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Table 4 Scope of literature by category. Category 4: Empirical description of obesity prevention within a health setting

From: Obesity prevention and the role of hospital and community-based health services: a scoping review

Study (author, year, country) Clinical focus Study type Main findings and limitation
Lindstrom et al., 2005 [60]
Finland
Obesity and Diabetes Description of Finnish Diabetes Prevention Study, focussing on weight management - Obesity needs to be seen as chronic condition and focus needs to be on behaviour change
- Individuals require personalised, ongoing, long-term support to make and sustain lifestyle change
- Screening high risk individuals in health settings and providing obesity prevention is effective in preventing Type 2 Diabetes
Lutfiyya et al. 2008 [24]
USA
Medical services for adults Analysis of 2003 Behavioural Risk factor Surveillance Survey to ascertain whether healthy weight patients receive primary obesity prevention advice - Only a very small proportion of healthy-weight adults received primary prevention
Ma et al. 2009 [61]
USA
Medical services for adults Analysis of data from National Ambulatory Medical Care Survey- all patient visits in 2 year period
Review of data for doctor visits to look at measurements for obesity plus rates of counselling
- Highlighted number of records that had data on weight and BMI missing plus low rates of intervention for people recorded as being overweight
- Data based on one visit- not possible to track if individual received advice on other visits
Aronne 2009 [62]
USA
Adults- assessment and treatment of obesity Outlines assessment and treatment of obese individuals. - Recommends long-term behavioural therapy to achieve the lasting benefits of weight loss interventions.
Kemper 2010 [25]
USA
Adults CVD risk/ BMI and need for weight loss counselling Reviewed records from nursing lead centre against NHLBI guidelines as to whether people were told to lose weight and how appropriate this advice was. - Small numbers, but only 12% counselled to lose weight and those that did receive advice, it wasn’t within guidelines
- Patients in programme self-selected so not reflective of broader society; self-reported risk factors
Phelan 2010 [26]
USA
Maternity- weight gain during pregnancy Discusses negatives of excessive weight gain in pregnancy and interventions - Interventions quite broad, doesn’t highlight definite solutions but does give good summary of reasons to act during pregnancy
Heslehurst 2011 [27]
UK
Maternity Broad description of shortcomings of maternity guidelines and potential issues in UK - Recommends further research into effectiveness of intervention to support women before, during and after pregnancy
Post et al 2011 [28]
USA
Medical physicians or other community based health professionals Analysis of survey (2005–08) which included record of BMI and question re: being told about weight status by GP or other health professional and questions re self-identifying as overweight and desire to lose weight - People told they were overweight more likely to recognise they were overweight and express desire to lose weight
- Half of overweight and third of obese not told overweight
- Based on self-reported recall of being provided weight advice
Ahn, Smith et al. 2012 [29]
USA
Older adults (≥65 years) Telephone and postal survey evaluating if a doctor or nurse had asked or given advice about weight, healthy diet, or physical activity
Study aimed to investigate the correlates of health professional–patient discussions about body weight, healthy diet, and physical activity.
- Being moderately or severely obese, more chronic conditions, and more frequent physician visits increased the likelihood of being recognized as overweight or obese and reporting lifestyle discussions.
- Based on self-reported recall of being provided weight advice
Hernandez- Boussard et al. 2012 [63]
USA
Community based medical practices Analysis of data from National Ambulatory Medical Care Survey- all patient visits in 2 year period that recorded height and weight to ascertain whether obese patients receive same preventive care as non-obese - Obese patients received significantly less preventative exams (e.g. mammogram, pap smear etc.); less tobacco and injury prevention advice and less psychological referrals but more diet, exercise and weight reduction education.
- Data based on one visit- not possible to track if individual received advice on other visits
Oken et al. 2013 [30]
USA
Maternity Interviews regarding gestational weight gain and the use of electronic medical records to support clinical decision making
Obstetric clinicians from one practice
Duration N/A
- Advice regarding gestational weight gain variable, may be enhanced by having clinical decision supports in electronic medical records
- Small number of participants, all from one practice
Miller et al. 2014 [31]
Australia
Maternity A general discussion of reasons for including weight management in pregnancy services and reasons why this is not happening - A very general summary - references selective research. Gives a good overview of issues but not a definitive solution. Touches on social issues but not in great detail