Adolescent report of lifestyle counseling

Physician counseling on lifestyle factors has been recommended as one way to help combat the obesity epidemic in the United States. The aim of this study was to examine the frequency of lifestyle counseling among healthy weight, overweight, and obese adolescents and determine the contributions of adolescent weight and physical activity.

Self-reported surveys on dietary and physical activity counseling, along with measured height, weight, and physical activity data by accelerometry were collected on 76 adolescents ages 11-14 years. General linear models tested for associations of reported lifestyle counseling by weight category, adjusting for physical activity, age, gender, race/ethnicity, and parent education.

Half (47%) of the subjects were overweight or obese. Frequency of lifestyle counseling varied by weight category, with obese adolescents reporting greater amounts of lifestyle counseling across all topics than their peers. Obese adolescents received more dietary (β = 0.88; standard error [SE] = 0.25; p = 0.001) and physical activity (β = 0.80; SE = 0.28; p = 0.006) counseling than healthy weight youth, as well as being told to increase their physical activity more often (β = 0.96; SE = 0.29; p = 0.001). There were no differences in lifestyle counseling between overweight and healthy weight subjects. Adolescents with greater daily moderate-to-vigorous physical activity reported less physical activity counseling (β = -0.02; SE = 0.008; p = 0.05).

Despite universal recommendations to counsel adolescents on lifestyle, only obese adolescents consistently report receiving such counseling. Given known difficulties in reversing obesity after onset, efforts should ensure that all adolescents receive lifestyle counseling.