Sarah E Jackson, William Warr, Jamie Brown, Jamie Hartmann-Boyce, Susan A Jebb, Kate Tudor, Lion Shahab, Paul Aveyard
{"title":"控制体重的努力和做法以及卫生专业人员的建议:英格兰全国横断面调查。","authors":"Sarah E Jackson, William Warr, Jamie Brown, Jamie Hartmann-Boyce, Susan A Jebb, Kate Tudor, Lion Shahab, Paul Aveyard","doi":"10.1136/bmjopen-2024-086764","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>There is evidence that general practitioners (GPs) can increase the uptake of weight management programmes that enhance weight loss compared with self-directed efforts, but the rate at which they do so is unclear. This study examined the prevalence of weight control efforts and practices, the reported frequency and impact of receipt of GP advice on weight loss attempts and perceptions of the appropriateness of health professionals delivering weight loss advice.</p><p><strong>Design: </strong>A nationally representative cross-sectional survey.</p><p><strong>Setting: </strong>England.</p><p><strong>Participants: </strong>1722 adults (≥16 years) surveyed in October 2018 (mean (SD) age=47.4 (19.2), 51.1% women).</p><p><strong>Main outcome measures: </strong>Weight control efforts and practices, whether a GP gave advice or a specific referral/prescription medication, perception of the appropriateness of GP weight loss advice.</p><p><strong>Results: </strong>Two-thirds (64.7% (95% CI 58.1% to 71.3%)) of people with obesity reported trying to lose weight. Of people with obesity who visited their GP in the past year, 40% (95% CI 32.2% to 47.7%) recalled receiving any advice on weight loss: 30.8% (95% CI 23.5% to 38.2%) general advice and 9.2% (95% CI 4.6% to 13.7%) a referral to a weight loss service or prescription medication for weight loss. Having received weight loss advice from a GP was strongly associated with a greater likelihood of trying to lose weight (general advice: OR<sub>adj</sub>=4.49, 95% CI 2.52 to 8.00; referral/medication: OR<sub>adj</sub>=9.25, 95% CI 2.65 to 32.3). Views on whether health professionals should deliver weight loss advice were mixed, with a substantial minority (19.4% (95% CI 17.5% to 21.4%)) finding it unacceptable. People with a BMI outside of the healthy weight range (underweight/overweight/obesity), women and those from more disadvantaged social grades were less likely to find it acceptable.</p><p><strong>Conclusions: </strong>Most people with obesity reported trying to lose weight but less than half recalled receiving advice on weight loss from their GP in the past year and few were referred to community weight-loss programmes. Those who recalled receiving GP advice on weight loss were substantially more likely to report taking action to lose weight. One in five people thought GP advice on weight loss was inappropriate.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":null,"pages":null},"PeriodicalIF":2.4000,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555096/pdf/","citationCount":"0","resultStr":"{\"title\":\"Weight control efforts and practices and health professional advice: a cross-sectional national survey in England.\",\"authors\":\"Sarah E Jackson, William Warr, Jamie Brown, Jamie Hartmann-Boyce, Susan A Jebb, Kate Tudor, Lion Shahab, Paul Aveyard\",\"doi\":\"10.1136/bmjopen-2024-086764\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>There is evidence that general practitioners (GPs) can increase the uptake of weight management programmes that enhance weight loss compared with self-directed efforts, but the rate at which they do so is unclear. This study examined the prevalence of weight control efforts and practices, the reported frequency and impact of receipt of GP advice on weight loss attempts and perceptions of the appropriateness of health professionals delivering weight loss advice.</p><p><strong>Design: </strong>A nationally representative cross-sectional survey.</p><p><strong>Setting: </strong>England.</p><p><strong>Participants: </strong>1722 adults (≥16 years) surveyed in October 2018 (mean (SD) age=47.4 (19.2), 51.1% women).</p><p><strong>Main outcome measures: </strong>Weight control efforts and practices, whether a GP gave advice or a specific referral/prescription medication, perception of the appropriateness of GP weight loss advice.</p><p><strong>Results: </strong>Two-thirds (64.7% (95% CI 58.1% to 71.3%)) of people with obesity reported trying to lose weight. Of people with obesity who visited their GP in the past year, 40% (95% CI 32.2% to 47.7%) recalled receiving any advice on weight loss: 30.8% (95% CI 23.5% to 38.2%) general advice and 9.2% (95% CI 4.6% to 13.7%) a referral to a weight loss service or prescription medication for weight loss. Having received weight loss advice from a GP was strongly associated with a greater likelihood of trying to lose weight (general advice: OR<sub>adj</sub>=4.49, 95% CI 2.52 to 8.00; referral/medication: OR<sub>adj</sub>=9.25, 95% CI 2.65 to 32.3). Views on whether health professionals should deliver weight loss advice were mixed, with a substantial minority (19.4% (95% CI 17.5% to 21.4%)) finding it unacceptable. People with a BMI outside of the healthy weight range (underweight/overweight/obesity), women and those from more disadvantaged social grades were less likely to find it acceptable.</p><p><strong>Conclusions: </strong>Most people with obesity reported trying to lose weight but less than half recalled receiving advice on weight loss from their GP in the past year and few were referred to community weight-loss programmes. Those who recalled receiving GP advice on weight loss were substantially more likely to report taking action to lose weight. One in five people thought GP advice on weight loss was inappropriate.</p>\",\"PeriodicalId\":9158,\"journal\":{\"name\":\"BMJ Open\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2024-11-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555096/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMJ Open\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1136/bmjopen-2024-086764\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMJ Open","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/bmjopen-2024-086764","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
摘要
目的:有证据表明,全科医生(GPs)可以提高体重管理计划的接受率,与自主减肥相比,全科医生可以提高减肥效果,但其提高率尚不明确。本研究调查了体重控制工作和做法的普遍程度、报告的接受全科医生建议的频率和对减肥尝试的影响,以及对医疗专业人员提供减肥建议的适当性的看法:设计:一项具有全国代表性的横断面调查:地点:英格兰:2018年10月调查的1722名成年人(≥16岁)(平均(标清)年龄=47.4(19.2),51.1%为女性).主要结果测量指标:体重控制的努力和做法、全科医生是否给出建议或具体转诊/处方药物、对全科医生减肥建议适当性的看法:三分之二的肥胖症患者(64.7% (95% CI 58.1% to 71.3%))表示曾尝试减肥。在过去一年曾就诊于全科医生的肥胖症患者中,40%(95% CI 32.2%至47.7%)回忆起曾接受过任何减肥建议:30.8%(95% CI 23.5%至38.2%)的人接受了一般建议,9.2%(95% CI 4.6%至13.7%)的人被转介到减肥服务机构或处方减肥药物。接受过全科医生的减肥建议与尝试减肥的可能性较大密切相关(一般建议:ORadj=4.49,95% CI 2.52 至 8.00;转诊/处方药:ORadj=9.25,95% CI 2.65 至 32.3)。对于医护人员是否应该提供减肥建议,人们的看法不一,相当一部分人(19.4% (95% CI 17.5% to 21.4%))认为这是不可接受的。体重指数超出健康体重范围(体重过轻/过重/肥胖)的人群、女性和社会阶层较低的人群不太可能接受减肥建议:大多数肥胖症患者都表示试图减肥,但只有不到一半的人记得在过去一年中接受过全科医生的减肥建议,而且很少有人被转介到社区减肥计划。那些回忆起曾接受过全科医生减肥建议的人更有可能采取减肥行动。五分之一的人认为全科医生的减肥建议不恰当。
Weight control efforts and practices and health professional advice: a cross-sectional national survey in England.
Objectives: There is evidence that general practitioners (GPs) can increase the uptake of weight management programmes that enhance weight loss compared with self-directed efforts, but the rate at which they do so is unclear. This study examined the prevalence of weight control efforts and practices, the reported frequency and impact of receipt of GP advice on weight loss attempts and perceptions of the appropriateness of health professionals delivering weight loss advice.
Design: A nationally representative cross-sectional survey.
Setting: England.
Participants: 1722 adults (≥16 years) surveyed in October 2018 (mean (SD) age=47.4 (19.2), 51.1% women).
Main outcome measures: Weight control efforts and practices, whether a GP gave advice or a specific referral/prescription medication, perception of the appropriateness of GP weight loss advice.
Results: Two-thirds (64.7% (95% CI 58.1% to 71.3%)) of people with obesity reported trying to lose weight. Of people with obesity who visited their GP in the past year, 40% (95% CI 32.2% to 47.7%) recalled receiving any advice on weight loss: 30.8% (95% CI 23.5% to 38.2%) general advice and 9.2% (95% CI 4.6% to 13.7%) a referral to a weight loss service or prescription medication for weight loss. Having received weight loss advice from a GP was strongly associated with a greater likelihood of trying to lose weight (general advice: ORadj=4.49, 95% CI 2.52 to 8.00; referral/medication: ORadj=9.25, 95% CI 2.65 to 32.3). Views on whether health professionals should deliver weight loss advice were mixed, with a substantial minority (19.4% (95% CI 17.5% to 21.4%)) finding it unacceptable. People with a BMI outside of the healthy weight range (underweight/overweight/obesity), women and those from more disadvantaged social grades were less likely to find it acceptable.
Conclusions: Most people with obesity reported trying to lose weight but less than half recalled receiving advice on weight loss from their GP in the past year and few were referred to community weight-loss programmes. Those who recalled receiving GP advice on weight loss were substantially more likely to report taking action to lose weight. One in five people thought GP advice on weight loss was inappropriate.
期刊介绍:
BMJ Open is an online, open access journal, dedicated to publishing medical research from all disciplines and therapeutic areas. The journal publishes all research study types, from study protocols to phase I trials to meta-analyses, including small or specialist studies. Publishing procedures are built around fully open peer review and continuous publication, publishing research online as soon as the article is ready.