Assessment of Weight and Health in the Emergency Department: A Cross-Sectional Study

Abstract

Introduction: The prevalence of obesity and obesity-related diseases continues to rise. A key aspect of prevention and treatment of these disorders requires clear communication about weight and health between patients and healthcare providers. Objective: We sought to examine the prevalence rate of obesity and associated comorbid illnesses in an emergency department (ED) population. A second aim was to assess patients’ perceptions of their weight and their overall health. Methods: This is a cross-sectional study performed in an academic tertiary-care center using a representative sample of patients (≥18 yr) who presented to the ED. Pregnant patients, patients who were medically unstable, cognitively impaired or who were unable or unwilling to provide informed consent were excluded. Anthropometric measurements were taken which include BMI (the ratio of a patient’s weight and height expressed as kg/m2) and waist circumference. In addition, the prevalence rates of all enrolled patients who 1) feel their health is affecting their weight and 2) who have had or recall discussions about their health and weight with their provider were examined by using a two-question validated survey. Results: The overall prevalence rate of obesity in this study was 38.6%. Only 71.8% (95% CI, 63.2% - 80.6%) of overweight patients (BMI = 25.0 - 29.9) and 28.4% (95% CI, 21.6% - 35.2%) of obese patients (BMI ≥ 30.0) believe their present weight is damaging to their health. Further, only 15.5% (95% CI, 8.5% - 22.6%) and 59.4% (95% CI, 53% - 67%) of those overweight and obese, respectively, recall being informed by their healthcare provider they are overweight. For morbidly obese patients (BMI ≥ 40.0), 79.6% (95% CI, 12.2 - 28.6) feel their weight is damaging their health and 83.7% (95% CI, 9.4 - 23.2) recall having a conversation about weight with their healthcare provider. Conclusion: Many obese and overweight patients believe their weight does not impact their health and have not had discussion about weight and health with their healthcare provider.