title: Weight related health status of patients treated by dietitians in primary care practice: first results of a cohort study.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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).
authors.affiliation: 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. egovers@amstelring.nl.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Govers
authors.forename: Jacob C
authors.initials: JC
authors.lastname: Seidell
authors.forename: Marjolein
authors.initials: M
authors.lastname: Visser
authors.forename: Ingeborg A
authors.initials: IA
authors.lastname: Brouwer
mesh_terms: D000328:Adult; D000368:Aged; D001168:Arthritis / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D050171:Dyslipidemias / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D064686:Nutritionists; D009765:Obesity / Q000178:diet therapy* / Q000453:epidemiology; D050177:Overweight / Q000178:diet therapy / Q000453:epidemiology; D018579:Patient Selection; D011320:Primary Health Care; D011446:Prospective Studies; D012044:Regression Analysis; D012108:Research Personnel; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000453:epidemiology; D016896:Treatment Outcome; D061217:Weight Reduction Programs; D055815:Young Adult