Programme no. 253-P
Predictive Factors of Weight Loss among Young Adults with psychosocial Problems and Overweight
Kirsten Schierup Freund*1, Jørgen Lous2
1research unit of general practice,University of Southern Denmark,5000 Odense,Denmark, 2research unit of general practice,University of Southern Denmark,5000 Odense,Denmark
* = Presenting author
Objectives: To identify predictive factors for weight loss after one year among young adults with psychosocial problems and overweight (BMI 25-30) or obesity (BMI >30 kg/m2).
Background: In a randomized controlled trial 27 general practitioners screened 2073 patients 20-45 years old in order to offer those with most psychosocial problems a preventive health consultations with respect to the patients agenda in order to support self-efficacy. Positive results after one year on SF-12 have been published earlier.
Before intervention 46 (21 %) considered quick weight loss (within 30 days). After intervention twenty-seven (12%) had weight loss as prioritized goal and 191 had not. At one year questionnaire follow-up the 22 responders had a weight loss of 4.7 kilo compared with 1.6 kilo in those without this goal.
Predictors of weight loss after one year were: weight loss as the first priority in the health consultation (OR=4,63), pre-interventional consideration of a quick weight loss (OR=3,43), being female (OR= 2,01), having many psychosocial problems (OR=1,96). The extent of weight loss could be explained in a linear regression model for about 9%. Being obese could explain (3%), consideration of a quick weight loss (3%), living as single (2%), and randomized to intervention (1%).
Material/Methods: 28 general practitioners (GPs) included patients aged 20-45 years to participate when coming to the surgery. The quartile with most psychosocial problems or lack of resources was invited after completing a 23-pages baseline questionnaire on e.g. resources, life situation, life style and goal setting for a better life. Intervention was a one-hour preventive health consultation with their GP focused on life coaching within self-chosen goals for a better life and three month´s follow-up. Among the 218 patients with a body mass index (BMI) of 25 kg/m2 or more, goal of weight loss were analysed.
Conclusion: In our models important predictors for weight loss and the extent of this one year after the preventive health consultation could be explained by “Pre-interventional consideration of a weight loss within 30 days”, “Having weight loss as first priority” “ Having many psychosocial problems”, “Being obese”, “Living as single”, and “Randomized to the health consultation”.
Points for discussion: To support change in life style behaviour especially among those with many psychosocial problems it is important to offer patient-centred structured consultation and respect both time-setting and specific goal. This seems to be a proxy for readiness and motivation to change and important base for suporting specific self-efficacy. In this way general practitioners might contribute to minimize inequality in health.