Abstract
BackgroundObesity is a major risk factor for development and progression of hypertension and diabetes, which often coexist in obese patients. Losing weight by means of energy restriction and physical activity has been effective in preventing and managing these diseases. However, weight control behaviors among overweight/obese adults with these conditions are poorly understood.MethodsUsing self-reported data from 143,386 overweight/obese participants (aged ≥ 18 years) in the 2003 Behavioral Risk Factor Surveillance System, we examined the proportion of overweight/obese adults who tried to lose weight and their weight control strategies by hypertension and/or diabetes status.ResultsAmong all participants, 58% of those with hypertension, 60% of those with diabetes, and 72% of those with both diseases tried to lose weight, significantly higher than the 50% of those with neither condition (Bonferroni corrected P < 0.017 for all comparisons). The multivariate-adjusted odds ratio (AOR) for trying to lose weight was 1.11 (95% confidence interval [CI]: 1.05–1.17) in participants with hypertension, 1.02 (95% CI: 0.90–1.15) in participants with diabetes, and 1.18 (95% CI: 1.07–1.29) in participants with both diseases (participants with neither condition as the referent). Among 78,446 participants who tried to lose weight, 23% of those with hypertension only and 28% of those with both hypertension and diabetes reported adopting a low fat/low calorie (LF/LC) diet in controlling their weight, significantly higher than 19% of those with neither disease (Bonferroni corrected P < 0.017 for all comparisons). Participants with both diseases had a significantly lower percentage of adopting physical activity in controlling their weight than those with neither condition (6% versus 12%, P < 0.01). After multivariate adjustment, the AOR for adopting a LF/LC diet plus physical activity to lose weight was 1.46 (95% CI: 1.15–1.84) in participants with both diseases. The AOR for adopting a LF/LC diet only to lose weight was 1.72 (95% CI: 1.35–2.20) in participants with both diseases and was 1.21 (95% CI: 1.03–1.40) in participants with hypertension only.ConclusionThe proportion of overweight/obese patients with diagnosed hypertension and/or diabetes who attempted to lose weight remains suboptimal and the weight control strategies varied significantly among these patients.
Highlights
The rising trend in overweight and obesity has been a serious and growing public health problem in the United States [1,2,3]
Data for our analyses came from the Behavioral Risk Factor Surveillance System (BRFSS), a population-based telephone survey of health-related behaviors regarding the leading causes of death among noninstitutionalized U.S adults aged ≥ 18 years
72.1% (95% confidence interval [CI]: 68.7–75.2%) of those with both hypertension and diabetes, 57.8% of those with hypertension only, and 60.0% of those with diabetes only attempted to lose weight, significantly higher than the 49.8% of those with neither condition (P < 0.017 for all comparisons)
Summary
The rising trend in overweight and obesity has been a serious and growing public health problem in the United States [1,2,3]. Obesity is associated with an increased risk of developing hypertension and diabetes [5,6,7,8,9,10,11,12,13,14]. The prevalence of obesity has doubled from 25.7% during 1976–1980 to 50.8% during 1999–2004 among people with hypertension [15]. Strong associations between a higher body mass index (BMI) and risk of hypertension or diabetes exist even among people within a normal BMI range [9,16]. Obesity is a major risk factor for development and progression of hypertension and diabetes, which often coexist in obese patients. Weight control behaviors among overweight/obese adults with these conditions are poorly understood
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