Dietitians tackle obesity

Treatment by a dietitian in primary care proves effective for patients with severe overweight. According to an article by researchers from the Netherlands Institute for Health Services Research (NIVEL) and the VU medical center, the greatest effect of dietetic treatment was seen in heavy patients and in those who had been treated for more than six months. The article was recently published in the Journal of Human Nutrition and Dietetics.
 

Obesity is an ever increasing problem worldwide. In the US, one third of the population is overweight and a further 35.9% is severely overweight or is obese. In the Netherlands, 48% of the population is overweight and of those, nearly 12% is obese. Overweight and obesity are significant risk factors for cardiovascular diseases and diabetes – conditions which are accompanied by high health care costs. Research has shown that a weight loss of 5% can contribute to both healthier blood test results and blood pressure.
 
Body-mass index
The degree of overweight is measured by the Body-mass index (BMI) which is a person’s body weight divided by the square of the person’s height. A healthy BMI is between 18.5 and 25. A BMI between 25 and 30 represents overweight and any measurement above this represents severe overweight or obesity. The study showed that through dietetic treatment, the BMI can be reduced by nearly a whole point. This represents an average weight loss of 3%. In patients who were treated for more than six months, the BMI was reduced by a further 0.83%, a figure that represents a clinically relevant average weight loss of 5.6%. Patients who had risk factors for cardiovascular or other diseases as well as their overweight, achieved less weight loss than people who were being treated for overweight alone. This was also the case in patients with psychological problems.
 
Tailored treatment
NIVEL researcher Jacqueline Tol explains: “What we see is that patients who are treated for longer than six months have good results. Unfortunately, more than half of all those who start dietetic care drop out within six months. If we were able to find out why treatment is successful with some patients and not with others, then we would be able to better suit the treatment to the needs of the patients, which would subsequently enable a larger group of patients to benefit.”
 
Registrations
The study is based on dietetic data from NIVEL’s Dutch registration network of dietitians in primary health care. The study included data from 32 dietitians for 3,960 patients with overweight.
 
Funding
Ministry of Health, Welfare and Sport
 
Collaborating partner
VU University Amsterdam