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Article(id=1311350397999083632, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1311350193946194882, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202511034, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1762099200000, receivedDateStr=2025-11-03, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1790579898595, onlineDateStr=2026-09-28, pubDate=1786291200000, pubDateStr=2026-08-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1790579898595, onlineIssueDateStr=2026-09-28, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1790579898595, creator=13701087609, updateTime=1790579898595, updator=13701087609, issue=Issue{id=1311350193946194882, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='15', pageStart='2689', pageEnd='2880', issueExtLink='null', onlineDate='null', pubDate='1786291200000', pubDateStr='2026-08-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1790579849945, creator='13701087609', updateTime=1790588319569, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1311385718195315029, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1311350193946194882, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1311385718195315030, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1311350193946194882, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=2786, endPage=2791, ext={EN=ArticleExt(id=1311350398187827313, articleId=1311350397999083632, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Current status and influencing factors of willingness to seek medical care for weight loss among overweight or obese individuals in the community, columnId=1228016572892119056, journalTitle=Modern Preventive Medicine, columnName=Primary Health Services, runingTitle=null, highlight=null, articleAbstract=
Objective

This study investigates the healthcare-seeking intentions and influencing factors related to weight loss among overweight/obese individuals in communities against the backdrop of the “Weight Management Year”.

Methods

From January to June 2025, a stratified random sampling method was used to select 535 overweight or obese residents from 4 community service centers in Cangzhou City. Sociodemographic characteristics and willingness to seek medical care for weight loss were investigated. Univariate analysis and multivariable logistic regression analysis were used to identify the influencing factors.

Results

A total of 535 questionnaires were distributed in the study, with 528 returned, yielding an effective response rate of 98.69%. The willingness to seek medical care for weight reduction among overweight/obese individuals in the community was generally low, at only 33.71%. Univariate analysis revealed statistically significant differences in medical-seeking intentions among individuals based on gender, education level, household monthly income, BMI classification, self-reported health status, and prior weight reduction experience (P<0.05). Multivariable logistic regression analysis further demonstrated that women exhibited higher willingness to seek weight reduction-related medical care than men (OR=1.628, 95% CI: 1.323-2.041). Participants with higher education levels, including postgraduate or above (OR=2.402, 95% CI: 1.204-4.785), an associate or bachelor’s degree (OR=1.853, 95% CI: 1.256-2.745), and high school or vocational high school education (OR=1.521, 95% CI: 1.126-2.053), had significantly higher intentions than those with junior high school education or below. Obesity was associated with a higher intention than overweight (OR=2.113, 95% CI: 1.453-3.072). Prior weight reduction experience was also associated with a higher intention (OR=1.681, 95% CI: 1.156-2.465). Self-reported good health status (OR=0.584,95% CI: 0.396-0.867) and average health status (OR=0.436, 95% CI: 0.285-0.679) were associated with lower intentions compared to poor self-rated health status. Subgroup analysis revealed that the promoting effect of higher education was only significant among women and individuals with weight loss experience (P<0.05), while the inhibitory effect of self-rated good or average health was only significant in obese populations (P<0.05).

Conclusion

The willingness to seek medical care for weight reduction among overweight/obese individuals in communities is low, influenced by factors such as gender, education level, BMI classification, prior weight loss experience, and self-reported health status. It is essential to enhance awareness of the disease attributes of obesity among males, individuals with lower education levels, and those who self-rate their health as good or average, and to guide them toward scientific weight management.

, authors=Yi-dan XING1, Yan-yan LI1, Xiu LIU2, En-tong LIU3, authorsList=Yi-dan XING, Yan-yan LI, Xiu LIU, En-tong LIU, authorCompany=null, correspAuthors=Yan-yan LI, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1311350400167538804, articleId=1311350397999083632, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=社区超重/肥胖人群减重相关就医意愿现状及影响因素分析, columnId=1228016573533847611, journalTitle=现代预防医学, columnName=基层卫生服务, runingTitle=null, highlight=null, articleAbstract=
目的

探讨“体重管理年”背景下，社区超重/肥胖人群减重相关就医意愿及其影响因素。

方法

采用分层随机抽样法，于2025年1—6月，招募沧州市4个社区服务中心超重/肥胖的居民535名，调查其社会人口学资料及减重相关就医意愿。采用单因素分析及多因素logistic回归分析人群减重相关就医意愿的影响因素。

结果

发放问卷535份，回收528份，有效回收率98.69%。社区超重/肥胖人群的减重相关就医意愿普遍较低，仅为33.71%。单因素分析显示，不同性别、教育程度、家庭月收入、BMI分级、自评健康状况及有无减重经历者就医意愿差异有统计学意义（P<0.05）。多因素logistic回归分析表明，减重相关就医意愿女性高于男性（OR=1.628,95%CI:1.323～2.041）；教育程度研究生及以上（OR=2.402,95%CI:1.204～4.785）、大专/本科（OR=1.853,95%CI:1.256～2.745）、高中/中专（OR=1.521,95%CI:1.126～2.053）高于初中及以下；肥胖高于超重（OR=2.113,95%CI:1.453～3.072）；有减重经历高于无减重经历（OR=1.681,95%CI:1.156～2.465）；自评健康状况良好（OR=0.584,95%CI:0.396～0.867）、一般（OR=0.436,95%CI:0.285～0.679）低于自评健康状况差。亚组分析提示，高学历的促进作用仅在女性及有减重经历者中显著（P<0.05），自评健康良好或一般的抑制作用仅在肥胖人群中显著（P<0.05）。

结论

社区超重/肥胖人群的减重相关就医意愿低下，受性别、教育水平、BMI分级、减重经历、自评健康状况等因素影响。需加强男性、低教育水平及自评健康良好或一般的人群对肥胖疾病属性的认知，引导科学体重管理。

, authors=邢一丹1, 李研研1, 刘秀2, 刘恩彤3, authorsList=邢一丹, 李研研, 刘秀, 刘恩彤, authorCompany=null, correspAuthors=李研研, authorNote=

邢一丹（1991—），女，本科，主管护师，研究方向：营养与健康

, correspAuthorsNote=
李研研，E-mail:
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邢一丹（1991—），女，本科，主管护师，研究方向：营养与健康

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邢一丹（1991—），女，本科，主管护师，研究方向：营养与健康

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Global Health Promotion, 2024, 17: 3452., articleTitle=Effect of an educational intervention based on the Health Belief Model on prevention and fear of falling among older People, refAbstract=null), Reference(id=1311350410623938755, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350397999083632, doi=null, pmid=null, pmcid=null, year=2024, volume=27, issue=20, pageStart=2505, pageEnd=2511, url=null, language=null, rfNumber=[23], rfOrder=34, authorNames=王萧冉, 关新月, 张丹, journalName=中国全科医学, refType=null, unstructuredReference=王萧冉，关新月，张丹.老年共病患者就医延迟行为及其影响因素研究[J].中国全科医学，2024，27(20)：2505-2511., articleTitle=老年共病患者就医延迟行为及其影响因素研究, refAbstract=null), Reference(id=1311350410703630532, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350397999083632, doi=null, pmid=null, pmcid=null, year=2024, volume=27, issue=20, pageStart=2505, pageEnd=2511, url=null, language=null, rfNumber=[23], rfOrder=35, authorNames=Wang XR, Guan XY, Zhang D, journalName=Chinese General Practice, refType=null, unstructuredReference=Wang XR, Guan XY, Zhang D. 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Chinese General Practice, 2024, 27(20):2505-2511.(In Chinese), articleTitle=Patient delay and associated factors in older adults with multimorbidity, refAbstract=null)], funds=[Fund(id=1311350404428951712, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350397999083632, awardId=20200288, language=CN, fundingSource=河北省医学科学研究课题计划(20200288), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1311350400381448309, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350397999083632, xref=1., ext=[AuthorCompanyExt(id=1311350400394031222, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350397999083632, companyId=1311350400381448309, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Nutrition, Cangzhou People’s Hospital, Cangzhou, Hebei 061001, China), AuthorCompanyExt(id=1311350400402419831, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350397999083632, companyId=1311350400381448309, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.沧州市人民医院营养科，河北 沧州 061001)]), AuthorCompany(id=1311350400473723000, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350397999083632, xref=2., ext=[AuthorCompanyExt(id=1311350400486305913, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350397999083632, companyId=1311350400473723000, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.沧州市人民医院骨科一、二区)]), AuthorCompany(id=1311350400553414778, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350397999083632, xref=3., ext=[AuthorCompanyExt(id=1311350400561803387, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350397999083632, companyId=1311350400553414778, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3.沧州市人民医院康复科)])], figs=[ArticleFig(id=1311350402424074394, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350397999083632, language=EN, label=Table 1, caption=

Univariate analysis of medical consultation willingness related to weight loss among overweight/obese individuals in the community ［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
因素分组合计愿意不愿意χ2值P值
性别男25670 (27.34)186 (72.66)6.2430.012
女272108 (39.71)164 (60.29)
年龄（岁）18～3514250 (35.21)92 (64.79)0.8970.863
36～5019868 (34.34)130 (65.66)
51～6513844 (31.88)94 (68.12)
66～705016 (32.00)34 (68.00)
教育程度初中及以下21240 (18.87)172 (81.13)9.318<0.001
高中/中专16850 (29.76)118 (70.24)
大专/本科13277 (58.33)55 (41.67)
研究生及以上1611 (68.75)5 (31.25)
婚姻状况已婚388130 (33.51)258 (66.49)0.1830.923
未婚/离异/丧偶14048 (34.29)92 (65.71)
职业状态在岗294102 (34.69)192 (65.31)1.2360.745
无业/待业11238 (33.93)74 (66.07)
离退休6221 (33.87)41 (66.13)
其他6017 (28.33)43 (71.67)
家庭平均月收入（元）<5 00018040 (22.22)140 (77.78)10.893<0.001
5 000～9 99922480 (35.71)144 (64.29)
≥10 00012458 (46.77)66 (53.23)
是否认为肥胖为疾病是386144 (37.31)242 (62.69)1.4510.528
否14234 (23.94)108 (76.06)
肥胖对健康威胁的认知肯定有危害25094 (37.60)156 (62.40)2.7880.092
可能有危害20056 (28.00)144 (72.00)
没有危害7828 (35.90)50 (64.10)
医疗保险状况职工医保16855 (32.74)113 (67.26)2.1260.110
居民医保323111 (34.37)212 (65.63)
无医保3712 (32.43)25 (67.57)
对减重医疗费用昂贵程度的主观评价贵17757 (32.20)120 (67.80)0.9130.902
一般26389 (33.84)174 (66.16)
便宜8832 (36.36)56 (63.64)
到达最近减重医疗机构的时间（min）<1523478 (33.33)156 (66.67)1.8930.441
15～3021272 (33.96)140 (66.04)
>308228 (34.15)54 (65.85)
对本地体重管理医疗服务的知晓情况不知晓18940 (21.16)149 (78.84)2.4520.118
部分知晓内容22788 (38.77)139 (61.23)
知晓内容及途径11250 (44.64)62 (55.36)
自评健康状况好25351 (20.16)202 (79.84)13.925<0.001
一般19669 (35.20)127 (64.80)
差7958 (73.42)21 (26.58)
对当前体重的担忧程度高28898 (34.03)190 (65.97)1.7580.513
中16856 (33.33)112 (66.67)
低7224 (33.33)48 (66.67)
BMI分级超重29680 (27.03)216 (72.97)15.67<0.001
肥胖23298 (42.24)134 (57.76)
是否患有肥胖相关并发症是318110 (34.59)208 (65.41)0.320.571
否21068 (32.38)142 (67.62)
有无减重经历有317127 (40.06)190 (59.94)12.34<0.001
无21151 (24.17)160 (75.83)
), ArticleFig(id=1311350402512154779, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350397999083632, language=CN, label=表1, caption=

社区超重/肥胖人群减重相关就医意愿单因素分析 ［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
因素分组合计愿意不愿意χ2值P值
性别男25670 (27.34)186 (72.66)6.2430.012
女272108 (39.71)164 (60.29)
年龄（岁）18～3514250 (35.21)92 (64.79)0.8970.863
36～5019868 (34.34)130 (65.66)
51～6513844 (31.88)94 (68.12)
66～705016 (32.00)34 (68.00)
教育程度初中及以下21240 (18.87)172 (81.13)9.318<0.001
高中/中专16850 (29.76)118 (70.24)
大专/本科13277 (58.33)55 (41.67)
研究生及以上1611 (68.75)5 (31.25)
婚姻状况已婚388130 (33.51)258 (66.49)0.1830.923
未婚/离异/丧偶14048 (34.29)92 (65.71)
职业状态在岗294102 (34.69)192 (65.31)1.2360.745
无业/待业11238 (33.93)74 (66.07)
离退休6221 (33.87)41 (66.13)
其他6017 (28.33)43 (71.67)
家庭平均月收入（元）<5 00018040 (22.22)140 (77.78)10.893<0.001
5 000～9 99922480 (35.71)144 (64.29)
≥10 00012458 (46.77)66 (53.23)
是否认为肥胖为疾病是386144 (37.31)242 (62.69)1.4510.528
否14234 (23.94)108 (76.06)
肥胖对健康威胁的认知肯定有危害25094 (37.60)156 (62.40)2.7880.092
可能有危害20056 (28.00)144 (72.00)
没有危害7828 (35.90)50 (64.10)
医疗保险状况职工医保16855 (32.74)113 (67.26)2.1260.110
居民医保323111 (34.37)212 (65.63)
无医保3712 (32.43)25 (67.57)
对减重医疗费用昂贵程度的主观评价贵17757 (32.20)120 (67.80)0.9130.902
一般26389 (33.84)174 (66.16)
便宜8832 (36.36)56 (63.64)
到达最近减重医疗机构的时间（min）<1523478 (33.33)156 (66.67)1.8930.441
15～3021272 (33.96)140 (66.04)
>308228 (34.15)54 (65.85)
对本地体重管理医疗服务的知晓情况不知晓18940 (21.16)149 (78.84)2.4520.118
部分知晓内容22788 (38.77)139 (61.23)
知晓内容及途径11250 (44.64)62 (55.36)
自评健康状况好25351 (20.16)202 (79.84)13.925<0.001
一般19669 (35.20)127 (64.80)
差7958 (73.42)21 (26.58)
对当前体重的担忧程度高28898 (34.03)190 (65.97)1.7580.513
中16856 (33.33)112 (66.67)
低7224 (33.33)48 (66.67)
BMI分级超重29680 (27.03)216 (72.97)15.67<0.001
肥胖23298 (42.24)134 (57.76)
是否患有肥胖相关并发症是318110 (34.59)208 (65.41)0.320.571
否21068 (32.38)142 (67.62)
有无减重经历有317127 (40.06)190 (59.94)12.34<0.001
无21151 (24.17)160 (75.83)
), ArticleFig(id=1311350402583457948, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350397999083632, language=EN, label=Table 2, caption=

Multivariable logistic regression analysis of weight loss-related healthcare-seeking intention among overweight/obese individuals in the community

, figureFileSmall=null, figureFileBig=null, tableContent=
影响因素B Waldχ2值OR（95%CI）P值
性别（ref:男）
女0.4810.1896.4821.628(1.323～2.041)0.011
教育程度（ref:初中及以下）
高中/中专0.4150.1547.2701.521(1.126～2.053)0.007
大专/本科0.6150.2019.3711.853(1.256～2.745)0.002
研究生及以上0.8750.3526.1822.402(1.204～4.785)0.013
家庭平均月收入（元，ref:<5 000)
5 000～9 9990.2100.1601.7221.235(0.902～1.691)0.189
≥10 0000.2850.1852.3731.338(0.937～1.918)0.123
自评健康状况（ref：差）
一般-0.8420.22813.6450.436(0.285～0.679)<0.001
好-0.5450.2017.3570.584(0.396～0.867)0.007
BMI分级（ref：超重）
肥胖0.7460.19215.1182.113(1.453～3.072)<0.001
有无减重经历（ref:无）
有0.5190.1947.1591.681(1.156～2.465)0.004
), ArticleFig(id=1311350402642178205, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350397999083632, language=CN, label=表2, caption=

社区超重/肥胖人群减重相关就医意愿多因素logistic回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
影响因素B Waldχ2值OR（95%CI）P值
性别（ref:男）
女0.4810.1896.4821.628(1.323～2.041)0.011
教育程度（ref:初中及以下）
高中/中专0.4150.1547.2701.521(1.126～2.053)0.007
大专/本科0.6150.2019.3711.853(1.256～2.745)0.002
研究生及以上0.8750.3526.1822.402(1.204～4.785)0.013
家庭平均月收入（元，ref:<5 000)
5 000～9 9990.2100.1601.7221.235(0.902～1.691)0.189
≥10 0000.2850.1852.3731.338(0.937～1.918)0.123
自评健康状况（ref：差）
一般-0.8420.22813.6450.436(0.285～0.679)<0.001
好-0.5450.2017.3570.584(0.396～0.867)0.007
BMI分级（ref：超重）
肥胖0.7460.19215.1182.113(1.453～3.072)<0.001
有无减重经历（ref:无）
有0.5190.1947.1591.681(1.156～2.465)0.004
), ArticleFig(id=1311350402730258590, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350397999083632, language=EN, label=Table 3, caption=

Analysis of weight loss-related healthcare-seeking intention across different subgroups

, figureFileSmall=null, figureFileBig=null, tableContent=
亚组对比影响因素亚组比较项目OR(95% CI)P值
性别对比教育程度（ref:初中及以下）女性研究生及以上2.254(1.701～2.983)<0.001
大专/本科1.822(1.353～2.453)<0.001
高中/中专1.450(1.120～1.877)0.005
男性研究生及以上1.206(0.853～1.695)0.098
大专/本科1.157(0.892～1.482)0.101
高中/中专1.086(0.850～1.372)0.283
BMI对比自评健康状况 (ref:差)BMI≥28 kg/m2良好0.407(0.254～0.644)<0.001
一般0.604(0.421～0.857)0.002
24 kg/m2≤BMI<28 kg/m2良好0.752(0.522～1.087)0.124
一般0.850(0.642～1.125)0.158
有无减重经历对比教育程度（ref:初中及以下）有减重经历研究生及以上2.351(1.520～3.643)<0.001
大专/本科1.934(1.425～2.564)<0.001
高中/中专1.338(1.089～2.187)0.009
无减重经历研究生及以上1.142(0.879～1.521)0.136
大专/本科1.093(0.738～1.312)0.175
高中/中专1.041(0.684～1.277)0.239
), ArticleFig(id=1311350402801561759, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350397999083632, language=CN, label=表3, caption=

不同亚组人群减重相关就医意愿分析

, figureFileSmall=null, figureFileBig=null, tableContent=
亚组对比影响因素亚组比较项目OR(95% CI)P值
性别对比教育程度（ref:初中及以下）女性研究生及以上2.254(1.701～2.983)<0.001
大专/本科1.822(1.353～2.453)<0.001
高中/中专1.450(1.120～1.877)0.005
男性研究生及以上1.206(0.853～1.695)0.098
大专/本科1.157(0.892～1.482)0.101
高中/中专1.086(0.850～1.372)0.283
BMI对比自评健康状况 (ref:差)BMI≥28 kg/m2良好0.407(0.254～0.644)<0.001
一般0.604(0.421～0.857)0.002
24 kg/m2≤BMI<28 kg/m2良好0.752(0.522～1.087)0.124
一般0.850(0.642～1.125)0.158
有无减重经历对比教育程度（ref:初中及以下）有减重经历研究生及以上2.351(1.520～3.643)<0.001
大专/本科1.934(1.425～2.564)<0.001
高中/中专1.338(1.089～2.187)0.009
无减重经历研究生及以上1.142(0.879～1.521)0.136
大专/本科1.093(0.738～1.312)0.175
高中/中专1.041(0.684～1.277)0.239
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社区超重/肥胖人群减重相关就医意愿现状及影响因素分析
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邢一丹 1 , 李研研 1 , 刘秀 2 , 刘恩彤 3
现代预防医学 | 基层卫生服务 2026,53(15): 2786-2791
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现代预防医学 |基层卫生服务 2026 , 53 (15) : 2786 -2791
社区超重/肥胖人群减重相关就医意愿现状及影响因素分析
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邢一丹1, 李研研1 , 刘秀2, 刘恩彤3
作者信息
  • 1.沧州市人民医院营养科，河北 沧州 061001
  • 2.沧州市人民医院骨科一、二区
  • 3.沧州市人民医院康复科
通讯作者:
李研研，E-mail:
作者简介:

邢一丹（1991—），女，本科，主管护师，研究方向：营养与健康

Current status and influencing factors of willingness to seek medical care for weight loss among overweight or obese individuals in the community
Yi-dan XING1, Yan-yan LI1 , Xiu LIU2, En-tong LIU3
Affiliations
  • Department of Nutrition, Cangzhou People’s Hospital, Cangzhou, Hebei 061001, China
出版时间: 2026-08-10 doi: 10.20043/j.cnki.MPM.202511034
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摘要
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目的

探讨“体重管理年”背景下，社区超重/肥胖人群减重相关就医意愿及其影响因素。

方法

采用分层随机抽样法，于2025年1—6月，招募沧州市4个社区服务中心超重/肥胖的居民535名，调查其社会人口学资料及减重相关就医意愿。采用单因素分析及多因素logistic回归分析人群减重相关就医意愿的影响因素。

结果

发放问卷535份，回收528份，有效回收率98.69%。社区超重/肥胖人群的减重相关就医意愿普遍较低，仅为33.71%。单因素分析显示，不同性别、教育程度、家庭月收入、BMI分级、自评健康状况及有无减重经历者就医意愿差异有统计学意义（P<0.05）。多因素logistic回归分析表明，减重相关就医意愿女性高于男性（OR=1.628,95%CI:1.323～2.041）；教育程度研究生及以上（OR=2.402,95%CI:1.204～4.785）、大专/本科（OR=1.853,95%CI:1.256～2.745）、高中/中专（OR=1.521,95%CI:1.126～2.053）高于初中及以下；肥胖高于超重（OR=2.113,95%CI:1.453～3.072）；有减重经历高于无减重经历（OR=1.681,95%CI:1.156～2.465）；自评健康状况良好（OR=0.584,95%CI:0.396～0.867）、一般（OR=0.436,95%CI:0.285～0.679）低于自评健康状况差。亚组分析提示，高学历的促进作用仅在女性及有减重经历者中显著（P<0.05），自评健康良好或一般的抑制作用仅在肥胖人群中显著（P<0.05）。

结论

社区超重/肥胖人群的减重相关就医意愿低下，受性别、教育水平、BMI分级、减重经历、自评健康状况等因素影响。需加强男性、低教育水平及自评健康良好或一般的人群对肥胖疾病属性的认知，引导科学体重管理。

超重  /  肥胖  /  减重  /  就医意愿  /  体重管理
Objective

This study investigates the healthcare-seeking intentions and influencing factors related to weight loss among overweight/obese individuals in communities against the backdrop of the “Weight Management Year”.

Methods

From January to June 2025, a stratified random sampling method was used to select 535 overweight or obese residents from 4 community service centers in Cangzhou City. Sociodemographic characteristics and willingness to seek medical care for weight loss were investigated. Univariate analysis and multivariable logistic regression analysis were used to identify the influencing factors.

Results

A total of 535 questionnaires were distributed in the study, with 528 returned, yielding an effective response rate of 98.69%. The willingness to seek medical care for weight reduction among overweight/obese individuals in the community was generally low, at only 33.71%. Univariate analysis revealed statistically significant differences in medical-seeking intentions among individuals based on gender, education level, household monthly income, BMI classification, self-reported health status, and prior weight reduction experience (P<0.05). Multivariable logistic regression analysis further demonstrated that women exhibited higher willingness to seek weight reduction-related medical care than men (OR=1.628, 95% CI: 1.323-2.041). Participants with higher education levels, including postgraduate or above (OR=2.402, 95% CI: 1.204-4.785), an associate or bachelor’s degree (OR=1.853, 95% CI: 1.256-2.745), and high school or vocational high school education (OR=1.521, 95% CI: 1.126-2.053), had significantly higher intentions than those with junior high school education or below. Obesity was associated with a higher intention than overweight (OR=2.113, 95% CI: 1.453-3.072). Prior weight reduction experience was also associated with a higher intention (OR=1.681, 95% CI: 1.156-2.465). Self-reported good health status (OR=0.584,95% CI: 0.396-0.867) and average health status (OR=0.436, 95% CI: 0.285-0.679) were associated with lower intentions compared to poor self-rated health status. Subgroup analysis revealed that the promoting effect of higher education was only significant among women and individuals with weight loss experience (P<0.05), while the inhibitory effect of self-rated good or average health was only significant in obese populations (P<0.05).

Conclusion

The willingness to seek medical care for weight reduction among overweight/obese individuals in communities is low, influenced by factors such as gender, education level, BMI classification, prior weight loss experience, and self-reported health status. It is essential to enhance awareness of the disease attributes of obesity among males, individuals with lower education levels, and those who self-rate their health as good or average, and to guide them toward scientific weight management.

Overweight  /  Obesity  /  Weight reduction  /  Willingness to seek medical care  /  Weight management
邢一丹, 李研研, 刘秀, 刘恩彤. 社区超重/肥胖人群减重相关就医意愿现状及影响因素分析. 现代预防医学, 2026 , 53 (15) : 2786 -2791 . DOI: 10.20043/j.cnki.MPM.202511034
Yi-dan XING, Yan-yan LI, Xiu LIU, En-tong LIU. Current status and influencing factors of willingness to seek medical care for weight loss among overweight or obese individuals in the community[J]. Modern Preventive Medicine, 2026 , 53 (15) : 2786 -2791 . DOI: 10.20043/j.cnki.MPM.202511034
正文
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超重与肥胖已成为全球性重大公共卫生挑战，给个人健康和社会医疗体系带来沉重负担[1]。我国成年居民超重率和肥胖率分别高达34.3%与16.4%[2]，且与2型糖尿病、高血压、冠心病等多种疾病的风险呈显著正相关[3]，疾病负担随之加重。2024年6月，国家卫生健康委员会等多部门联合启动了“体重管理年”行动，旨在推动专业、科学的体重管理服务落地，提升居民体重管理意识与能力[4]。然而，现有研究多集中于减重方法的有效性评价，对社区超重/肥胖人群的主观就医意愿、影响因素探讨尚不充分。就医意愿是健康行为理论中的关键前置变量，是连接健康知识、信念与就医行为的桥梁[5]。在超重/肥胖负担潜在加重的背景下，就医意愿成为影响有效干预能否实施的重要行为变量，亟待深入研究。本研究聚焦于社区超重/肥胖人群的减重相关就医意愿，分析现状及影响因素，以期提升体重管理服务的针对性与可及性。
1　对象与方法
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1.1　研究对象
于2025年1—6月，采用分层随机抽样法，按社区成立年限（新成立为≤3年、成长型为3<n≤10年、成熟为10<n≤20年及老旧为≥20年）从沧州市每层抽取一个社区，通过查询社区健康档案电话邀请和在候诊区张贴海报吸引主动联系者的方式招募535名（新成立社区117人、成长型社区126人、成熟社区140人、老旧社区152人)居民为研究对象。
纳入标准：（1）年龄18～70岁；（2）达到身体质量指数（body mass index，BMI）≥24.0 kg/m2（超重）或≥28.0 kg/m2（肥胖）的标准；（3）在研究社区连续居住≥6个月；（4）具备基本的沟通与理解能力。排除标准：（1）合并严重心、肝、肾功能不全等重大躯体疾病者；（2）存在认知障碍，无法配合完成调查者；（3）妊娠期妇女；（4）近3个月内参加过系统性减重干预项目者。本研究经沧州市人民医院伦理委员会审查批准（K2025-259-02），所有研究对象均签署知情同意书。
样本量估计：以多因素logistic回归为主要分析方法，依据每个变量对应的事件数（events per variable，EPV）原则即每个自变量需10～20例阳性事件估算样本量，取EPV为15。预调查显示就医意愿率约35%，拟纳入自变量10个，则阳性事件为150例，对应样本量约429例。考虑15%的无效问卷，至少需505例，实际发放535份。
1.2　研究方法
1.2.1　调查工具
Andersen模型1968年由Andersen[6]创建，分析个体服务利用与选择，包含倾向特征、使能资源、需要因素、健康行为与结果四个维度。结合模型，团队自行设计调查问卷，包括：（1）倾向特征：性别、年龄、教育程度、婚姻状况、职业状态、家庭平均月收入、是否认为肥胖为疾病、肥胖对健康威胁的认知；（2）使能资源：医疗保险状况、对减重医疗费用昂贵程度的主观评价、到达最近减重医疗机构的时间、对本地体重管理医疗服务的知晓情况；（3）需要因素：自评健康状况、对当前体重的担忧程度、BMI分级、是否患有肥胖相关并发症（高血压[7]、2型糖尿病[8]、血脂异常[9]、非酒精性脂肪性肝病[10]、睡眠呼吸暂停综合征[11]、骨关节炎[12]、冠心病[13]、脑卒中[14]）；（4）健康行为与结果：有无减重经历、未来半年内减重相关就医意愿、倾向于寻求帮助的机构类型、倾向于接受的医疗方式。该问卷Cronbach α为0.821。结构效度：凯泽-梅印-奥尔金检验（Kaiser-Meyer-Olkin,KMO）= 0.916，Bartlett球形检验P<0.001，适合因子分析。采用主成分法及最大方差旋转提取特征根>1的公因子4个，与Andersen模型四维度一致，累积方差解释率70.3%。各条目因子载荷0.673～0.851，交叉载荷均<0.4，结构效度良好。
1.2.2　调查与质控方法
研究团队统一培训调查员并通过考核，现场向调查对象发放并回收问卷。为保护参与者隐私，调查在独立、安静的空间进行，确保其回答的私密性。问卷回收后双人录入数据，共发放问卷535份，其中7份存在数据缺失予以剔除，回收528份完整病例，有效回收率为98.69%。
1.2.3　统计分析方法
采用SPSS 26.0进行数据录入与分析，计数资料以例数（%）表示，单因素分析采用χ2检验，对单因素分析中具有统计学意义的因素行多重共线性诊断，方差膨胀因子（variance inflation factor,VIF）<5且容忍度>0.2的变量纳入多因素logistic回归分析。对多因素分析中效应显著的变量行亚组分层分析。检验水准α=0.05。
2　结果
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2.1　研究对象的基本情况、减重相关就医意愿现状及偏好
最终纳入528名研究对象，男性256人（48.48%），女性272人（51.52%），平均年龄为（42.57±11.76）岁。未来半年内具有减重相关就医意愿者共178名，就医意愿率仅为33.71%。倾向于寻求帮助的机构类型：基层社区卫生服务中心102人（19.32%），综合医院减重门诊76人（14.39%），商业健身机构118人（22.35%），商业理疗保健机构46人（8.71%），不寻求任何外部帮助186人（35.23%）；在178名有就医意愿人群中，接受个体化饮食与运动指导87人，中医药调理66人，口服药物治疗19人，代谢减重手术6人。
2.2　社区超重/肥胖人群减重相关就医意愿单因素分析
单因素分析显示，不同性别、教育程度、家庭平均月收入、BMI分级及减重经历差异有统计学意义（P<0.05）。见表1。
2.3　社区超重/肥胖人群减重相关就医意愿多因素分析
对单因素分析P<0.05的变量行共线性诊断，各变量VIF介于1.12～1.48之间，容忍度介于0.596～0.763之间，无严重共线性。以是否有减重相关就医意愿为因变量，以性别、教育程度、家庭平均月收入、自评健康状况、BMI分级及有无减重经历为自变量进行多因素逐步logistic回归分析。结果显示：女性、高中/中专、大专/本科及研究生及以上文化程度、肥胖、有减重经历为减重相关就医意愿的保护因素。自评健康状况为一般和良好为危险因素。家庭平均月收入无统计学意义（P>0.05）。见表2。
2.4　不同亚组中影响因素效应的差异
根据多因素回归中效应显著且分层后各组样本量充足的原则，将性别、BMI分级及有无减重经历三个变量进行分层分析。结果显示：女性及有减重经历者，随着学历升高，就医意愿显著增强（P<0.05），男性及无减重经历者的就医意愿在不同学历人群中无统计学差异（P>0.05）；自评健康状况的抑制作用在肥胖人群中更为突出，自评健康一般和良好均会显著降低就医意愿（P<0.05），而在超重人群中，无统计学意义（P>0.05）。见表3。
3　讨论
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3.1　社区超重/肥胖人群减重相关就医意愿及偏好
研究发现，社区超重/肥胖人群未来半年内减重相关就医意愿率仅为33.71%，显著低于慢性病患者总体水平[15]。公众对高血压、糖尿病等慢性病较重视，但对超重/肥胖是否需专业医疗干预存在认知分歧。传统手段多通过调整饮食结构或运动[16]管理体重，导致体重相关健康风险认知与主动就医行为脱节。
有就医意愿者中，57.30%首选基层社区卫生服务中心，与李夏丽等[17]研究结论相似，基层医疗机构地理可及性高、服务连续性强。商业机构选择比例高于综合医院，依据健康信念模型与计划行为理论，即个体行为意向受感知获益、感知障碍及社会规范影响，从感知获益层面：商业机构提供可量化的短期效果，契合个体对可见成效的需求；从感知易用性角度：其多分布于社区服务便捷，优于医院就诊流程；从主观规范而言：社交媒体对健身减重的推崇形成社会压力。医疗体系需优化服务流程、强化效果可视化反馈与宣传引导。
治疗方式上，个体化饮食与运动指导接纳度最高，其次为中医药调理。与国际肥胖指南[18]中强调生活方式干预是一线治疗原则相符。中医药调理的高接受度，体现了人群对传统文化的认同，提示体重管理融合中医药技术，有助于提升服务吸引力。
3.2　社区超重/肥胖人群减重相关就医意愿的影响因素的整体分析
研究发现，女性减重相关就医意愿显著高于男性，可能为女性对自身形象关注度更高，意愿更强。Elliott M等[19]发现，部分男性因将减重视为女性化而产生羞耻感，参与意愿偏低，与本研究结果呼应。肖青等[20]指出女性健康素养及医疗服务利用意识更强。因此，应特别关注男性群体，通过针对性宣教提升其对超重/肥胖的认知。
研究显示，教育程度是减重相关就医意愿的保护因素，学历越高意愿越强，与前人结果一致[21]，符合Andersen模型中教育通过提升个体信息获取能力，促进服务利用的核心观点。高学历者通常具备更高的健康素养，对超重/肥胖的危害理解更充分，进而采取主动就医行为。因此，针对低学历人群，应注意采取通俗易懂的宣教及面对面指导方式，弥补其健康信息获取能力的不足。
研究指出，肥胖者就医意愿显著高于超重者。既往研究[22]指出个体的并发症风险、日常生活受限随BMI等级的上升而加重，促使其主动寻求专业医疗干预。因此，肥胖人群是体重管理服务优先关注的核心目标人群。
研究表明，自评健康状况良好与一般是减重就医意愿的危险因素，与健康信念模型的核心原则一致，即个体对健康严重性感知越差，采取健康行为的可能性就越小。王萧冉等[23]研究也发现，自评健康状况良好是就医延迟的重要因素。因此，加强公众尤其自评健康良好者对肥胖是一种独立疾病的理解，帮其认识肥胖的潜在危害。
研究提示，有减重经历者就医意愿显著高于无减重经历者，揭示了实践经验对健康信念与行为转变的催化作用。经历过减重失败的个体，可对体重管理的复杂性与困难度体会更深，从而对科学干预产生更强的需求与信任。
研究报告，家庭平均月收入在单因素分析中显著，但纳入多因素后未见显著效应。共线性诊断已排除严重共线性，该效应可能通过教育程度、自评健康等中介变量传递效应，上述对就医意愿的直接影响更强（表2中所示），收入的独立效应被稀释，而非收入本身通过经济可及性直接发挥作用，后续研究可进一步采用结构方程模型验证中介路径。该结果提示相关部门在制定促进策略时，除了考虑经济层面，更应注重提升相关人群的健康认知能力。
3.3　社区超重/肥胖人群减重相关就医意愿的影响因素的亚组分析
亚组分析提示，教育程度的保护效应存在明显的性别与减重经历差异：高学历仅在女性、有减重经历亚组群体显著，而在男性和无减重经历亚组中则未达到统计学意义。女性对体型关注度更高，高学历强化了信息获取能力，而男性可能更受病耻感等心理因素影响，削弱了学历的正向作用。有减重经历者通过失败体验到自行管理的局限性，激发了专业干预需求，高学历的信息甄别能力在此过程中得以充分发挥；而无减重经历者尚未形成这一需求，高学历的优势未能显现。
自评健康状况良好或一般的抑制作用在肥胖人群效应显著，而在超重人群中虽呈负向但不显著。提示对于肥胖个体，若仍保持感觉良好的状态，对潜在的代谢风险认知不足，主动寻求医疗帮助的动机显著降低。体重管理中应对该类人群重点识别。
本研究通过对沧州市社区超重/肥胖者调查，发现该人群未来半年内减重相关就医意愿处于较低水平，女性、较高教育程度、肥胖以及有减重经历是就医意愿的保护因素；自评健康状况良好或一般是危险因素。基层社区卫生服务中心和商业健康机构是减重偏好场所，个体化生活方式指导及中医药调理是偏好的服务形式。
本研究存在若干局限性：横断面设计无法推断因果关系；样本仅来自单一城市特定社区，外推性有限；招募途径中包含在社区卫生服务中心候诊区主动联系的方式，可能引入就诊者偏倚导致就医意愿率被高估；亚组分析部分变量样本量较小，可能降低检验效能并增加I类错误风险，结果需谨慎解读；就医意愿为自我报告，可能存在社会期望偏倚；研究未纳入社区类型及资源等宏观变量。未来可采用纵向设计、多水平模型及定性访谈，在不同地域样本中深入探讨健康决策的生态背景。
基金
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  • 河北省医学科学研究课题计划(20200288)
文献
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2026年第53卷第15期
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doi: 10.20043/j.cnki.MPM.202511034
  • 接收时间：2025-11-03
  • 首发时间：2026-09-28
  • 出版时间：2026-08-10
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  • 收稿日期：2025-11-03
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河北省医学科学研究课题计划(20200288)
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    1.沧州市人民医院营养科，河北 沧州 061001
    2.沧州市人民医院骨科一、二区
    3.沧州市人民医院康复科

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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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