Physician weight recommendations for overweight and obese firefighters, United States, 2011-2012

Abstract

Introduction: National guidelines state that health care professionals (HCPs) should advise patients on the importance of maintaining a healthy weight. Firefighters have high rates of obesity, and cardiovascular events are the leading cause of line-of-duty deaths in firefighters. This study assessed the association of age and body mass index (BMI) with HCP weight recommendations among male firefighters.

Methods: We used data on self-reported HCP weight recommendations and measured BMI from a 2011-2012 national sample of male firefighters (N = 1,002). HCP recommendations were recorded as no advice, maintain, gain, or lose weight, and BMI was categorized as normal (<25.0 kg/m(2)), overweight (25.0-29.9 kg/m(2)), class I obese (30.0-34.9 kg/m(2)), and class II or III obese (≥35.0 kg/m(2)). We used multinomial logistic regression to estimate the odds of receiving weight advice by age and BMI categories.

Results: Most firefighters (96%) reported visiting an HCP in the past year. Most (69%) firefighters and 48% of class I to III obese firefighters reported receiving no weight advice. Higher BMI predicted HCP advice to lose weight (odds ratio class I obese vs normal weight: 12.98; 95% confidence interval: 5.38-31.34). Younger firefighters were less likely to receive weight loss advice than older firefighters, except among those who were class II or III obese.

Conclusions: HCPs are important sources of health information for firefighters. Overweight and obese firefighters, particularly those who are younger, do not consistently receive HCP advice to lose weight. This marks a missed opportunity to prevent further weight gain and reduce obesity-related health outcomes.

Figure

Probability of receiving health care professional weight loss advice, by body mass index (BMI) and age, among male US firefighters in the Fuel 2 Fight study, 2011–2012. Model with interaction: ln=−3.99+1.55(Overweight)+3.14(Class I Obese)+4.32(Class II-III Obese)+0.19(Age)–0.14(Overweight×Age)–0.15(Class I Obese×Age)–0.21(Class II-III Obese×Age)+0.53(Comorbidities)+0.41(WA). Log odds are based on the mean for each age category. [Table: see text]