Achievement of Weight Loss in Patients with Overweight During Dietetic Treatment in Primary Health Care

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2019 Nov 28

PMID 31774845

Citations 5

Authors

Lisa D M Verberne

Chantal J Leemrijse

Markus M J Nielen

Roland D Friele

Affiliations

Soon will be listed here.

Abstract

Introduction: Dietitians are the preferred primary health care professionals for nutritional care in overweight patients. Guidelines for dietitians recommend a weight reduction of ≥ 5% of initial body weight after one year of treatment. The purpose of this study was to evaluate weight change in patients with overweight who were treated by dietitians in Dutch primary health care, and to identify patient characteristics that were associated with it.

Materials And Methods: This observational study data was based on real life practice data of patients with overweight during the period 2013-2017, derived from dietetic practices that participated in the Nivel Primary Care Database. Multilevel linear regression analyses were performed to investigate weight change after dietetic treatment and to explore associations with patient characteristics.

Results: In total, data were evaluated from 56 dietetic practices and 4722 patients with a body mass index (BMI) ≥ 25 kg/m2. The mean treatment time was 3 hours within an average timeframe of 5 months. Overall, patients had a mean weight change of -3.5% (95% CI: -3.8; -3.1) of their initial body weight, and a quarter of the patients reached a weight loss of 5% or more, despite the fact that most patients did not meet the recommended treatment duration of at least one year. The mean BMI change was -1.1 kg/m2 (95% CI: -1.2; -1.0). Higher weight reductions were shown for patients with a higher initial BMI and for patients with a longer treatment time. Sex and age were not associated with weight change, and patients with other dietetic diagnoses, such as diabetes, hypertension, and hypercholesterolemia, had lower weight reductions.

Conclusions: This study showed that dietetic treatment in primary health care coincided with modest weight reduction in patients with overweight. The weight loss goals were not reached for most patients, which was possibly due to a low treatment adherence.

Citing Articles

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Verberne L, Leemrijse C, Nielen M, Friele R BMC Nutr. 2020; 6(1):62.

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References

Phung O, Scholle J, Talwar M, Coleman C . Effect of noninsulin antidiabetic drugs added to metformin therapy on glycemic control, weight gain, and hypoglycemia in type 2 diabetes. JAMA. 2010; 303(14):1410-8. DOI: 10.1001/jama.2010.405. View

Millen B, Wolongevicz D, Nonas C, Lichtenstein A . 2013 American Heart Association/American College of Cardiology/the Obesity Society Guideline for the Management of Overweight and Obesity in Adults: implications and new opportunities for registered dietitian nutritionists. J Acad Nutr Diet. 2014; 114(11):1730-5. DOI: 10.1016/j.jand.2014.07.033. View

Verberne L, Hendriks M, Rutten G, Spronk I, Savelberg H, Veenhof C . Evaluation of a combined lifestyle intervention for overweight and obese patients in primary health care: a quasi-experimental design. Fam Pract. 2016; 33(6):671-677. DOI: 10.1093/fampra/cmw070. View

Kloek C, Tol J, Veenhof C, van der Wulp I, Swinkels I . Dutch General Practitioners' weight management policy for overweight and obese patients. BMC Obes. 2015; 1:2. PMC: 4472618. DOI: 10.1186/2052-9538-1-2. View

Johnstone A, Murison S, Duncan J, Rance K, Speakman J . Factors influencing variation in basal metabolic rate include fat-free mass, fat mass, age, and circulating thyroxine but not sex, circulating leptin, or triiodothyronine. Am J Clin Nutr. 2005; 82(5):941-8. DOI: 10.1093/ajcn/82.5.941. View

Finkler E, Heymsfield S, St-Onge M . Rate of weight loss can be predicted by patient characteristics and intervention strategies. J Acad Nutr Diet. 2012; 112(1):75-80. PMC: 3447534. DOI: 10.1016/j.jada.2011.08.034. View

van Esch T, Brabers A, van Dijk C, Gusdorf L, Groenewegen P, de Jong J . Increased cost sharing and changes in noncompliance with specialty referrals in The Netherlands. Health Policy. 2016; 121(2):180-188. DOI: 10.1016/j.healthpol.2016.12.001. View

Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C . Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014; 384(9945):766-81. PMC: 4624264. DOI: 10.1016/S0140-6736(14)60460-8. View

Willaing I, Ladelund S, Jorgensen T, Simonsen T, Moll Nielsen L . Nutritional counselling in primary health care: a randomized comparison of an intervention by general practitioner or dietician. Eur J Cardiovasc Prev Rehabil. 2004; 11(6):513-20. DOI: 10.1097/01.hjr.0000152244.58950.5f. View

10.

Tol J, Swinkels I, de Bakker D, Seidell J, Veenhof C . Dietetic treatment lowers body mass index in overweight patients: an observational study in primary health care. J Hum Nutr Diet. 2013; 27(5):426-33. DOI: 10.1111/jhn.12175. View

11.

Pischon T, Sharma A . Use of beta-blockers in obesity hypertension: potential role of weight gain. Obes Rev. 2002; 2(4):275-80. DOI: 10.1046/j.1467-789x.2001.00044.x. View

12.

Welty F, Nasca M, Lew N, Gregoire S, Ruan Y . Effect of onsite dietitian counseling on weight loss and lipid levels in an outpatient physician office. Am J Cardiol. 2007; 100(1):73-5. PMC: 2726994. DOI: 10.1016/j.amjcard.2007.02.056. View

13.

Mitchell L, Ball L, Ross L, Barnes K, Williams L . Effectiveness of Dietetic Consultations in Primary Health Care: A Systematic Review of Randomized Controlled Trials. J Acad Nutr Diet. 2017; 117(12):1941-1962. DOI: 10.1016/j.jand.2017.06.364. View

14.

Mertens I, Van Gaal L . Overweight, obesity, and blood pressure: the effects of modest weight reduction. Obes Res. 2000; 8(3):270-8. DOI: 10.1038/oby.2000.32. View

15.

Howatson A, Wall C, Turner-Benny P . The contribution of dietitians to the primary health care workforce. J Prim Health Care. 2015; 7(4):324-32. DOI: 10.1071/hc15324. View

16.

Jensen M, Ryan D, Apovian C, Ard J, Comuzzie A, Donato K . 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. J Am Coll Cardiol. 2013; 63(25 Pt B):2985-3023. DOI: 10.1016/j.jacc.2013.11.004. View

17.

Wing R, Lang W, Wadden T, Safford M, Knowler W, Bertoni A . Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes. Diabetes Care. 2011; 34(7):1481-6. PMC: 3120182. DOI: 10.2337/dc10-2415. View

18.

Dansinger M, Tatsioni A, Wong J, Chung M, Balk E . Meta-analysis: the effect of dietary counseling for weight loss. Ann Intern Med. 2007; 147(1):41-50. DOI: 10.7326/0003-4819-147-1-200707030-00007. View

19.

Lenoir L, Maillot M, Guilbot A, Ritz P . Primary care weight loss maintenance with behavioral nutrition: An observational study. Obesity (Silver Spring). 2015; 23(9):1771-7. PMC: 4660887. DOI: 10.1002/oby.21157. View