Obezite polikliniğine başvuran hastalarda başvuru sayısı ve sıklığının kilo verme başarısına etkisinin incelenmesi
Küçük Resim Yok
Tarih
2024
Yazarlar
Dergi Başlığı
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Cilt Başlığı
Yayıncı
Düzce Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş ve Amaç: Obezite, küresel çapta giderek artış gösteren bir sağlık sorunu haline gelmiştir. Aşırı kilolu veya obez bireylerde sağlık durumunu olumsuz etkileyen birçok hastalığın riskini artırdığı bilinmektedir. Bu nedenle, obeziteyle mücadele etmek ve sağlıklı kilo kaybını teşvik etmek önemli bir halk sağlığı önceliği haline gelmiştir. Obezite yönetimine ilişkin tedavi yaklaşımlarının etkinliği ve başarısı, başvuru sayısı ve sıklığının da dikkate alınması gereken önemli faktörler arasındadır. Literatürde obezite hastalarında başvuru sayısı, başvuru sıklığı ile ilgili yapılan çalışma sayısının nispeten daha az olduğu, vizit sayısı ve hasta takibinin önemli olduğu vurgulanmıştır. Bu çalışmanın amacı obezite polikliniğine başvuran fazla kilolu obez hastalarda başvuru sayısı ve sıklığının kilo verme başarısına etkisinin incelenmesidir. Yöntem: Bu retrospektif gözlemsel çalışmaya Düzce Üniversitesi Aile Hekimliği Obezite Polikliniğine 01.01.2018-31.12.2022 tarihleri arasında kilo verme isteğiyle başvuran, en az 2 vizite gelen, 18 yaş üstü fazla kilolu (VKİ≥25) ve obez (VKİ≥30) hastalar dahil edilmiştir. VKİ'yi etkileyecek derecede hastalıklara (kronik kalp hastalığı, kronik böbrek hastalığı vb. gibi) sahip olanlar, psikiyatrik yeme bozukluğu tanısı almış olan hastalar, gebe olanlar ve sadece bir defa başvurusu olan hastalar çalışmaya dahil edilmemiştir. Hastaların takiplerindeki ilk, son ve en düşük kiloları, bu değerlere ulaşılması için geçen süreler, takiplerde bakılan kan lipit değerleri, HOMA-IR ve Tanita (vücut kompozisyonları) verileri incelendi. Retrospektif olarak toplanan bu veriler analiz edilip kilo verme başarısı ile hastaların takip süreci boyunca vizit sayısı ve sıklığı arasındaki ilişki değerlendirildi. Bulgular: Çalışmaya 1531 obez ve fazla kilolu hasta dahil edildi. Katılımcıların %84,20'si (n=1306) kadın, %15,80'i (n=245) erkekti. Yaş ortalamaları 39,28±12,6, ilk VKİ ortalaması 35,74±6,66, en düşük VKİ ortalaması 33,87±6,41, son VKİ ortalaması 34,61±6,41, en yüksek kilo ortalaması 94,59±18,14, en düşük kilo ortalaması 88,35±17,31, son kilo ortalaması 90,26±17,82, en fazla verilen kilo ortalaması 4,86±5,43 olarak bulundu. Hastaların obezite ile ilişkili hastalıklarına bakıldığında %17,92 (n=278) ile en sık hipertansiyon görüldü. Takiplerde %16,26 hastanın hiç kilo veremediği (n=249), %43,31 hastanın %0-5 arasında kilo verdiği(n=663), %25,41 hastanın %5-10 arasında kilo verdiği (n=389), %9,34 hastanın %10-15 arasında kilo verdiği (n=143), %5,68 hastanın %15 den fazla kilo verdiği (n=87) tespit edildi. Toplam vizit sayısı ve yıllık vizit sayısı değerleri kilo verme başarısı açısından anlamlı parametreler olarak bulundu (p<0,001). İstatiksel olarak anlamlılık gösteren kesim noktaları ise toplam vizit sayısı için 5,5 (duyarlılık=%55 özgüllük=%82, AUC=0,757) ve yıllık vizit sayısı için 1,46 (duyarlılık=%72 özgüllük=%59, AUC=0,721) olarak bulunmuştur. Sonuç: Bu çalışmada, obezite tedavisinde sık başvurunun ve yoğun bireysel danışmanlığın kilo verme başarısını artırabileceği ve kaybedilen kiloların uzun süre korunmasına yardımcı olabileceği sonucuna varılmıştır. Bireylerin kilo verme hedeflerine ulaşması ve kilo kontrolünü uzun süre sürdürebilmesi için bireysel danışmanlık ve motivasyonel desteğin önemi vurgulanmalıdır.
Introduciton and Aim: Obesity has become an increasingly global health problem. It is known that overweight or obese individuals increase the risk of many diseases that negatively affect their health. Therefore, combating obesity and promoting healthy weight loss has become an important public health priority. The effectiveness and success of treatment approaches to obesity management, as well as the number and frequency of applications, are among the important factors that should be taken into consideration. It has been emphasized in the literature that the number of studies on the number of applications and frequency of applications in obesity patients is relatively low, and that the number of visits and patient follow-up are important. The aim of this study is to examine the effect of the number and frequency of admissions on weight loss success in overweight and obese patients who apply to the obesity clinic. The aim of this study is to examine the effect of the number and frequency of admissions on weight loss success in overweight and obese patients who apply to the obesity clinic. Method: This retrospective observational study included patients who applied to Düzce University Family Medicine Obesity Polyclinic between 01.01.2018 and 31.12.2022 with the desire to lose weight, attended at least 2 visits, were over 18 years of age and were overweight (BMI≥25) and obese (BMI≥30) patients were included. Those with diseases that affect BMI (such as chronic heart disease, chronic kidney disease, etc.), patients diagnosed with psychiatric eating disorders, patients who were pregnant, and patients who applied only once were not included in the study. The patients' first, last and lowest weight during their follow-up, the time it took to reach these values, blood lipid values during follow-up, HOMA-IR and Tanita (body composition) data were examined. These retrospectively collected data were analyzed and the relationship between weight loss success and the number and frequency of visits of the patients during the follow-up period was evaluated. Results: 1531 obese and overweight patients were included in the study. 84.20% (n=1306) of the participants were women and 15.80% (n=245) were men. Average age is 39.28±12.6, initial BMI average is 35.74±6.66, lowest BMI average is 33.87±6.41, final BMI average is 34.61±6.41, highest weight average is 94, 59±18.14, the lowest average weight was 88.35±17.31, the final average weight was 90.26±17.82, and the highest average weight was 4.86±5.43. When the obesity-related diseases of the patients were examined, hypertension was the most common with 17.92% (n = 278). During follow-up, 16.26% of the patients could not lose any weight (n=249), 43.31% of the patients lost 0-5% of the weight (n=663), and 25.41% of the patients lost 5-10% of the weight (n=389). It was determined that 9.34% of the patients lost 10-15% of their weight (n=143), and 5.68% of the patients lost more than 15% of their weight (n=87). Total number of visits and annual number of visits were found to be significant parameters in terms of weight loss success (p<0.001). The statistically significant cut-off points were 5.5 (sensitivity=55% specificity=82%, AUC=0.757) for the total number of visits and 1.46 (sensitivity=72% specificity=59%, AUC=0.721) for the annual number of visits. Conclusion: This study concluded that frequent application and intensive individual counseling in obesity treatment can increase the success of weight loss and help maintain the lost weight for a long time. The importance of individual counseling and motivational support should be emphasized in order for individuals to achieve their weight loss goals and maintain weight control for a long time.
Introduciton and Aim: Obesity has become an increasingly global health problem. It is known that overweight or obese individuals increase the risk of many diseases that negatively affect their health. Therefore, combating obesity and promoting healthy weight loss has become an important public health priority. The effectiveness and success of treatment approaches to obesity management, as well as the number and frequency of applications, are among the important factors that should be taken into consideration. It has been emphasized in the literature that the number of studies on the number of applications and frequency of applications in obesity patients is relatively low, and that the number of visits and patient follow-up are important. The aim of this study is to examine the effect of the number and frequency of admissions on weight loss success in overweight and obese patients who apply to the obesity clinic. The aim of this study is to examine the effect of the number and frequency of admissions on weight loss success in overweight and obese patients who apply to the obesity clinic. Method: This retrospective observational study included patients who applied to Düzce University Family Medicine Obesity Polyclinic between 01.01.2018 and 31.12.2022 with the desire to lose weight, attended at least 2 visits, were over 18 years of age and were overweight (BMI≥25) and obese (BMI≥30) patients were included. Those with diseases that affect BMI (such as chronic heart disease, chronic kidney disease, etc.), patients diagnosed with psychiatric eating disorders, patients who were pregnant, and patients who applied only once were not included in the study. The patients' first, last and lowest weight during their follow-up, the time it took to reach these values, blood lipid values during follow-up, HOMA-IR and Tanita (body composition) data were examined. These retrospectively collected data were analyzed and the relationship between weight loss success and the number and frequency of visits of the patients during the follow-up period was evaluated. Results: 1531 obese and overweight patients were included in the study. 84.20% (n=1306) of the participants were women and 15.80% (n=245) were men. Average age is 39.28±12.6, initial BMI average is 35.74±6.66, lowest BMI average is 33.87±6.41, final BMI average is 34.61±6.41, highest weight average is 94, 59±18.14, the lowest average weight was 88.35±17.31, the final average weight was 90.26±17.82, and the highest average weight was 4.86±5.43. When the obesity-related diseases of the patients were examined, hypertension was the most common with 17.92% (n = 278). During follow-up, 16.26% of the patients could not lose any weight (n=249), 43.31% of the patients lost 0-5% of the weight (n=663), and 25.41% of the patients lost 5-10% of the weight (n=389). It was determined that 9.34% of the patients lost 10-15% of their weight (n=143), and 5.68% of the patients lost more than 15% of their weight (n=87). Total number of visits and annual number of visits were found to be significant parameters in terms of weight loss success (p<0.001). The statistically significant cut-off points were 5.5 (sensitivity=55% specificity=82%, AUC=0.757) for the total number of visits and 1.46 (sensitivity=72% specificity=59%, AUC=0.721) for the annual number of visits. Conclusion: This study concluded that frequent application and intensive individual counseling in obesity treatment can increase the success of weight loss and help maintain the lost weight for a long time. The importance of individual counseling and motivational support should be emphasized in order for individuals to achieve their weight loss goals and maintain weight control for a long time.
Açıklama
Anahtar Kelimeler
Aile Hekimliği, Family Medicine, Obezite, beden kitle indeksi, kilo verme, vizit sayısı, başvuru sıklığı, Obesity, body mass index, weight loss, number of visits, frequency of visits
