Govers Elisabeth, Seidell Jacob C, Visser Marjolein, Brouwer Ingeborg A
Department of Health Sciences and the EMGO Institute for Health and Care Research, Faculty of Earth and Life Sciences, VU University Amsterdam, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands.
BMC Fam Pract. 2014 Sep 25;15:161. doi: 10.1186/1471-2296-15-161.
Overweight and obesity are common in the Netherlands: in 2006 51% of adult men and 42% of adult women were overweight; 10% of men and 12% of women were obese. Patients with overweight or obesity in the Netherlands are often referred to dietitians in primary care for weight loss treatment. We followed a prospective observational cohort to study the effectiveness of this treatment and present the baseline results in this article.
We invited dietitians throughout the country, who completed at baseline a questionnaire for each patient including weight, stature, waist circumference, age, gender, morbidities, medication, education level, ethnicity, referral, treatment expectations, history of previous weight loss attempts, and exercise.
At baseline data from 1546 patients were obtained from 158 dietitians working in 26 practices. The majority (73%) of patients were obese (BMI ≥ 30 kg/m2); and 10% had a BMI of 40 kg/m2 or more. The majority of patients (94%) had a high to extremely high weight related health risk (WRHR): (BMI 25-30 kg/m2 with comorbidities, or BMI 30-35 kg/m2 without comorbidities, up to BMI ≥35 with comorbidities and BMI ≥40 with or without comorbidities). More than half (57%) had comorbidities and a long history of weight loss attempts. An extremely high WRHR was seen in 24.5% of the sample. Patients with very high to extremely high WRHR often had type 2 diabetes mellitus; hypertension; dyslipidaemia; osteo arthritis; and sleep apnoea. Patients of middle and old age had a higher risk for very high and extremely high WRHR. Those with other comorbidities and those who asked for referral themselves had a lower risk.
The study was effective in recruiting dietitians to participate. The sample is representative for dietitians working in primary care. The majority of patients (94%) had a high to extremely high weight related health risk (WRHR).
超重和肥胖在荷兰很常见：2006年，51%的成年男性和42%的成年女性超重；10%的男性和12%的女性肥胖。荷兰超重或肥胖患者常被转介至初级保健机构的营养师处接受减肥治疗。我们对一个前瞻性观察队列进行了随访，以研究这种治疗的效果，并在本文中呈现基线结果。
我们邀请了全国各地的营养师，他们在基线时为每位患者填写了一份问卷，内容包括体重、身高、腰围、年龄、性别、疾病、用药情况、教育水平、种族、转诊情况、治疗期望、既往减肥尝试史和运动情况。
在基线时，从26个诊所工作的158名营养师那里获得了1546名患者的数据。大多数（73%）患者肥胖（BMI≥30kg/m²）；10%的患者BMI为40kg/m²或更高。大多数患者（94%）有高到极高的体重相关健康风险（WRHR）：（BMI 25 - 30kg/m²且有合并症，或BMI 30 - 35kg/m²无合并症，直至BMI≥35有合并症以及BMI≥40无论有无合并症）。超过一半（57%）的患者有合并症且有长期减肥尝试史。样本中24.5%的患者有极高的WRHR。WRHR非常高到极高的患者常患有2型糖尿病、高血压、血脂异常、骨关节炎和睡眠呼吸暂停。中老年患者有更高的风险出现非常高和极高的WRHR。有其他合并症的患者以及自行要求转诊的患者风险较低。
该研究成功招募到了营养师参与。该样本代表了在初级保健机构工作的营养师所接触的患者情况。大多数患者（94%）有高到极高的体重相关健康风险（WRHR）。
