Recognition and management of overweight and obesity in primary care in Germany

摘要: BACKGROUND: In contrast to the well-documented high prevalence of overweight and obesity in general population, prevalence, recognition rates management by primary care physicians—as core gatekeeper health system—remains poorly studied. PURPOSE OF THE STUDY: To examine (1) point (BMI 25.0–29.9 kg/m2) (BMI≥30 kg/m2) patients, (2) patterns patients with high-risk constellations (diabetes, hypertension, cardiovascular disease, etc.), (3) doctors' interventions, as well patients' use perceived effectiveness weight-loss interventions (4) factors associated non-treatment. METHODS: Cross-sectional study 45 125 unselected consecutive attendees recruited from a representative nationwide sample 1912 practices. Measures: standardized clinical appraisal each patient physician (diagnostic status recognition, severity, comorbidity, current past interventions). Patient self-report questionnaire: height weight, illness history, treatments their effectiveness, attitudes behaviors. RESULTS: all, 37.9% all were overweight, 19.4% obese. Rates for highest diabetes (43.6 36.7%) hypertension (46.1 31.3%), followed disorders. overweight/obesity increased steadily number comorbid conditions. Doctors' (20–30%) (50–65%) was low, actual weight control even lower (past 12 months: 8–11%, lifetime: 32–39%). success quite limited. Co- multimorbidity particular other variables identified predictors but prediction loss CONCLUSIONS: Primary is largely deficient, predominantly due four interrelated factors: poor status, inefficient efforts at intervention, acceptance such dissatisfaction existing life-style modification strategies.