One-Year Evaluation of Family Medicine Obesity Clinic Applications

Yıl 2019, , 481 - 486, 20.12.2019

Emre Yılmaz Pemra Cöbek Ünalan , Arzu Uzuner , Burcu Başaran Güngör

https://doi.org/10.21763/tjfmpc.651372

Öz

Aim/Background: Obesity is a public health problem that can affect an individual's
quality of life, causing an increase in mortality and morbidity. The
aim of the present study is to evaluate the characteristics of the obese
patients who were admitted to Family Medicine Outpatient Clinic of Marmara
University Hospital in order to improve their management. Methods: This is a descriptive study
assessing 297 patients applied to Marmara University Family Medicine Obesity
Clinic between 01/01/2014 and 01/01/2015. Participants were evaluated
retrospectively by interview and clinical observation form and a 3-day dietary
log. Results: The study included a total
of 297 participants with mean age 33.7 ± 14.8 years. Of the participants, 81.2%
were ≥19 years of age and 18.8% of them were <19 age group; 86.7% of those
≥19 years of age (n = 209) were women; 65.6% had chronic diseases and education
level of 58% was secondary school and under. Females’ education level was lower
than males and they had more chronic diseases than men; and more diet
experiences (p<0.002, p<0.027,
p<0.001). Those who had diet experience before are willing to lose more weight
(p<0.021). Mean body mass index
(BMI) was higher in patients with chronic diseases, who were married and ho had
low level of education (p<0.001,
p<0.007, p<0.004). Conclusion: Individuals
admitted to the obesity outpatient clinic were mostly women who had a lower
education, who had more chronic illnesses and more attempts to lose weight
previously. Obesity management should be planned according to these
characteristics. In addition, all patients who admit to Family Medicine
Outpatient Clinics for any reason and detected to have a high BMI should be
referred to Obesity Clinic and supported for losing weight.

Giriş ve Amaç: Obezite, bireylerin yaşam kalitesini
etkileyerek mortalite ve morbiditede artışa neden olan bir hastalıktır. Bu
araştırmanın amacı Marmara Üniversitesi Aile Hekimliği polikliniklerinde obez
hasta yönetimini geliştirmek için başvuranları değerlendirmektir. Yöntem: Bu araştırma, Marmara
Üniversitesi Aile Hekimliği obezite polikliniğine 01.01.2014-01.01.2015
tarihleri arasında başvuran hastaların özelliklerini değerlendiren tanımlayıcı
tipte bir araştırmadır. Katılımcılar, görüşme ve klinik izlem formu ile
birlikte 3 günlük yeme günlüğü ile retrospektif olarak değerlendirilmiştir. Bulgular: Toplam 297 katılımcının yaş
ortalaması 33.7±14,8 yıldır. Katılımcıların %81,2’si ≥19 yaş, %18,8’i <19
yaş grubundadır. ≥19 yaş olanların %86,7’si (n=209) kadın olup; %65,6’sının bir
kronik hastalığı vardır, %58’inin eğitim durumu ortaokul ve altı düzeydedir.
Kadınlar erkeklere göre daha düşük eğitim seviyesi ve daha çok kronik hastalığa
sahip, daha önceden diyet yapma deneyimleri daha çoktur (p<0.002, p<0.027, p<0.001). Daha önceden diyet yapmış olanların vermek istedikleri
kilo daha çoktur (p<0.021).
BKİ ortalaması; düşük eğitim seviyesindekilerde, evlilerde ve kronik hastalığı
olanlarda daha yüksek bulunmuştur (p<0.001,
p<0.007, p<0.004). Sonuç: Marmara
Üniversitesi Aile Hekimliği obezite polikliniğine başvuran kişiler, erkeklere
göre eğitim düzeyi düşük, daha çok kronik hastalığa sahip ve kilo vermeyi daha
önceden de denemiş olan kadınlardır. Obezite yönetimi bu özelliklere göre
planlanmalıdır. Ayrıca aile hekimliği polikliniklerine herhangi bir nedenle
başvuran ve BKİ’si yüksek saptanan tüm hastalar obezite polikliniğine
yönlendirilmeli, kilo verme konusunda desteklenmelidir.

Anahtar Kelimeler

Obesity, family medicine, primary care, obesity management

Kaynakça

• 1. The GBD 2013 Obesity Collaboration. Global, regional and national prevalence of overweight and obesity in children and adults 1980-2013: A systematic analysis. Lancet.2014; 384(9945): 766-781.
• 2. Swinburn BA, Sacks G, Hall DK, McPherson K, Finegood DT, Moodie ML, Gortmaker SL. The global obesity pandemic: shaped by global drivers and local environments. Lancet 2011; 378: 804–14.
• 3. World Health Organization. Global Status Report on noncommunicable diseases. 2014.Switzerland. Accessed on http://www.who.int/nmh/publications/ncd-status-report-2014/en/ at 17.07.2018
• 4. Dietz WH, Robinson TN. Clinical practice. Overweight children and adolescents. N Engl J Med. 2005; 352(20): 2100-9.
• 5. The Emerging Risk Factors Collaboration. Separate and combined associations of body-mass index and abdominal adiposity with cardiovascular disease: collaborative analysis of 58 prospective studies. Lancet.2011; 377:1085–95.
• 6. Prospective Studies Collaboration. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet.2009; 373: 1083–96.
• 7. Finkelstein EA, Trogdon JG, Cohen JW, Dietz W. Annual Medical Spending Attributable to Obesity: Payer-And Service-Specific. Health Affairs.2009; 28(5): 822-83.
• 8. Satman I, Omer B, Tutuncu Y et al Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol.2013;28:169–180.
• 9. Compernolle S, Decocker K, Abbott G. Do sedantery behaviours mediate associations between socio-demographic characteristics and BMI in women living in socio-economically disadvantaged neighborhoods. International Journal of Behavioral Nutrition and Physical Activity.2015; 12:48.
• 10. Bakhshi E, Eshraghian MR, Mohammad K, Foroushani AR, Zeraati H, Fotouhi A et al. Sociodemographic and smoking associated with obesity in adult women in Iran: Results from the National Health Survey. J Public Health. 2008; 30:429-35.
• 11. Alvarez AG, Majem LS, Barba LR, Castell C, Faz M, Uauy R et al. Obesity and overweight trends in Catalonia, Spain (1992-2003): Gender an socio-economic determinants. Public Health Nutr. 2007; 10:1368-78.
• 12. Fouad MF, Rastam S, Ward KD, Maziak W. Prevalence of Obesity and Its Associated Factors in Allepo, Syria. Prev Control. 2006; 2:85-94.
• 13. Maskarinec G, Takata Y, Pagano I, Carlin L, Goodman M, Marchand L, Nomura A. Trends and Dietary Determinants of Overweight and Obesity in A Multiethnic Population. Obesity. 2006; 14:717-26.
• 14. Hosseinpour NS, Mirmiran P, Hosseinpanah GF, Azizi F. Association of Marital Status and Marital Transition With Metabolic Syndrome: Tehran Lipid and Glucose Study. Int J Endocrinol Metab. 2014; 12(4): e18980.
• 15. Álvarez AG et al Obesity and overweight trends in Catalonia, Spain (1992–2003): gender and socio-economic determinants. Public Health Nutrition.2007;10(11A):1368–1378.
• 16. MF Fouad et al Prevalence of obesity and its associated factors in Aleppo, Syria.Prev Control. 2006; 2(2): 85–94.
• 17. Maskarinec G et al Trends and Dietary Determinants of Overweight and Obesity in a Multiethnic Population. Obesity (Silver Spring).2006; 14(4): 717-26.
• 18. Hosseinpour NS et al Association of Marital Status and Marital Transition withMetabolic Syndrome: Tehran Lipid and Glucose Study.Int J Endocrinol Metab.2014; 12(4): e18980.
• 19. Foster GD et al What is a reasonable weight loss? Patients' expectations and evaluations of obesity treatment outcomes.J Consult Clin Psychol. 1997; 65(1): 79-85.
• 20. National Institutes of Health, National Heart, Lung, and Blood Institute, North American Association for The Study of Obesity.The Practical Guide Identification, Evaluation, and Treatment of Overweight and Obesity in Adults.2013. Accessed on http://www.nhlbi.nih.gov/files/docs/guidelines/prctgd_c.pdfat 17.07.2018
• 21. Wing RR, Pinto AM, Niemeier H. Maintenance: The Ultimate Goalin A ClinicalManagament of Overweight and Obese Children and Adults.Apovian CM, Lenders CM. First Edition.Taylor and Francis, Florida.2007: 192.