Original Article

Tipping the Scales: The Effect of Literacy on Obese Patients’ Knowledge and Readiness to Lose Weight

Authors: Estela M. Kennen, MA, Terry C. Davis, PHD, Jian Huang, MD, Herbert Yu, MD, PHD, Donna Carden, MD, Ricky Bass, MD, Connie Arnold, PHD

Abstract

Objectives: The purpose of this study was to determine the association between the literacy level of overweight/obese patients and their weight-loss knowledge, attitudes, and readiness.


Methods: Structured patient interviews and a literacy screening instrument were administered in two primary care clinics at a university-based public hospital.


Results: A convenience sample of 210 overweight or obese adult outpatients (body mass index ≥25 kg/m2 or ≥30 kg/m2, respectively) were enrolled. Mean respondent age was 52 years; 74% were female, and 76% were black. Two thirds of patients read below a 9th grade level. Half of patients across all literacy levels reported currently attempting weight loss. There was a significant relation between literacy level and weight-loss knowledge, attitudes, and readiness (P < 0.05).


Conclusions: Patients with low literacy were significantly less likely to understand the adverse health consequences of obesity and the need to lose weight and to report being ready to lose weight. Patient education and counseling for weight loss should be tailored for patients with low literacy skills.


Key Points


* Patients with low literacy are less likely to understand the health benefits of losing weight, and are less likely to report being ready to lose weight.


* Patients with low literacy may lack understanding of the importance of weight loss or struggle with the literacy skills needed to monitor and measure weight loss.


* Patient education and counseling for weight loss in public hospitals should be tailored for patients with low literacy skills.

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