Patient perceptions of weight cycling and weight stability in a primary care population

Abstract:

The prevalence of overweight and obesity remains stubbornly high in US children, adolescents, and adults and persists as a major public health concern. Weight-management efforts in the primary care setting can lead to unforeseen complications, including weight cycling and its detrimental consequences. Research has associated weight cycling with significant cardiovascular disease risk factors, increased risk for endometrial cancer, visceral adiposity and its associated pathologies, and increased binge eating. Although the greatest benefit accrues to individuals with obesity, a weight-inclusive approach to counseling focused on healthy habits rather than weight management can decrease the risk of all-cause mortality for individuals classified as normal weight, overweight, and obese. This project seeks to determine the factors leading to weight cycling versus weight stability in the primary care setting. Using principles of grounded theory, we analyzed secondary data from previous interviews and conducted additional interviews. We also conducted axial coding by attaching descriptors to each interview to investigate differences and similarities between response patterns. Data from Weight Cycling and Weight Stable cohorts are compared and analyzed. Analysis shows that participants in both Weight Cycling and Weight Stable cohorts have similar levels of health literacy, suggesting that this is not the distinguishing factor between groups. The Weight Stable cohort more often endorsed trusting themselves around food and eating intuitively. The Weight Cycling cohort more often coded for stress, emotional or mental health challenges, and lack of social support. The resulting framework from this research can guide individuals', physicians', and clinics' decision-making about how to best support individuals to reduce the impact of weight cycling and instead promote weight stability, thereby promoting long-term health.

Audience Take Away:

• Discuss the role of the primary care setting in addressing weight management among patients
• Identify the methodology used in this study to explore factors related to weight cycling and weight stability in a primary care population.
• List the main findings of the study, including implications for primary care clinical practice.
• Apply research findings to clinical practice and work in community-based settings.

Biography:

Leslie Ruffalo, PhD MS is an Associate Professor and the Co-Director of Medical Student Education in the Department of Family and Community Medicine at the Medical College of Wisconsin. Dr. Ruffalo defines herself as a community-engaged health researcher and educator. Her research philosophy is to apply community engaged research principles to answer research questions that are important to the community. Dr. Ruffalo’s research approach has been applied to weight management, veteran health, food security, school-based health and wellness, and rural health. She is the Co-Director of the Continuous Professional Development Course in the medical school, the Director of the Community Health Program Evaluation Course in the Masters in Public Health Program, and she is one of the founding faculty members of the DrPH program in the Graduate School. Dr. Ruffalo has been a presenter on over 100 peer-reviewed state, national, or international presentations and authored over 25 peer-reviewed publications.