Moderately overweight and obese patients in general practice: a population based survey.
BACKGROUND
Obesity is a main threat to public health in the Western world and is associated with diseases such as diabetes mellitus and coronary heart diseases. Up to now a minority of research studied the relation between obesity and the use of primary health care. In the Netherlands the general practitioner (GP) is the main primary health care provider. The objective of this article is to evaluate GP consultation and prescription of drugs in moderate and severely overweight (obese) persons in the Netherlands.


METHODS
Data were used from a representative survey of morbidity in Dutch general practice in 2001. Our study sample consisted of 8,944 adult respondents (18+ years) who participated in an extensive health interview. Interview data were linked to morbidity and prescription registration data from 95 general practices where respondents were listed. Body mass index (BMI) was calculated using self-reported height and weight. Analyses were controlled for clustering within practices as well as for socio-demographic and life style characteristics.


RESULTS
Obesity (BMI > or = 30 kg/m2) was observed in 8.9% of men and 12.4% of women; for moderate overweight (BMI 25-< 30 kg/m2) these percentages were 42.2% and 30.4% respectively. Obese men and women were more likely to consult their GP than persons without overweight. This especially holds for diseases of the endocrine system, the cardiovascular system, the musculoskeletal system, the gastro-intestinal system, and skin problems. Related to this, obese men and women were more likely to receive drugs for the cardiovascular system, the musculoskeletal system, alimentary tract and metabolism (including, for example, antidiabetics), and dermatologicals, but also antibiotics and drugs for the respiratory system. For moderately overweight men and women (BMI 25- < 30 kg/m2) smaller but significant differences were found for diseases of the endocrine system, the cardiovascular system, and the musculoskeletal system.


CONCLUSIONS
Obesity increases the workload of Dutch general practitioners and the use of prescribed medication. The current increase in the prevalence of obesity will further increase the use of health care and related costs. Since a large majority of Dutch persons visit their GP over the course of one year, GPs' potential role in effective prevention strategies cannot be denied.
van Dijk
Liset
L
NIVEL, Netherlands Institute for Health Services Research, P,O, Box 1568, 3500 BN Utrecht, The Netherlands. L.vanDijk@nivel.nl
Otters
Hanneke B
HB
Schuit
Albertine J
AJ
D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000191:economics / Q000209:etiology; D015331:Cohort Studies; D015897:Comorbidity; D017281:Cost of Illness; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000191:economics / Q000209:etiology; D004363:Drug Utilization / Q000191:economics / Q000706:statistics & numerical data*; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D017048:Health Care Costs; D006306:Health Surveys; D006801:Humans; D008297:Male; D008659:Metabolic Diseases / Q000188:drug therapy / Q000191:economics / Q000209:etiology; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D009765:Obesity / Q000150:complications* / Q000191:economics / Q000453:epidemiology*; D050177:Overweight / Q000502:physiology; D011320:Primary Health Care; D018570:Risk Assessment; D012307:Risk Factors; D012871:Skin Diseases / Q000188:drug therapy / Q000191:economics / Q000209:etiology; D011795:Surveys and Questionnaires; D016526:Workload / Q000706:statistics & numerical data