title: Physician diagnosis of overweight status predicts attempted and successful weight loss in patients with cardiovascular disease and central obesity.
abstract: BACKGROUND
  Despite the association of central obesity with adverse outcomes, most patients with cardiovascular disease (CVD) are unable to successfully lose weight. We undertook this analysis to evaluate the effect of motivational factors, and clinical factors, including physician diagnosis of overweight, on weight loss in patients with CVD and central obesity in the United States.
  
  
  RESULTS
  We used data from the National Health and Nutrition Examination Survey 1999 to 2004. Waist circumference ≥ 102 cm in men and ≥ 88 cm in women were used to classify central obesity. We examined demographic, motivational and clinical determinants of attempted and successful weight loss using multivariable logistic regression. Successful weight loss was defined as ≥ 5% weight loss in the preceding year. There were 907 respondents with CVD and central obesity of which 78% were aware of their overweight status and 80% were desirous to weigh less. Despite this awareness and desire, only 49% of centrally obese adults had attempted weight loss in the last year. Only 62% (n = 584) reported that they had been informed that they were overweight by a physician. On multivariable analysis, physician diagnosis of overweight was a significant predictor of weight loss attempts (OR 2.42, 95% CI 1.44-4.09, P = .006) and successful weight loss (OR 2.70, 95% CI 1.40-5.19, P = .001).
  
  
  CONCLUSIONS
  In a nationally representative sample of adults with CVD and central obesity, physician diagnosis of overweight status emerged as a significant predictor of attempted and successful weight loss.
authors.affiliation: Department of Internal Medicine, Mayo Clinic Rochester, Rochester, MN, USA.
authors.forename: Siddharth
authors.initials: S
authors.lastname: Singh
authors.forename: Virend K
authors.initials: VK
authors.lastname: Somers
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Clark
authors.forename: Kristin
authors.initials: K
authors.lastname: Vickers
authors.forename: Donald D
authors.initials: DD
authors.lastname: Hensrud
authors.forename: Yoel
authors.initials: Y
authors.lastname: Korenfeld
authors.forename: Francisco
authors.initials: F
authors.lastname: Lopez-Jimenez
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D002983:Clinical Competence; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D050177:Overweight / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D010353:Patient Education as Topic; D010820:Physicians / Q000592:standards*; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D015431:Weight Loss / Q000502:physiology*