Parental influence on obesity in Northern Plains American Indian youth

Little is known regarding American Indian (AI) parental influence on children's diet and physical activity (PA), or if this influence is associated with childhood weight. We compared AI parents' diet, PA, and support for these behaviors with the child's body mass index. Scores for parental support of positive PA and diet were higher among parents of overweight/obese children. Parent PA and nutrition behaviors were in a similar, but not significant, direction with respect to child body mass index. Findings suggest that future research is needed to determine what parental, societal, or community variables influence AI children to engage in healthy eating and PA, especially if they are overweight or obese, and the age at which these variables would have the most impact on these behaviors.     

Physical activity, food choice, and weight management goals and practices among US college students

INTRODUCTION: Physical activity and a healthy diet have been recommended to help reverse the increasing prevalence of overweight among adolescents and adults in the United States. METHODS: Data is from the 1995 National College Health Risk Behavior Survey. A representative sample of US undergraduate college students (n = 4609) were analyzed to examine associations of physical activity and food choice with weight management goals and practices. RESULTS: Based on self-reported height and weight, 35% of students were overweight or obese (body mass index > or = 25.0). Nearly half (46%) of all students reported they were trying to lose weight. Female students were less likely than male students to be overweight, but more likely to be trying to lose weight. Among female and male students, using logistic regression to control for demographics, trying to lose weight was associated with participation in vigorous physical activity and strengthening exercises, and consumption of < or = 2 servings/ day of high-fat foods. Female and male students who reported using exercise to lose weight or to keep from gaining weight were more likely than those who did not to participate in vigorous, strengthening, and moderate physical activity, and were more likely to eat > or = 5 servings/day of fruits and vegetables and < or = 2 servings/day of high-fat foods. Among students who were trying to lose weight, only 54% of females and 41% of males used both exercise and diet for weight control. CONCLUSION: Colleges should implement programs to increase student awareness of healthy weight management methods and the importance of physical activity combined with a healthy diet.     

Psychosocial factors associated with binge eating among overweight and obese male veterans

The study's primary objective is to compare psychosocial characteristics of overweight/obese male Veterans who report binge eating with those who do not report binge eating. Participants include 111 overweight/obese male Veterans who completed questionnaires assessing binge eating, depression, stress, body image, self-efficacy for healthy eating and physical activity, and barriers to physical activity. Of the study sample, 25.2% are classified as binge eaters. Binge eating status is not significantly associated with age, race/ethnicity, weight, or BMI. Binge eating is associated with higher scores on measures of depression, barriers to exercise, self-classified weight, and lower self-efficacy for both healthy eating and exercise, but is not associated with body satisfaction or recent stress. Findings suggest that a sizable minority of overweight/obese male Veterans engage in binge eating. Depressive symptoms, self-efficacy, and perceived barriers all significantly predicted binge eating. These findings have implications both for identification of overweight/obese men at risk for binge eating disorder as well as for weight loss treatment in the Veteran population.     

Weight-loss practices and asthma: findings from the behavioral risk factor surveillance system

OBJECTIVE: To describe weight-control practices and receipt of weight-loss advice among obese people with asthma. RESEARCH METHODS AND PROCEDURES: We analyzed data from the 2000 Behavioral Risk Factor Surveillance System. RESULTS: Among 13953 participants with current asthma, 27.3% had a body mass index of >or=30 kg/m2. Overall, 48.1% of participants with asthma reported trying to lose weight (64.1% among overweight or obese participants and 72.9% among obese participants). Among participants with asthma who were trying to lose or maintain weight, 74.7% reported trying to reduce their energy and/or fat intake, and 57.8% reported using physical activity. Approximately 29.7% were using the recommended combination of energy and/or fat intake reduction and physical activity of >or=150 min/wk. During the 12 months before the interview, 16.2% of overweight and 44.9% of obese participants with asthma reported receiving advice to lose weight. Among obese participants receiving weight-loss advice, 82.9% reported trying to lose weight compared to 63.8% of participants who did not receive such advice. DISCUSSION: Health professionals can play an important role in educating their patients with asthma about the importance of weight control and assisting their overweight and obese patients in setting appropriate weight goals and helping them achieve those goals.     

Differences in eating and activity markers among normal weight, overweight, and obese rural women.

PURPOSE: The purpose of this study was to examine differences in healthy eating and physical activity behaviors and associated biomarkers among normal weight (body mass index [BMI] < 25), overweight (BMI 25-29.9), and obese (BMI > or = 30) rural women. METHODS: Random digit dialing was used to recruit 225 rural women (57.9 +/- 5.6 years). Measures of healthy eating and physical activity were completed on the computer during individual sessions at the rural sites. Research nurses then assessed a battery of biomarkers of activity and eating, including blood lipids, blood pressure, cardiorespiratory fitness (VO(2max)), and resting heart rate. RESULTS: Major findings were differences across weight categories in daily calories consumed and expended, daily fruit servings, daily meat group servings, high-density lipoprotein cholesterol, vital signs, and cardiorespiratory fitness. The obese women both consumed and expended significantly more calories daily than those in the other two weight groups. Obese women consumed significantly fewer fruit group servings than both the normal weight and overweight women. Obese women consumed significantly more meat group servings than overweight women. There also were significant differences in systolic blood pressure, diastolic blood pressure, resting heart rate, high-density lipoprotein cholesterol, and cardiorespiratory fitness across the three weight groups. CONCLUSIONS: This study provides evidence of major differences in some eating and activity behaviors and biomarkers across BMI groups. Major differences exist between the normal weight and overweight group as compared to the obese group.     

Making tortillas without lard: Latino parents' perspectives on healthy eating, physical activity, and weight-management strategies for overweight Latino children

Latinos are among the most overweight racial/ethnic groups of US children. The study aim was to identify parents' perspectives on healthy eating, physical activity, and weight-management strategies for overweight Latino children. Four focus groups were conducted of Mexican immigrant, Mexican-American, Puerto Rican, and other Latino families with overweight children. Parents were asked 33 questions and sampled four healthy substitutes for traditional Latino foods, including multigrain enchiladas and brown rice. Nineteen parents were interviewed in the focus groups. The children′s median body mass index was 23; 60% had a body mass index ≥95th percentile. Parents identified 22 themes regarding the most important things parents can do to help overweight children lose weight, including encouragement, not making the child feel left out, the whole family eating healthy, and the parent setting a good example. Parents identified 17 themes regarding the most important things overweight children can do to help themselves lose weight, including eating healthier, limiting portion size and second helpings, drinking more water, increased physical activity, decreased screen time, children educating themselves at school, asking parents for help, and participating in interventions that include the whole family. Challenges to getting kids to exercise included expense, time constraints, and neighborhood safety. Parents were open to integrating healthy substitutes into traditional Latino meals/snacks, and found them palatable. One mother stated, “We have to keep our traditional foods, but realize that we can make them more nutritious.” Parents reported their children would accept high-fiber foods and low-fat dairy. In designing effective weight-management interventions for overweight Latino children, the study findings may prove useful in identifying healthy, well-accepted foods and beverages; agreeable physical activities; suitable targets for reducing inactivity; and efficacious strategies for enhancing traditional foods and meals so that there is an increased likelihood of healthy diet and weight loss. Parental input on the most important things that children and parents can do to help children lose weight and on challenges faced in trying to get children to exercise might provide valuable guidance in devising effective, evidence-based interventions that are likely to be adhered to.     

Physical activity as a predictor of body composition in American Indian children

OBJECTIVE: To examine physical activity in second grade American Indian children as a predictor of percentage body fat 3 years later. RESEARCH METHODS AND PROCEDURES: Physical activity was assessed as average vector magnitude (AVM) counts from an accelerometer in 454 second grade children as part of the Pathways study. BMI was assessed, and skinfolds and bioelectrical impedance were used to estimate fat mass, fat-free body mass, and percentage body fat in validated prediction equations. Associations were examined using mixed models regression controlling for baseline body composition. RESULTS: In normal-weight children, higher AVM counts were significantly associated with decreases in percentage body fat. Among overweight children, higher AVM counts were significantly associated with increases in BMI, fat mass, and fat-free mass but not percentage body fat. DISCUSSION: Higher physical activity levels in second grade were associated with lower levels of percentage body fat in fifth grade in normal-weight but not in overweight children. BMI showed no association with physical activity among normal-weight children, and increases in BMI were associated with increasing amounts of physical activity among overweight children. These findings emphasize the importance of valid body composition measures and may indicate important differences in associations between physical activity and adiposity in normal-weight as compared with overweight children.     

Cigarette smoking for weight loss or control among adolescents: gender and racial/ethnic differences.

PURPOSE: To describe gender and racial/ethnic differences in the prevalence of cigarette smoking for weight loss or control in an adolescent population-based sample, and relationships among heavy smoking, weight concerns and smoking to lose or control weight. METHODS: Anonymous questionnaires were administered to 81,247 9th and 12th grade public school students across the state of Minnesota in 1998. Variables of interest included smoking frequency, weight concerns, and smoking for weight loss or control. Logistic regression analyses were used to estimate the odds of smoking to lose or control weight by race/ethnicity and gender, and to evaluate the relationships between smoking to lose or control weight and heavy smoking, perceptions of overweight, and weight concerns by race/ethnicity and gender. RESULTS: With the exception of black females, female smokers of different racial/ethnic groups were as likely as white girls to smoke for weight loss or control. Compared to white male smokers, American Indian and Asian American male smokers were more likely to smoke for weight loss or control, and black, Hispanic, and mixed race male smokers were equally likely to smoke for weight loss or control. Heavy smokers, smokers who perceived themselves as overweight or were weight-concerned were significantly more likely to report smoking as a weight control method. CONCLUSIONS: Smoking for weight control is prevalent across many race/ethnic groups and both genders among adolescents.     

Physical Activity and BMI: Evidence From the Panel Study of Income Dynamics Child Development Supplement

BACKGROUND: This study assessed the association between amount of physical activity and body mass index (BMI) percentile among middle and high school children. Total daily physical activity needs to include both in and out of school physical activity. METHODS: A secondary data analysis was performed on 1306 children drawn from the Panel Study of Income Dynamics Child Development Supplement (CDS III, 2007). The dependent variable in this study was BMI percentile, while the independent variable was physical activity. The multinomial logistic regression model was used to assess the associations between physical activity and BMI percentile controlling for age, gender, race/ethnicity, parental income, and neighborhood safety. RESULTS: Children who engaged in low daily physical activity levels had 1.8 times the odds of being obese versus normal weight than those who engaged in moderate levels [odds ratio (OR) = 1.80, confidence interval (CI) = 1.31, 2.48]. African‐American children had 1.6 times the odds of being obese than normal weight (OR = 1.55, CI = 0.99, 2.43) and Hispanic children had approximately 1.8 times the odds of being obese than normal weight in comparison to non‐Hispanic white children (OR = 1.79, CI = 1.00, 3.21). Females had about 1.5 times the odds of being overweight than normal weight than males (OR = 1.49, CI = 1.04, 2.13). CONCLUSIONS: This study suggests that the accumulation of 30 minutes or more of daily physical activity may be effective in decreasing obesity prevalence among middle and high school‐aged children.     

Association between socioeconomic status, weight, age and gender, and the body image and weight control practices of 6- to 19-year-old children and adolescents.

The aim of the study was to examine the effect of socioeconomic status (SES), age, weight and gender on the body image and weight control practices of children and adolescents, and to investigate whether health education about weight issues should target low socioeconomic groups. The study participants were a randomly selected group of school children who completed a questionnaire, and had their height and weight measured. Participants (n = 1131) were aged 6-19 years from 12 schools in New South Wales. SES, age, gender, body weight, body image, skipping breakfast, physical self-esteem, attempts to lose or gain weight, and dietary and weight control advice received from others were examined. Log-linear, chi 2 and MANOVA analyses were used to determine interactions between variables. Low SES children were more likely to be overweight, to skip breakfast, to perceive themselves as 'too thin', to be trying to gain weight and less likely to receive dietary or weight control advice. Physical self-esteem was lowest among overweight girls of middle/upper SES and greatest among boys of low SES, despite the latter being more likely to be overweight. Being overweight does not appear to adversely affect the physical self-esteem of children of low SES, particularly boys. Health educators should examine these issues with young people to help make health education and nutrition education most relevant and appropriate.     

Weight-related attitudes and behaviors in fourth grade American Indian children

OBJECTIVE: American Indian children have a high prevalence of obesity, yet little is known about weight-related attitudes and the prevalence of dieting in this population. This study assessed weight concerns, body size perceptions, weight reduction attempts, and weight loss methods in fourth grade American Indian children. RESEARCH METHODS AND PROCEDURES: Participants (n = 304) attended one of eight schools in the Pathways Feasibility Study. Question and answer choices were read to children by trained staff, and children marked their own answers. RESULTS: Thirty-eight percent of the children reported that they had tried to lose weight. The most common strategy for weight reduction was exercising more. Girls were more likely than boys to be dissatisfied with their body size (48% of girls vs. 34% of boys desired a slimmer body size; 22% of girls vs. 15% of boys desired a larger body size; p<0.001). Children who had tried to lose weight were more likely to indicate that the size they most desired and the most healthy size were smaller than their perceived size (p<0.001). Children who reported trying to lose weight were also more likely to want to be skinnier and to be unhappy about their weight than were children who did not report trying to lose weight (p<0.001 for both). DISCUSSION: We conclude that weight loss attempts and weight-related concerns are prevalent in American Indian children at a young age.     

Perceived health risk of excess body weight among overweight and obese men and women: differences by sex

OBJECTIVES: To describe perceptions of health risk from excess body weight among adults, and assess if lack of perceived risk was associated with trying to lose weight. METHODS: Sex-specific logistic regression models were used to determine odds of disagreement that one's weight is a health risk and odds of trying to lose weight among overweight (BMI=25.0-29.9 kg/m(2), n=1296) and obese (BMI> or =30 kg/m(2), n=1335) adult participants in the 2004 Styles' surveys. RESULTS: Men were more likely than women to disagree their body weight was a health risk (among the overweight, 62% vs. 43%; the obese 20% vs. 14% obese). Disagreement with risk was associated with good health status and race/ethnicity among both sexes and lower education and income among women. Odds of currently trying to lose weight were significantly lower among obese men who disagreed, and overweight men and women who were neutral or disagreed that their body weight was a health risk. CONCLUSIONS: Many overweight and obese adults do not perceive their weight to be a health risk; this perception was associated with lower prevalence of trying to lose weight, particularly among men. Discussion by clinicians about the health risks of excess weight may alter perceived risk and help promote weight loss efforts.     

Obesity and weight control practices in 2000 among veterans using VA facilities

OBJECTIVE: To examine obesity prevalence and weight control practices among veterans who use Department of Veterans Affairs (VA) medical facilities (VA users). RESEARCH METHODS AND PROCEDURES: Data from the 2000 Behavioral Risk Factor Surveillance System, a telephone survey of 184,450 adults, were analyzed. Outcome measures included BMI, weight control practices (the intent to manage weight, and diet and physical activity patterns), and receipt of professional weight control advice. RESULTS: Of VA users, 44% were overweight and 25% were obese. After controlling for demographic factors, VA users were somewhat less likely to be overweight (odds ratio, 0.86; 95% confidence interval, 0.74 to 1.00) but equally likely to be obese (odds ratio, 1.08; 95% confidence interval, 0.92 to 1.27), compared with non-VA users. Among obese VA users, 75% reported trying to lose weight, and another 17% reported trying to maintain weight. Of these, only 40% decreased both calorie and fat intake. Only 27% of obese VA users who reported increasing exercise to lose weight followed recommendations for regular and sustained physical activity. Of obese VA users, 59% were inactive or irregularly active. Only 51% of obese VA users received professional advice to lose weight. Obese VA users were more likely than obese non-VA users to report trying to lose weight, modifying diet to lose weight by decreasing both calories and fat intake, and receiving professional weight control advice. DISCUSSION: Interventions for weight management programs in VA facilities need to take into account the high prevalence of overweight/obesity among VA users and should emphasize effective weight control practices.     

Risk Factors for Obesity and High Blood Pressure in Chinese American Children: Maternal Acculturation and Children’s Food Choices

The objective of this study is to explore risk factors associated with overweight and high blood pressure in Chinese American children. Students and their parents were recruited from Chinese language schools in the San Francisco Bay Area. Data were collected on 67 children and their mothers, and included children’s weight, height, waist and hip circumferences, blood pressure, level of physical activity, dietary intake, usual food choice, knowledge about nutrition and physical activity, and self-efficacy regarding diet and physical activity. Mothers completed questionnaires on demographic data and acculturation. About 46% of children had a body mass index exceeding the 85th percentile. Lower level of maternal acculturation is a risk factor for overweight and higher waist to hip ratio. Children’s unhealthy food choices were predictive of high body mass index and high systolic blood pressure, whereas older age and less physical activity in children were predictors of high diastolic blood pressure. Developing culturally sensitive and developmentally appropriate interventions to reduce overweight and high blood pressure is critical to reduce health disparities among minority children.     

上海市闵行区不同营养状况小学生生命早期脂肪高峰和脂肪重积聚特征

  目的  研究不同营养状况小学一年级学生生命早期脂肪高峰和脂肪重积聚特征,为寻求干预工作的重点时机提供参考。  方法  于2019年9—12月选取接受学校常规体检的上海市闵行区2 330名小学一年级学生,根据体质量指数(BMI)分为正常、超重、肥胖3类体重状态。回顾性获取研究对象1~80个月的身高和体重检查记录,使用广义相加混合模型分性别拟合该3类人群BMI生长曲线,计算脂肪高峰和脂肪重积聚时间及对应的BMI值。  结果  一年级小学生超重检出率为16.31%(380名),肥胖检出率为16.09%(375名)。小学一年级时体重状态为肥胖的儿童,生命最初80个月内BMI拟合值持续高于小学一年级时体重状态为超重或正常的儿童。不同体重状态小学一年级学生的脂肪高峰发生时间均为9月龄,但超重与肥胖的小学生在脂肪高峰时的BMI值高于同性别的正常体重小学生。小学一年级正常体重儿童的脂肪重积聚发生时的月龄为72个月,超重男童为52个月,女童为55个月;肥胖男童为22个月,女童为23个月。小学一年级时正常体重的儿童,其脂肪重积聚时的BMI拟合值也小于小学一年级时超重或肥胖的儿童。  结论  不同体重状态的小学一年级学生脂肪高峰月龄趋于一致,但脂肪重积聚月龄却存在差异。肥胖小学生的脂肪重积聚时间明显提前,脂肪重积聚时的BMI值也高于其他体重状态小学生。     

Dietary Intakes and Physical Activity among Preschool-Aged Children Living in Rural American Indian Communities before a Family-Based Healthy Lifestyle Intervention

Objective

To report dietary intake and physical activity among preschool-aged children living in rural American Indian communities before participation in a family-based healthy lifestyle intervention and to compare data to current age-specific recommendations.

Subjects/design

One hundred thirty-five preschool-aged children, living in rural American Indian communities, provided diet and physical activity data before participating in a 2-year randomized healthy lifestyle intervention. Three 24-hour dietary recalls assessed nutrient and food and added sugar intake, which were compared to the National Academy of Science's Dietary Reference Intakes, the US Department of Agriculture's MyPyramid, and American Heart Association recommendations. Time watching television and moderate plus vigorous activity was compared to MyPyramid and American Academy of Pediatrics recommendations.

Statistical analysis

Nutrient, food group, added sugar intake, and time watching television and in moderate or vigorous activity were compared to recommendations by computing the percent of recommendations met. Nonparametric tests identified differences in diet and physical activity among age groups and normal and overweight children (body mass index <85th and ≥85th percentile).

Results

Average nutrient intakes met recommendations whereas food group intakes did not. Mean fruit and vegetable intakes for 2- to 3-year-olds were 0.36 c/day fruit and 0.45 c/day vegetables and, for 4- to 5-year-olds, 0.33 c/day fruit and 0.48 c/day vegetables. Both age groups reported consuming more than 50 g added sugar, exceeding the recommendation of 16 g. Overweight vs normal weight children reported significantly more sweetened beverage intake (8.0±0.10 vs 5.28±0.08 oz/day, P<0.01). On average, all children reported watching television 2.0 hours/day and significant differences were observed for total television viewing and nonviewing time between overweight and normal weight children (8.52±0.6 vs 6.54±0.6 hours/day, P<0.01). All children engaged in <20 minutes/day of moderate or vigorous activity.

Conclusions

Overall, children in this sample did not meet MyPyramid recommendations for fruits or vegetables and exceed added sugar intake recommendations. Television viewing time and time when the television was on in the home was highly prevalent along with low levels of moderate or vigorous activity. The Healthy Children Strong Families intervention we studied has potential for improving nutrition and physical activity among preschool-aged children living in rural American Indian communities.     

Young teenagers' perceptions of their own and others' bodies: a qualitative study of obese, overweight and 'normal' weight young people in Scotland

The rise in numbers of overweight/obese children in the UK is causing widespread concern. Biomedical constructions of body acceptability and 'good health' mean that overweight/obese young people are frequently seen as deviant. The socio-cultural contexts within which young teenagers become fat, and lay conceptualisations of fatness, have largely been ignored. This qualitative study involved in-depth interviews with teenagers aged 13-14 years (n = 36), drawn from families living in areas classified as socio-economically disadvantaged. Half of the sample had a Body Mass Index (BMI) classifying them as overweight or obese, whilst the remainder were classified as being 'normal' weight. Participants' embodied perceptions of fatness were complex and sometimes contradictory. We discuss what young teenagers perceive the influences on fatness and body size to be; the professed consequences of being fat; participants' experiences of attempting to lose weight; and, their reported interactions with friends and family relating to fatness and dieting. Participants rarely mentioned any health-related consequences of their own and others' fatness, although wearing 'nice' clothes and being slowed down were raised as considerations by girls and boys, respectively. 'Normal' weight teenagers who disliked their bodies or who wanted to lose weight often claimed to be anxious about this. Being very obese also led to anxiety and reported attempts at 'crash dieting'. Acceptance of body size/shape was, however, common amongst the overweight and obese teenagers, although some had attempted weight loss. The teenagers in this study were rarely supportive of friends or family who attempted to lose weight and frequently disagreed with others' perceptions of fatness. These findings are important as they contradict the common perception that being overweight/obese is related to body dissatisfaction and that young people have a fear of fatness.     

Relationship of satisfaction with body size and trying to lose weight in a national survey of overweight and obese women aged 40 and older,United States

BACKGROUND: Despite the potential benefits of weight loss, the factors associated with weight loss behavior are only beginning to be identified. We examined the association between sociodemographic factors, perceived health, satisfaction with body size, and trying to lose weight. METHODS: Data were obtained from the 1996-1997 U.S. Women's Determinants Study. We included over 1,700 overweight and obese women aged 40 and older from the following four racial/ethnic groups: Hispanic, black, American Indian/Alaskan Native, and non-Hispanic white. RESULTS: About half of the women reported that they were satisfied or very satisfied with their body size. Satisfaction was associated with lower body mass index (BMI), greater age, lower educational level, and better self-rated health. Compared with non-Hispanic white women, women in the other racial/ethnic groups expressed greater body satisfaction. About 65% of women reported that they were currently trying to lose weight. The strongest predictor of trying to lose weight was satisfaction with body size; women who were not satisfied were nine times more likely to report trying to lose weight than those who were very satisfied. Other significant predictors were BMI, race/ethnicity, and age. CONCLUSIONS: Our findings should serve as the impetus for the inclusion of measures of body image in surveillance and intervention studies of weight loss and control.     

Arthritis, body mass index, and professional advice to lose weight: implications for clinical medicine and public health

BACKGROUND: Arthritis is the leading cause of disability in the United States. Obesity is a risk factor for arthritis, but the relationship between arthritis and weight has not been well characterized at the population level in the United States. Previous research shows that physicians often fail to advise their obese patients to lose weight. OBJECTIVES: To describe the relationship between body weight and arthritis in the United States, and to assess predictors of efforts to lose weight among obese adults with arthritis, including the impact of professional advice to lose weight. METHODS: Data from the 2000 Behavioral Risk Factor Surveillance System (a population-based survey of U.S. adults) from the 35 states that collected information on weight and height, arthritis, and efforts to lose weight. Arthritis was based on self-report of doctor diagnosis or chronic joint symptoms. Main outcome measures were arthritis and efforts to lose weight among adults with arthritis. RESULTS: Overall, 31.7% of respondents had self-reported arthritis. There was a strong relationship between body weight and arthritis. Specifically, the prevalence of arthritis was 25.9% among normal weight (18.5 to 24.9 body mass index [BMI]) adults; 32.1% among overweight (25 to 29.9 BMI) adults; and 43.5% among obese (>30 BMI) adults. This association persisted after adjusting for other factors (adjusted odds ratio [AOR] for having arthritis among obese individuals compared with healthy weight individuals, 3.6; 95% confidence interval [CI]=3.2-3.8). Among obese adults with arthritis who had a routine checkup within the past 12 months, only 43% were advised to lose weight by a health professional. However, recipients of such advice were more likely to try to lose weight than nonrecipients, and professional advice was the strongest independent predictor of weight loss efforts (AOR=2.8; 95% CI=2.5-3.1). CONCLUSIONS: Body mass index (BMI) is an important independent risk factor for self-reported arthritis. Although physicians often fail to advise obese adults with arthritis to lose weight, adults who report receiving such advice were more likely to report weight-loss efforts. Improved awareness of the relationship between arthritis and weight might help motivate patients to lose weight, and physician advice to lose weight could contribute to the prevention and treatment of arthritis.