title: Physician weight recommendations for overweight and obese firefighters, United States, 2011-2012.
abstract: BACKGROUND
  National guidelines state that health care professionals (HCPs) should advise patients on the importance of maintaining a healthy weight. Firefighters have high rates of obesity, and cardiovascular events are the leading cause of line-of-duty deaths in firefighters. This study assessed the association of age and body mass index (BMI) with HCP weight recommendations among male firefighters.
  
  
  METHODS
  We used data on self-reported HCP weight recommendations and measured BMI from a 2011-2012 national sample of male firefighters (N = 1,002). HCP recommendations were recorded as no advice, maintain, gain, or lose weight, and BMI was categorized as normal (<25.0 kg/m(2)), overweight (25.0-29.9 kg/m(2)), class I obese (30.0-34.9 kg/m(2)), and class II or III obese (≥35.0 kg/m(2)). We used multinomial logistic regression to estimate the odds of receiving weight advice by age and BMI categories.
  
  
  RESULTS
  Most firefighters (96%) reported visiting an HCP in the past year. Most (69%) firefighters and 48% of class I to III obese firefighters reported receiving no weight advice. Higher BMI predicted HCP advice to lose weight (odds ratio class I obese vs normal weight: 12.98; 95% confidence interval: 5.38-31.34). Younger firefighters were less likely to receive weight loss advice than older firefighters, except among those who were class II or III obese.
  
  
  CONCLUSIONS
  HCPs are important sources of health information for firefighters. Overweight and obese firefighters, particularly those who are younger, do not consistently receive HCP advice to lose weight. This marks a missed opportunity to prevent further weight gain and reduce obesity-related health outcomes.
authors.affiliation: The University of Texas Health Science Center at Houston, School of Public Health, Houston, Texas.
authors.forename: Michelle Lynn
authors.initials: ML
authors.lastname: Wilkinson
authors.affiliation: The University of Texas Health Science Center at Houston, School of Public Health, Houston, Texas.
authors.forename: Austin Lane
authors.initials: AL
authors.lastname: Brown
authors.affiliation: National Development and Research Institutes, Leawood, Kansas.
authors.forename: Walker Seward Carlos
authors.initials: WS
authors.lastname: Poston
authors.affiliation: National Development and Research Institutes, Leawood, Kansas.
authors.forename: Christopher Keith
authors.initials: CK
authors.lastname: Haddock
authors.affiliation: National Development and Research Institutes, Leawood, Kansas.
authors.forename: Sara Anne
authors.initials: SA
authors.lastname: Jahnke
authors.affiliation: The University of Texas Health Science Center at Houston, School of Public Health, Division of Epidemiology, Human Genetics, and Environmental Sciences, Michael & Susan Dell Center for Healthy Living, 1200 Pressler Dr, RAS E1027, Houston, TX 77030. E-mail: rena.s.day@uth.tmc.edu.
authors.forename: Rena Sue
authors.initials: RS
authors.lastname: Day
mesh_terms: D000328:Adult; D000367:Age Factors; D000428:Alcohol Drinking / Q000453:epidemiology; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control; D015331:Cohort Studies; D015897:Comorbidity; D003376:Counseling / Q000592:standards*; D061388:Firefighters / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D009765:Obesity / Q000453:epidemiology / Q000517:prevention & control*; D050177:Overweight / Q000453:epidemiology / Q000517:prevention & control*; D010346:Patient Care Management / Q000592:standards; D010817:Physician-Patient Relations; D018570:Risk Assessment; D064424:Tobacco Use / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D015430:Weight Gain / Q000502:physiology; D015431:Weight Loss / Q000502:physiology