APH 2008, 66, 88-101:

Overweight and obesity in primary practice. A patient-based study

A. Al-Windi

Keywords: Body Mass Index (BMI), cardiovascular disease, general practice, primary care, musculoskeletal disorders

Objective:
To identify factors related to overweight and obesity in a multi-ethnic primary care practice population.

Methods:
Cross-sectional based on questionnaire survey and medical examination. Multinomial logistic regression analysis was used to identify predictors of overweight and obesity. Four hundred and seventy adult patients (≥16 years old) who visited the Jordbro Health Centre (JHC), Haninge Municipality, Stockholm, Sweden, participated in this study. Measurements: Body mass index (BMI). Overweight, defined as (BMI>25 kg/m2), and obesity (BMI>30 kg/m2) were explored in relation to sociodemographic characteristics, symptoms, chronic disease, lifestyle factors and medical tests.

Results:
In this study 68.5% were overweight or obese, i.e. had a BMI > 25 kg/m2. Among those, 39.3% were overweight and 29.2% obese. The OR for subjects born outside Sweden and overweight was 1.36 (95%CI 1.07-1.22) and for hypertension and obesity 2.60 (95%CI 1.23-5.49). Subjects with musculoskeletal disorder had a fourfold OR for obesity (OR=4.72, 95%CI 1.89-10.20). The OR for having high fasting plasma glucose and obesity was 3.83 (95%CI 1.90-7.71) while for subjects with high fasting serum triglycerides the OR for overweight was 4.75 (95%CI 2.08-10.88) and for obesity 11.80 (95%CI 4.83-28.84).

Conclusions:
Patients with musculoskeletal disorders need further attention with regard to the risk of developing obesity even if the relationship between obesity and muskuloskeletal disorders can be explained bidirectionally and it may be worthwhile to consider both as deserving attention separately and as risk factors for each other. Furthermore, this study suggests a liberal attitude toward screening for diabetes among the overweight and obese patients.