Primary prevention of overweight and obesity: An analysis of national survey data

BACKGROUND: Obesity is rapidly approaching tobacco as the leading cause of preventable morbidity and mortality. Health care providers have the opportunity to address this through primary prevention strategies. OBJECTIVE: To assess whether health care professionals provide primary prevention for overweight and obesity by examining the percentage of healthy-weight (body mass index [BMI] = 18.5-24.9 kg/m²) individuals who report being advised to maintain a healthy weight. DESIGN: Cross-sectional analysis of the 2003 Behavioral Risk Factor Surveillance Survey data. PARTICIPANTS: Noninstitutionalized U.S. adults >18 years of age. RESULTS: Among healthy BMI respondents, only 2.6% reported receiving primary prevention. Logistic regression analyses yielded that healthy-weight adults receiving primary prevention were more likely to report: being 18-49 years of age, annual household incomes <$35,000, having at least 1 comorbidity, having a health care provider, changed eating habits to include less fat or fewer calories, and using physical activity to maintain or lose weight. Men were also more likely to receive primary prevention. CONCLUSIONS: Only a very small proportion of healthy-weight adults received primary prevention, which suggests that physicians are missing opportunities to help address the epidemic of adult obesity in the US.