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Overweight and obesitas: effect on GP consultation and the use of medication.

Dijk, L. van, Otters, H., Schuit, J. Overweight and obesitas: effect on GP consultation and the use of medication. European Journal of Public Health: 2004, 14(4 Suppl.) 87. Abstract. 12 th Annual EUPHA meeting: Urbanisation and health: new challenges in health promotion and prevention in Oslo, Norway, 7-9 october 2004.
Background: Most research on health consequences of obesitas examined differences in occurrences of specific health problems such as diabetes mellitus and coronary heart disease and related use of care, rather than investigating differences in the use of care in general, such as rate GP consultation and use of medication in general. Aim: To examine differences in GP consultation and use of prescribed and self-medication between adults (18 years and older) with and without overweight/obesitas. Methods: Data from the Second Dutch National Survey of General Practice
(DNSGP-2) were used. During this representative survey of morbidity in 104 Dutch general practices in 2001, a random sample of almost 10,000 persons of 18 years and older responded to a health interview including questions on self medication. Data from 96 practices with 9062 respondents were included. Body mass index (BMI) was calculated using self reported weight and height. Interview data were linked to morbidity and prescription data from the GPs’ registrations. Data were analysed using multilevel analyses to take into account the clustering of respondents within practices. Outcome variables were the number of consultations and the number of different medications within the year of registration. Analyses were controlled for confounding variables such as gender, age and socio-economic status. Results: Of all respondents, 11% was obese (BMI: 30+) and another 36% was overweight (BMI: 25-30). Men reported more overweight than women, but women more often were obese. Old age and obesitas/ overweight are positively correlated, except for the eldest age category (75 years and older). Preliminary results showed that already at young age (18-24 years) obese persons consult their GP more often and use more medication. Differences between obese persons and non-overweight persons increased during the life course, but differences became smaller after the age of 75 years. Differences between overweight and non-overweight persons were much smaller; the largest differences were found in the age 55-74 years (both for men and women). After controling for socio-economic status, age and sex differences in GP consultation and use of medication between the three categories of BMI still were significant. Conclusions: From young adulthood onwards, obesitas leads to an increase of GP consultation and use of medication. Because of the high consultation rates of obese persons, general practitioners could play an important role in treatment and prevention and a more active role of GPs is recommended.
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