese people.

Low rates of obesity diagnosis and management as well as differential treatment by patient characteristics is concerning. There is a growing body of evidence suggesting that patients who are told by their physician that they are overweight are more likely to lose weight relative to those who are not told (Ma 2004), that patients who are counseled about their weight or weight-related behaviors are more likely to report working on those areas, and that patients who are advised by their physician to modify their behavior are generally more confident and motivated to engage in lifestyle modifications (e.g., dietary changes, increased physical activity).

The primary purpose of this paper was to examine whether obese patients receive an obesity diagnosis and weight-related counseling from their ...