Inpatient obesity intervention with postdischarge telephone follow‐up: A randomized trial

Abstract

BACKGROUND Obesity‐related comorbidities frequently contribute to acute illness. Obesity interventions during hospitalization are not often utilized but may be effective. OBJECTIVE To examine whether inpatient weight loss intervention with postdischarge follow‐up results in weight loss at 6 months when compared to control. DESIGN Prospective, randomized controlled trial. SETTING Academic medical center in Chicago, Illinois. PATIENTS Obese adult inpatients. INTERVENTION Intervention subjects viewed a weight education video, underwent personalized counseling, and set specific weight loss, dietary, and fitness goals prior to discharge. All participants were followed by phone over the subsequent 6 months. The trial was unblinded to participants, physicians, and investigators. MEASUREMENTS Primary outcome was weight change between groups at 6 months. Weight change from baseline and waist‐to‐hip ratios (WHR) were also assessed. RESULTS For 176 participants in the intention‐to‐treat analysis, mean baseline weight for the intervention group was 107.7 kg (standard deviation [SD] = 16.7) and 105.1 kg (SD = 17.4) for controls. Mean weight loss at 6 months was 1.08 kg (SD = 4.33) for intervention subjects and 1.35 kg (SD = 3.65) among controls. There was no significant difference in weight loss between groups at 6 months (P = 0.26). As‐treated analysis yielded similar results. There were no differences in WHRs between the intervention and control at 6 months (0.04 vs 0.04, P = 0.59). CONCLUSIONS We found no difference in weight loss between the intervention and control groups at 6 months. Journal of Hospital Medicine 2014;9:515–520. © 2014 Society of Hospital Medicine

A retrospective case‐control cohort analysis of comorbidity and health expenditure in hospitalized adults diagnosed with obesity utilizing ICD‐10 diagnostic coding

“…Of concern is that in our Ob cohort, nearly one in three had obesity mentioned in their discharge letter and only a minority had obesity treatment as an inpatient, which represents a "missed opportunity" for intervention. One study of a brief video and general counselling provided to hospitalized individuals with obesity saw minimal weight differences 6 months post discharge, 20 whereas the majority of outpatient and communitybased weight loss programs have shown modest to significant weight loss ranging from 5 to greater than 15% total body weight loss. [21][22][23][24][25][26] Clearly, methods of intervention require further exploration as data on inpatient obesity treatment is lacking.…”

Physician Characteristics Associated With Sugar-Sweetened Beverage Counseling Practices

“…This may be due to physicians’ perception that inpatient interventions are not effective in changing patient outcomes, that inpatient providers do not have sufficient time to implement effective counseling, or that patients do not want interventions while hospitalized. 44,45 There is, however, some evidence that inpatient interventions can lead to positive change in patients’ stages of readiness to change 46 and that patients are willing to initiate obesity-related counseling with inpatient providers. 47 Inpatient encounters, therefore, may be a prime opportunity for the initiation of counseling.…”

Is pregnancy a teachable moment for diet and physical activity behaviour change? An interpretative phenomenological analysis of the experiences of women during their first pregnancy

“…Empirically, the majority of research on significant life events as cues to action has focused on negative health experiences such as receiving a false‐positive screening result (Floyd, Steffens, Pavlik, & Andrykowski, ) and hospitalization (Wachsberg et al ., ) rather than positive life transitions, such as pregnancy, and in relation to unequivocally negative behaviours such as smoking (e.g., Flocke et al ., ). By contrast, pregnancy is often posited as having the potential to generate a TM.…”