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Zelenytė V, Valius L, Domeikienė A, Gudaitytė R, Endzinas Ž, Šumskas L, Maleckas A. Body size perception, knowledge about obesity and factors associated with lifestyle change among patients, health care professionals and public health experts. BMC FAMILY PRACTICE 2021; 22:37. [PMID: 33588766 PMCID: PMC7885487 DOI: 10.1186/s12875-021-01383-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 02/04/2021] [Indexed: 11/21/2022]
Abstract
Background The attitudes towards obesity may have an important role on healthier behavior. The goal of the present study was to explore the attitudes towards obesity and to investigate how these attitudes were associated with lifestyle-changing behavior among the patients attending primary care centers, health care professionals and public health experts. Methods This cross-sectional survey study was performed in 10 primary care offices in different regions in Lithuania and in 2 public health institutions. Nine hundred thirty-four patients, 97 nurses, 65 physicians and 30 public health experts have filled the questionnaire about attitudes towards obesity and presented data about lifestyle-changing activities during last 12 months. The attitudes were compared between different respondent groups and factors associated with healthier behaviors were analyzed among overweight/obese individuals in our study population. Results Participants failed to visually recognize correct figure corresponding to male and female with obesity. Majority of respondents’ perceived obesity as a risk factor for heart diseases and diabetes but had less knowledge about other diseases associated with weight. About one third of respondents changed their lifestyle during last 12 months. Overweight individuals with age < 45 years (OR 1.64, 1.06–2.55; p = 0.025) were more likely and those who overestimated current weight (OR 0.44, 0.20–0.96; p = 0.036) less likely to change their lifestyle. Disappointment with their current weight (OR 2.57, 1.36–4.84; p = 0.003) was associated with healthier behavior among participants with obesity. Conclusion Participants had similar body size perception and knowledge about obesity. Younger age had significant association with lifestyle changing behavior among overweight individuals and disappointment with current weight among obese participants.
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Affiliation(s)
- Virginija Zelenytė
- Department of Preventive Medicine, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus st. 9, LT-44307, Kaunas, Lithuania.
| | - Leonas Valius
- Department of Family Medicine, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus st. 9, LT-44307, Kaunas, Lithuania
| | - Auksė Domeikienė
- Department of Preventive Medicine, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus st. 9, LT-44307, Kaunas, Lithuania.,Department of Family Medicine, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus st. 9, LT-44307, Kaunas, Lithuania
| | - Rita Gudaitytė
- Department of Surgery, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus st. 9, LT-44307, Kaunas, Lithuania
| | - Žilvinas Endzinas
- Department of Surgery, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus st. 9, LT-44307, Kaunas, Lithuania
| | - Linas Šumskas
- Department of Preventive Medicine, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus st. 9, LT-44307, Kaunas, Lithuania.,Institute of Health Research, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Almantas Maleckas
- Department of Surgery, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus st. 9, LT-44307, Kaunas, Lithuania.,Department of Gastrosurgical Research and Education, Sahlgrenska Academy, University of Gothenburg, Bla Straket 5, SE-41345, Gothenburg, Sweden
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Christensen VT, Jæger MM. Weight and social comparison: Does the weight of a stranger affect a person's perception of their own weight? Health Psychol Open 2019; 5:2055102918819260. [PMID: 30622726 PMCID: PMC6304710 DOI: 10.1177/2055102918819260] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Research suggests that social context affects individuals’ perception of their
own weight. Using face-to-face interviews as the social context, we analyze the
effect of interviewers’ (N = 90) body mass index on respondents’ (N = 3068)
self-perceived weight level. Respondents reported a higher weight level when the
interviewer had a higher body mass index (absolute social comparison). Female
respondents reported a lower weight level if interviewers had a higher body mass
index than they did (relative social comparison). Results suggest that weight
perception reflects both absolute and relative social comparison, especially
among women. Future research should consider causation and self-selection when
studying social context and body image.
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Hassamal S, Trutia A, Dalkilic A, Pandurangi AK. A pilot study of body image perceptions, and attitudes toward obesity in hospitalized psychotic and non-psychotic patients. Asian J Psychiatr 2017; 26:8-12. [PMID: 28483098 DOI: 10.1016/j.ajp.2016.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 12/16/2016] [Accepted: 12/27/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Body image perceptions, and attitudes toward obesity were examined and compared between psychotic and non-psychotic patients with a mood disorder. METHODS 80 psychotic patients and 36 non-psychotic patients with a mood disorder admitted to an acute inpatient psychiatric unit participated in the study. On admission, each patient completed a visual silhouettes scale of actual self and ideal self, as well as the Attitudes Toward Obese Persons (ATOP) scale. RESULTS Analogous to the general population, psychotic and non-psychotic patients had similar body image perceptions, and experienced discrepancy between actual and ideal body image. Female patients with serious mental illness (SMI) picked a heavier actual self body image, and experienced greater discrepancy between actual and ideal body image compared to male patients with SMI. Psychotic and non-psychotic patients experienced similar mostly neutral attitudes toward obese persons, however there was a trend for depressed patients to have more negative attitudes toward obese persons compared to non-depressed patients. DISCUSSION The presence of an acute psychotic episode did not affect body perceptions, or obesity attitudes; however depressed patients had more negative obesity attitudes. Similar to the general population, females with SMI overassessed their body size, and experienced more body dissatisfaction compared to males with SMI.
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Affiliation(s)
- Sameer Hassamal
- Department of Addiction Psychiatry, UCLA-Kern Medical Center, Bakersfield, CA 93306, USA; Los Angeles County Department of Mental Health, Los Angeles, CA 90020, USA.
| | - Alexandru Trutia
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA 23298, USA.
| | - Alican Dalkilic
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA 23298, USA.
| | - Ananda K Pandurangi
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA 23298, USA.
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Mueller KG, Hurt RT, Abu-Lebdeh HS, Mueller PS. Self-perceived vs actual and desired weight and body mass index in adult ambulatory general internal medicine patients: a cross sectional study. BMC OBESITY 2014. [PMID: 26217512 PMCID: PMC4511430 DOI: 10.1186/s40608-014-0026-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND No study has compared patients' self-reported heights and weights (and resultant self-reported body mass indexes [BMIs]) with their actual heights, weights, and BMIs; their self-perceived BMI categories; and their desired weights and BMIs and determined rates of clinicians' documented diagnoses of overweight and obesity in affected patients in a single patient group. The objectives of this study were to make these comparisons, determine patient factors associated with accurate self-perceived BMI categorization, and determine the frequency of clinicians' documented diagnoses of overweight and obesity in affected patients. RESULTS A total of 508 consecutive adult general internal medicine outpatients (257 women, 251 men; mean age, 62.9 ± 14.9 years) seen at Mayo Clinic in Rochester, Minnesota, between November 9 and 20, 2009, completed a questionnaire in which they reported their heights, weights, self-perceived BMI categories ("underweight," "about right," "overweight," or "obese"), and desired weights. These self-reported data were compared to actual heights, actual weights, and actual BMI categories (measured after the questionnaire was completed). Overall, 70% of the patients were overweight or obese. The average self-reported weight was significantly lower than the average actual weight (80.3 ± 20.1 kg vs 81.9 ± 21.1 kg; P < .001). The average self-reported BMI was significantly lower than the average actual BMI (27.6 ± 5.7 kg/m(2) vs 28.3 ± 6.1 kg/m(2); P < .001). Overall, 32% of patients had obesity; however, only 6% perceived they were obese. Accuracy of self-perceived BMI category decreased with higher actual BMI category (P < .001 for trend). Female sex, higher education level, smoking status, and lower BMI were associated with higher accuracy of self-perceived BMI category. Desired weight loss increased with higher self-perceived and actual BMI categories (P < .001 for trends). Of the 165 patients who actually were obese, only 40 (24%) had obesity documented as a diagnosis in their medical records by their clinicians. Statistical tests used were the paired t test, the Pearson χ2 test, the Cochrane-Armitage trend test, the Wald test of marginal homogeneity, analysis of variance, and univariate and multivariate logistic regression. CONCLUSIONS Many obese patients inaccurately perceive their BMI categories; accuracy decreases with increasing BMI. Clinicians should inform patients of their BMIs and prescribe treatment plans for those with overweight and obesity.
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Affiliation(s)
- Kirsten G Mueller
- Division of General Internal Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905 Minnesota
| | - Ryan T Hurt
- Division of General Internal Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905 Minnesota ; Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Haitham S Abu-Lebdeh
- Division of General Internal Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905 Minnesota ; Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota
| | - Paul S Mueller
- Division of General Internal Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905 Minnesota
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Rueda-Clausen CF, Benterud E, Bond T, Olszowka R, Vallis MT, Sharma AM. Effect of implementing the 5As of obesity management framework on provider-patient interactions in primary care. Clin Obes 2014; 4:39-44. [PMID: 25425131 DOI: 10.1111/cob.12038] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Revised: 08/07/2013] [Accepted: 09/06/2013] [Indexed: 12/24/2022]
Abstract
WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT Obesity counselling in primary care is positively associated with self-reported behaviour change in patients with obesity. Obesity counselling is rare, and when it does occur, it is often of low quality because of poor training and/or competency of providers' obesity management, lack of time and economical disincentives, and negative attitude towards obesity and obesity management. 5As frameworks are routinely used for behaviour-change counselling and addiction management (e.g. smoking cessation), but few studies have examined its efficacy for weight management. WHAT THIS STUDY ADDS This study presents pilot data from the implementation and evaluation of an obesity management tool (5As of Obesity Management developed by the Canadian Obesity Network) in a primary care setting. Results show that the tool facilitates weight management in primary care by promoting physician-patient communications, medical assessments for obesity and plans for follow-up care. Obesity remains poorly managed in primary care. The 5As of Obesity Management is a theory-driven, evidence-based minimal intervention designed to facilitate obesity counselling and management by primary care practitioners. This project tested the impact of implementing this tool in primary care clinics. Electronic self-administered surveys were completed by pre-screened obese subjects at the end of their appointments in four primary care clinics (over 25 healthcare providers [HCPs]). These measurements were performed before (baseline, n = 51) and 1 month after implementing the 5As of Obesity Management (post-intervention, n = 51). Intervention consisted of one online training session (90 min) and distribution of the 5As toolkit to HCPs of participating clinics. Subjects completing the survey before and after the intervention were comparable in terms of age, sex, body mass index, comorbidities, satisfaction and self-reported health status (P > 0.2). Implementing the 5As of Obesity Management resulted in a twofold increase in the initiation of obesity management (19 vs. 39%, P = 0.03), and caused a statistically significant increase in the perceived follow-up/coordination efforts (self-reported Patient Assessment of Chronic Illness Care components, 45 ± 22 vs. 67 ± 12 points, P = 0.002), as well as two components of the 5As framework: Assess (50 ± 29 vs. 66 ± 15 points, P = 0.03) and Assist (54 ± 26 vs. 72 ± 13 points, P = 0.01). Our results suggest that using the 5As of Obesity Management facilitates weight management in primary care by promoting physician-patient communications, medical assessments for obesity and plans for follow-up care.
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Affiliation(s)
- C F Rueda-Clausen
- Obesity Research and Management, Department of Medicine, University of Alberta, Edmonton, Canada; South Calgary Primary Care Network (SCPCN), Calgary, Canada
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Bowen PG, Bryant PH, Hess A, McCarty KH, Ivey JB. Modifying Public Policies to Combat Obesity. J Nurse Pract 2014. [DOI: 10.1016/j.nurpra.2013.11.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Pulvers K, Bachand J, Nollen N, Guo H, Ahluwalia JS. BMI-based norms for a culturally relevant body image scale among African Americans. Eat Behav 2013; 14:437-40. [PMID: 24183131 PMCID: PMC3817499 DOI: 10.1016/j.eatbeh.2013.07.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Revised: 05/31/2013] [Accepted: 07/15/2013] [Indexed: 11/28/2022]
Abstract
The present study provides body mass index (BMI) standards for interpreting culturally relevant body image figure scores among African American men and women. Concordance between participants' and independent raters' figure selection is evaluated and the sensitivity and specificity of the figures for predicting overweight status are reported. African American adults (n = 498, 71% female) selected the figure most closely resembling them currently, and had their height and weight measured to calculate BMI. Three independent raters selected the figure that most closely resembled a subset of the participants (n = 277, 75% female). Probability that overweight status was correctly identified was 85% for participants and 98% for raters. ROC analysis showed that figures selected by raters (86%) and participants (83%) were equally sensitive in predicting overweight status using the gold standard, BMI. Figures selected by raters (98%) were more specific in predicting overweight status than when selected by participants (75%). Considerations in using participant- or rater-based norms for interpreting figure scores are discussed.
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Affiliation(s)
- Kim Pulvers
- Department of Psychology, California State University San Marcos, United States.
| | - Jennifer Bachand
- California State University San Marcos, Department of Psychology
| | - Nicole Nollen
- University of Kansas Medical Center, Department of Preventive Medicine and Public Health
| | - Hongfei Guo
- University of Minnesota, Division of Biostatistics and Clinical and Translational Sciences Institute
| | - Jasjit S. Ahluwalia
- University of Minnesota Medical School, Center for Health Equity and Department of Medicine
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Reile R, Leinsalu M. Differentiating positive and negative self-rated health: results from a cross-sectional study in Estonia. Int J Public Health 2013; 58:555-64. [DOI: 10.1007/s00038-013-0445-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Revised: 12/05/2012] [Accepted: 01/17/2013] [Indexed: 10/27/2022] Open
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An exploration of body dissatisfaction and perceptions of Black and White girls enrolled in an intervention for overweight children. Body Image 2011; 8:379-84. [PMID: 21700518 PMCID: PMC3170454 DOI: 10.1016/j.bodyim.2011.05.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Revised: 04/24/2011] [Accepted: 05/08/2011] [Indexed: 11/21/2022]
Abstract
Silhouette measures are one approach to assessing body dissatisfaction in children, although little is known about their use among racially diverse, overweight girls seeking weight-loss treatment. This study assessed racial differences in body dissatisfaction and body size perceptions of 58 girls (ages 6-11, 66% Black, 34% White) participating in a randomized trial for pediatric overweight. Body dissatisfaction did not differ between races; 99% of girls reported an ideal figure smaller than their current one. Black girls selected a larger silhouette to represent their ideal body size, and most girls in both racial groups underestimated their actual size. Outcomes strengthen the argument that, despite an overall preference for a larger body size, obesity might mitigate cultural factors that protect Black girls from body dissatisfaction. Additional research is needed to enhance understanding of children's body size perceptions and dissatisfaction to inform assessment and treatment of pediatric obesity and associated disordered eating symptoms.
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