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澳大利亚多学科体重管理诊所就诊次数和就诊月数与临床显著体重减轻的相关性。

Association of clinically significant weight loss with number of patient visits and months of attendance at an Australian multidisciplinary weight management clinic.

机构信息

Healthy Weight Clinic, MQ Health, Macquarie University Hospital, Sydney, New South Wales, Australia.

Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia.

出版信息

Clin Obes. 2022 Jun;12(3):e12520. doi: 10.1111/cob.12520. Epub 2022 Mar 27.

Abstract

Despite the obesity epidemic, there are relatively few multidisciplinary obesity services in Australia, and only limited data on the effectiveness of these services. The aim of this study was to evaluate the effectiveness of a university hospital-based weight management clinic-the 'Healthy Weight Clinic' in supporting patients to achieve clinically significant weight loss (≥5% reduction in body weight), weight maintenance, and changes in body composition. A retrospective review was conducted to determine weight and associated health outcomes in patients who attended an initial consultation in the first 2 years of the clinic-between March 2017 and March 2019. Follow up was at least 1 year for all patients. Patients who underwent bariatric surgery were excluded. Of 213 total patients, 172 patients attended more than one follow-up consultation for lifestyle modification. Mean weight change and percentage total weight change at last follow-up was -6.2 kg (SD 7.4) and - 6.0% (SD 6.9), respectively. For every additional clinic follow-up, there was 21.4% increased odds of achieving clinically significant weight loss, and for every additional month of follow-up, there was 10.1% increased odds of achieving clinically significant weight loss. Twenty percent of patients (34/172) maintained ≥5% of initial body weight loss for at least 1 year. Body composition measurements were also favourable, with significant changes in percentage skeletal muscle mass of +0.8% (SD 1.5) and in percentage fat mass by -1.4% (SD 3.2). Regular support in a structured holistic multidisciplinary obesity service enables patients to achieve clinically meaningful weight loss and improved skeletal muscle mass to body fat ratio, and maintain this loss for at least 1 year. Improved weight loss was associated with more patient visits and longer duration of attendance at the clinic.

摘要

尽管肥胖症在澳大利亚呈流行趋势,但提供多学科肥胖症服务的机构却相对较少,且有关这些服务效果的数据也有限。本研究旨在评估基于大学医院的体重管理诊所——“健康体重诊所”在支持患者实现临床显著减重(体重减轻≥5%)、维持体重以及改变身体成分方面的有效性。本研究通过回顾性分析确定了在该诊所成立的前 2 年内(2017 年 3 月至 2019 年 3 月)首次就诊患者的体重和相关健康结果。所有患者的随访时间均至少为 1 年。接受减重手术的患者被排除在外。在 213 名患者中,有 172 名患者至少进行了 1 次以上的生活方式改变咨询随访。末次随访时的平均体重变化和总体重变化百分比分别为-6.2kg(SD 7.4)和-6.0%(SD 6.9)。每多进行一次诊所随访,实现临床显著减重的几率就会增加 21.4%;每多随访一个月,实现临床显著减重的几率就会增加 10.1%。20%的患者(34/172)至少 1 年内维持了初始体重减轻量的≥5%。身体成分测量也显示出有利的结果,骨骼肌量百分比增加了 0.8%(SD 1.5),体脂肪量百分比减少了 1.4%(SD 3.2)。在结构化的多学科肥胖症综合服务的定期支持下,患者可以实现临床意义上的体重减轻和骨骼肌量与体脂肪比例的改善,并将体重维持至少 1 年。体重减轻的改善与患者就诊次数的增加和在诊所就诊时间的延长有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1444/9285583/c64ca544c17b/COB-12-0-g001.jpg

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