Associations between components of primary care dietetic treatment and clinically relevant weight loss in Dutch patients with overweight and obesity

Background: In the Netherlands, primary care dietitians are the preferred health care professionals for weight management in patients living with overweight and obesity. A clinically relevant weight loss of ≥5% is associated with positive health outcomes. However, a significant proportion of patients fail to achieve ≥5% weight loss.
Objective: This study aimed to identify components in dietetic treatment that are associated with clinically relevant weight loss (≥5%) in patients with overweight and obesity in Dutch primary care.
Methods: In this retrospective study we analyzed data from patients with overweight and obesity in two databases: Health Risk Control (HRC) and ‘Diëtetiek Effectief En Toekomstbestendig’ (DIEET), covering treatment data from 2016 to 2020. We used multilevel logistic regression to assess associations between patient and treatment characteristics, and ≥5% weight loss upon conclusion of treatment.
Results: Data from 561 patients with overweight and obesity were analyzed. In the DIEET database (n= 383), ≥5 consultations (Odds Ratio (OR) 1.82, 95% Confidence Interval (CI): 1.17-12.80) and >3 hours of consultation (OR 1.57, 95% CI: 1.01-2.42)) were positively associated with ≥5% weight loss after 9 months. Patients on diabetes medication had lower odds of reaching effective/clinically relevant weight loss (OR 0.59, 95% CI: 0.37-0.95) compared to those not on diabetes medication. In the HRC database (n = 178), patients with a primary treatment aim to lose weight had higher odds of effective weight loss (OR 4.36; 95% CI: 1.95-9.74) than those focusing on cardiovascular or diabetes management.
Conclusion: These findings underline the importance of frequent and prolonged dietetic consultations in achieving effective weight loss in primary care settings. Special attention should be given to patients using diabetes medication, as they may require tailored approaches to overcome potential barriers to weight loss.