Influence of intense multidisciplinary follow-up and orlistat on weight reduction in a primary care setting.
BACKGROUND
Obesity is the most common health problem in developed countries. Recently, several physicians' organizations have issued recommendations for treating obesity to family physicians, including instructions in nutrition, physical activity and medications. The aim of this study was to examine if effective weight-reducing treatment can be given by a family physician. It compares regular treatment with intensive treatment that include close follow-up and orlistat treatment.


METHODS
The study was conducted in three primary care clinics. 225 patients were divided into three groups according to their choice. Group A received a personal diet with fortnightly meetings with the family physician and dietitian and orlistat treatment. Group B received a general diet, monthly meetings with the family physician only and orlistat treatment. Group C received a personal diet, monthly meetings with the dietitian only and no drug treatment. The primary endpoint was reduction of at least 5% of the initial weight during the study period.


RESULTS
A greater percentage of patients in group A achieved their weight reduction goals than in other groups (51%, 13% and 9% in groups A, B and C, respectively, p < 0.001). There was a significant reduction in triglycerides in all groups, a significant reduction of low density lipids (LDL) in groups A and B and no significant difference in high density lipids (HDL) in any group.


CONCLUSIONS
Significant weight reduction was obtained in a family physician setting. Further research is needed to evaluate if, by providing the family physician with the proper tools, similar success can be achieved in more clinics.
Feigenbaum
Amiel
A
Department of Family Medicine, Sackler School of Medicine, Tel Aviv University; Tel Aviv, Israel. amielfe@netvision.net.il
Pasternak
Shmuel
S
Zusk
Efrat
E
Sarid
Miri
M
Vinker
Shlomo
S
D000328:Adult; D019440:Anti-Obesity Agents / Q000627:therapeutic use*; D015992:Body Mass Index; D003266:Continuity of Patient Care; D004038:Diet, Reducing; D005194:Family Practice / Q000592:standards*; D005260:Female; D006302:Health Services Research; D006801:Humans; D007557:Israel; D007783:Lactones / Q000627:therapeutic use*; D008049:Lipase / Q000037:antagonists & inhibitors*; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy* / Q000188:drug therapy*; D000077403:Orlistat; D010348:Patient Care Team; D011320:Primary Health Care / Q000592:standards*; D016896:Treatment Outcome; D015431:Weight Loss / Q000187:drug effects
D019440:Anti-Obesity Agents; D007783:Lactones; D008055:Lipids; D000077403:Orlistat; D008049:Lipase