Obesity and health literacy in general practice

Context: Obesity is a major contributor to burden of disease and occurs in 28% of primary care patients in Australia (28%). Patient knowledge and skills are sorely tested by the complexities of diet and physical activity information. Low health literacy skills compromise the ability of patients with obesity to change their behaviours, communicate and use primary care services effectively. Obese patients with low health literacy suffer stigma and are often assumed by providers to have low motivation. Objective: To understand the association between health literacy, motivation and management in general practice patients with obesity. Design: Cross sectional analysis of data from the baseline of a cluster RCT. Setting: Australian General Practice Patients or Other Participants: Patients aged 40-70 years, without chronic disease with a BMI >29.9 and low health literacy. Data collection and analysis: Telephone interviews assessing 9 domains of health literacy (HLQ), intention to lose weight, education and referral provided by GPs. Results: 120 patients with mean BMI 36.7 (SD 5.3). The health literacy domains with the lowest scores in this sample were: actively managing my health (AMH); appraisal of health information (CA); having sufficient information to manage my health (HSI) and ability to find good information (FHI). 78% of the sample were trying to lose weight which was associated with two domains (AMH and CA). Among those trying to lose weight, those with higher HSI and CA reported having sufficient information to help them lose weight. Half of patients recalled recieving education and 29% referral but neither were were related to any health literacy domains. Conclusions: Many patients with obesity have poor health literacy and this is associated with a reduced motivation and information about how to lose weight. GPs need to tailor their advice and referral to the needs of this group