Assessing the value of weight loss among primary care patients

Wee, Christina C.; Hamel, Mary B.; Davis, Roger B.; Phillips, Russell S.
December 2004
JGIM: Journal of General Internal Medicine;Dec2004, Vol. 19 Issue 12, p1206
Academic Journal
journal article
Background: Modest weight loss of 10% of baseline weight is beneficial and achievable for overweight and obese patients. However, whether primary care patients value modest weight loss is unclear.Objective: To quantify the value patients place on modest weight loss.Design: Cross-sectional telephone survey.Setting: Patients at a large hospital-based primary care practice.Participants: Three hundred sixty-five primary care patients (60% response rate).Measurements: Utilities or value for weight loss estimated from willingness to risk death or trade time in exchange for losing different levels of weight (weight loss in pounds equivalent to a 5%, 10%, and 20% reduction in initial weight or to achieve a body mass index [BMI] of 25 kg/m2) using the standard gamble and time tradeoff formats.Results: Of respondents, 15% of overweight (BMI, 25 to 29.9 kg/m2) and 42% of obese patients (BMI > or = 30 kg/m2) believed they needed to lose more than 10% of their weight to derive any health benefits. However, 18% of overweight and 33% of obese patients were willing to risk death to lose 10% of their weight. Patients with higher BMI valued higher degrees of weight loss. Among the overall sample, the utilities derived using standard gamble were 0.95 for current weight, 0.96 for 5% weight loss, 0.97 for 10% weight loss, and 0.98 for 20% weight loss; among obese patients, utilities were 0.88, 0.91, 0.93, and 0.96, respectively. Utilities derived using time tradeoff were lower but correlated with utilities derived from standard gamble. Utilities did not vary by education, gender, race, having comorbidities, or smoking.Conclusions: Many primary care patients value modest weight loss. The value placed on loss of 10% body weight among obese patients where utility improved from 0.88 to 0.93 is similar to recovery from major depression. Nevertheless, the majority of patients still do not highly value modest weight loss. Clinicians should emphasize the health benefits of modest weight loss when counseling about weight.


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