The treatment of obesity : an evaluation of different methods of administering dietary advice
Obesity is one of the most important health problems in the UK and its prevalence is increasing. It is often neglected, despite it being associated with a range of serious diseases such as coronary heart disease, hypertension, diabetes, gall stones, peptic ulcer, gout and certain cancers. Most of these are reversed by weight loss but there are concerns that many treatments available to theobese are ineffective. The obese and overweight are the largest treatment group seen by dietetic departments and utilise a large proportion of clinic time. It is important that the best, most appropriate treatment is given to these patients based on their needs but, given the shortage of dietitians in the health service and the limited timeavailable, the benefit/cost effectiveness of such work needs to be evaluated. The present study evaluated four methods of advising the obese and overweightincluding slimming groups and traditional individual counselling. The "multi-professional" approach to administering dietary advice was also reviewed using two groups in cardiac rehabilitation programmes.Dietary assessments by food records, nutrition knowledge by a questionnaire and body weight measurements were taken at the start of the study, at the end of the healthy eating programmes and 6 months after the programmes had finished. The groups advised on an individual basis were assessed at a corresponding time interval.The data obtained were compared statistically for the 6 groups. The attrition rate was highest for the subjects advised in slimming groups and lowest for the cardiac rehabilitation groups. The weight loss was highest for the subjects advised in individual consultations and lowest for the cardiac groups. The nutrition knowledge scores increased for all groups with no statistical differences between the groups. The results are reviewed and the future provision of dietetic services to the obese and overweight is discussed.
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