The Association between a Recorded Diagnosis of Obesity and Clinically Significant Weight Loss in the Primary Care Setting: A Nationwide Registry.

IF 3.9 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Obesity Facts Pub Date : 2024-10-21 DOI:10.1159/000542080

Michal Kasher Meron, Nira Koren-Morag, Dan Oieru

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Abstract

Introduction: Overweight and obesity (OW/OB) are underdiagnosed. The primary aim was to assess whether a diagnosis of OW/OB recorded by a primary care physician (PCP) is associated with clinically significant weight loss, compared to a missed diagnosis. The secondary aim was to investigate the association between OW/OB diagnosis and patient attendance at dietary consultations.

Methods: This retrospective, observational cohort study was conducted using a nationwide healthcare database. The study included a random sample of 200,000 adults with BMI ≥25 kg/m2, recorded on a primary care visit, between 2014 and 2020. Patients with prior diagnosis of OW/OB or obesity-related complications were excluded. The independent variable was OW/OB diagnosis recorded by the PCP immediately after BMI measurement. The outcome variable was ≥5% weight loss at a second weight measurement within 9-15 months. Multivariate regression analysis was applied.

Results: Of the 200,000 people with OW/OB, 36,033 (18.0%) had a diagnosis of OW/OB, and 37,368 (18.7%) had a second body weight measurement, of which 7,635 (20.4%) lost ≥5% of their baseline body weight. The prescription rate of anti-obesity medication was 1.2% and did not differ between patients who achieved weight loss and those who did not. Those with a recorded diagnosis were 2.6 times more likely to visit a dietitian (odds ratio [OR] 2.57, 95% confidence interval [CI]: 2.56-2.64) and 2.5 times more likely to achieve weight loss (OR 2.53, 95% CI: 2.46-2.60). After adjusting for multiple confounders, including attendance at dietary consultation, people who received OW/OB diagnosis were 32% more likely to achieve weight loss (OR 1.32, 95% CI: 1.28-1.36, p < 0.001) compared to people with missed diagnosis.

Conclusions: Recording a diagnosis of obesity among relatively healthy people is associated with clinically significant weight loss at 1-year follow-up, independent of attendance at dietary consultation. Early obesity diagnosis is a significant opportunity to promote weight loss in the primary care setting and may affect weight trajectory.

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基层医疗机构中肥胖症诊断记录与临床显著体重减轻之间的关联：全国范围内的登记

简介超重和肥胖症（OW/OB）的诊断率很低。研究的主要目的是评估与漏诊相比，由初级保健医生（PCP）记录的超重/肥胖诊断是否与临床上显著的体重减轻有关。次要目的是调查OW/OB诊断与患者参加饮食咨询之间的关联：这项回顾性、观察性队列研究是利用一个全国性的医疗保健数据库进行的。研究随机抽取了 20 万名体重指数（BMI）≥ 25 kg/m2 的成年人，这些人在 2014-2020 年间接受了初级保健就诊记录。之前诊断出OW/OB或肥胖相关并发症的患者被排除在外。自变量为 BMI 测量后初级保健医生立即记录的 OW/OB 诊断。结果变量是在9-15个月内第二次测量体重时体重下降≥5%。采用多变量回归分析：在 20000 名 OW/OB 患者中，有 36 033 人（18.0%）确诊为 OW/OB，有 37 368 人（18.7%）进行了第二次体重测量，其中有 7 635 人（20.4%）的体重下降≥基线体重的 5%。抗肥胖药物处方率为 1.2%，体重减轻和体重未减轻的患者之间没有差异。有诊断记录的患者去看营养师的几率是前者的 2.6 倍（OR 2.57，95%CI 2.56-2.64），体重减轻的几率是前者的 2.5 倍（OR 2.53，95%CI 2.46-2.60）。在对包括参加饮食咨询在内的多种混杂因素进行调整后，获得 OW/OB 诊断的人与漏诊的人相比，体重减轻的可能性要高出 32% （OR 1.32 95%CI 1.28-1.36，p<0.001）：结论：在相对健康的人群中记录肥胖诊断与随访 1 年的临床显著体重减轻有关，与参加饮食咨询无关。早期肥胖诊断是初级保健中促进体重减轻的一个重要机会，并可能影响体重轨迹。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Obesity Facts 医学-内分泌学与代谢

CiteScore

6.80

自引率

5.60%

发文量

审稿时长

6-12 weeks

期刊介绍： ''Obesity Facts'' publishes articles covering all aspects of obesity, in particular epidemiology, etiology and pathogenesis, treatment, and the prevention of adiposity. As obesity is related to many disease processes, the journal is also dedicated to all topics pertaining to comorbidity and covers psychological and sociocultural aspects as well as influences of nutrition and exercise on body weight. The editors carefully select papers to present only the most recent findings in clinical practice and research. All professionals concerned with obesity issues will find this journal a most valuable update to keep them abreast of the latest scientific developments.