title: Multimorbidity and weight loss in obese primary care patients: longitudinal study based on electronic healthcare records.
abstract: OBJECTIVE
  To analyse the association between cardiovascular and mental comorbidities of obesity and weight loss registered in the electronic primary healthcare records.
  
  
  METHODS
  Longitudinal study of a cohort of adult patients assigned to any of the public primary care centres in Aragon, Spain, during 2010 and 2011.
  
  
  METHODS
  Adult obese patients for whom data on their weight were available for 2010 (n=62,901), and for both 2010 and 2011 (n=42,428).
  
  
  RESULTS
  Weight loss (yes/no) was calculated based on the weight difference between the first value registered in 2010 and the last value registered in 2011. Multivariate logistic regression models were adjusted for individuals' age, sex, total number of chronic comorbidities, type of obesity and length of time between both weight measurements.
  
  
  RESULTS
  According to the recorded clinical information, 9 of 10 obese patients showed at least one chronic comorbidity. After adjusting for covariates, weight loss seemed to be more likely among obese patients with a diagnosis of diabetes and/or dementia and less likely among those with hypertension, anxiety and/or substance use problems (p<0.05). The probability of weight loss was also significantly higher in male patients with more severe obesity and older age.
  
  
  CONCLUSIONS
  An increased probability of weight loss over 1 year was observed in older obese male patients, especially among those already manifesting high levels of obesity and severe comorbidities such as diabetes and/or dementia. Yet patients with certain psychological problems showed lower rates of weight reduction. Future research should clarify if these differences persist beyond potential selective weight documentation in primary care, to better understand the trends in weight reduction among obese patients and the underlying role of general practitioners regarding such trends.
authors.affiliation: EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, Spain University of Zaragoza, Zaragoza, Spain Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Carlos III Health Institute, Zaragoza, Spain.
authors.forename: Amaia
authors.initials: A
authors.lastname: Calderón-Larrañaga
authors.affiliation: University of Zaragoza, Zaragoza, Spain.
authors.forename: Paola
authors.initials: P
authors.lastname: Hernández-Olivan
authors.affiliation: EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, Spain University of Zaragoza, Zaragoza, Spain Delicias Sur Health Centre, Zaragoza, Spain.
authors.forename: Francisca
authors.initials: F
authors.lastname: González-Rubio
authors.affiliation: EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, Spain University of Zaragoza, Zaragoza, Spain San Pablo Health Centre, Zaragoza, Spain.
authors.forename: Luis A
authors.initials: LA
authors.lastname: Gimeno-Feliu
authors.affiliation: EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, Spain Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Carlos III Health Institute, Zaragoza, Spain.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Poblador-Plou
authors.affiliation: EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, Spain University of Zaragoza, Zaragoza, Spain Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Carlos III Health Institute, Zaragoza, Spain.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Prados-Torres
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000150:complications; D001008:Anxiety Disorders / Q000150:complications; D002908:Chronic Disease; D003704:Dementia / Q000150:complications; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000150:complications*; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000523:psychology; D009767:Obesity, Morbid / Q000150:complications / Q000523:psychology; D011320:Primary Health Care; D013030:Spain; D019966:Substance-Related Disorders / Q000150:complications; D015431:Weight Loss; D055815:Young Adult
keywords: PRIMARY CARE