BARRIERS TO WEIGHT LOSS IN PATIENTS WITH PRIMARY IMMUNODEFICIENCY DISEASE

Overweight and obesity are leading risk factors of hypertension, cardiovascular diseases, type-2 diabetes, and certain types of cancer. In patients with primary immune deficiency (PID), obesity-related diseases impose clinical complications beyond that observed in the general population; thus, maintaining a healthy weight should be a clinical goal for patients with PID. The purpose of this study was to explore perceived barriers and facilitators to maintaining healthy weight and weight loss in patients with PID. This was a cross-sectional study of 128 adult participants with PID who received immunoglobulin treatments at a large, teaching hospital in Southern California. An adapted version of Champion’s Health Belief Model survey, consisting of 39 items, was used to measure barriers and other health belief model constructs. Patients were invited to participate and could complete the survey either in hard copy or online. Demographic data was collected from medical records. Descriptive analysis and multiple regression were used for data analysis. A p < .05 was considered as statistically significant. Results indicated that most participants were overweight or obese (64%). Participants who received infusions at home (vs. in the clinic) had increased odds of obesity. Perceived barriers to weight loss were identified as follows: being too tired to exercise, being too embarrassed to ask for help to lose weight, and not having time to prepare a healthy meal. Perceived facilitators to weight loss were the ability to identify iv healthy from unhealthy foods, commitment to search for new information to improve health, and belief that losing weight reduced cholesterol, blood pressure and blood sugar. In conclusion, the prevalence of overweight and obesity was higher in this group than that found at national levels. Significant barriers and facilitators associated with weight loss were identified. Any intervention aiming at weight loss for PID patients needs to take into considerations barriers that are unique to this population. Further research is needed to identify specific associations between PID, its clinical sequelae, and weight loss in groups with more demographic diversity and to confirm the high prevalence of overweight and obesity in the overall PID population.