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Obesity: under-diagnosed and under-treated in hospital outpatient departments

International Journal of Obesity volume 26, pages 581–584 (2002)Cite this article

Abstract

OBJECTIVE: This study investigated whether medically significant obesity (body mass index>30 kg/m2) is recognised effectively in hospital outpatient departments and how those identified as obese are subsequently managed.

DESIGN: A retrospective analysis of patients' hospital records (rheumatology n=108, cardiology n=257, orthopaedic n=250) established the reported prevalence of obesity and subsequent referral patterns. In addition, BMI was measured prospectively on a separate cohort (rheumatology n=188, cardiology n=203, orthopaedic n=179) to determine the true prevalence.

RESULTS: Generally, obesity management appeared minimal and inconsistent. Retrospective analysis revealed an apparently low rate of obesity (4% cardiology, 5% rheumatology and 3% orthopaedics), whilst the true prevalence was found to be 30% for cardiology, 25.1% for orthopaedics and 20.2% for rheumatology. Although this appears to show a large disparity between the apparent and the true prevalence, it is impossible to establish precisely the degree of under-estimation, as the lack of height measurements (14% only) in the retrospective sample affects the reliability of the apparent prevalence. Further comparison with the general population showed obesity to be particularly common in men attending cardiology clinics.

CONCLUSION: An outpatient clinic consultation could be a useful starting point for integrating obesity and disease management, by helping to identify obesity, initiate appropriate referrals and assist in obesity education.

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Acknowledgements

We particularly thank the clinical directors of cardiology, rheumatology and orthopaedics and the nursing staff of the outpatient department for their cooperation throughout this study.

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Authors and Affiliations

  1. Diabetes and Endocrinology Clinical Research Group, Clinical Sciences Centre, University Hospital Aintree, Liverpool, UK

    J Cleator, E Richman, KS Leong, L Mawdsley, S White & J Wilding

Authors
  1. J Cleator
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  2. E Richman
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  3. KS Leong
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  4. L Mawdsley
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  5. S White
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  6. J Wilding
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Correspondence to J Wilding.

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Cleator, J., Richman, E., Leong, K. et al. Obesity: under-diagnosed and under-treated in hospital outpatient departments. Int J Obes 26, 581–584 (2002). https://doi.org/10.1038/sj.ijo.0801945

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  • DOI: https://doi.org/10.1038/sj.ijo.0801945

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