Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Asia Pacific Family Medicine
Published in: Asia Pacific Family Medicine 1/2015

Open Access 01-12-2015 | Research

Interventions for body weight reduction in obese patients during short consultations: an open-label randomized controlled trial in the Japanese primary care setting

Authors: Satoshi Kanke, Takumi Kawai, Naomi Takasawa, Yukiko Mashiyama, Atsushi Ishii, Ryuki Kassai

Published in: Asia Pacific Family Medicine | Issue 1/2015

Login to get access

Abstract

Background

Family physicians should maintain regular contact with obese patients to ensure they effectively reduce their body weight. However, family physicians in Japan have on average only 6 (min) per consultation, and conventional interventions for body weight reduction require a longer consultation or additional manpower. A brief intervention within the limited consultation time available is therefore needed. Here we investigated the effectiveness of a brief weight reduction intervention for obese patients and the related factors for reducing body weight during routine consultations in the primary care setting.

Method

We conducted an open-label randomized controlled trial at a family medicine clinic in Fukushima, Japan from January 2010 to June 2011. Patients aged 30 to 69 years with body mass index ≥25 who were diagnosed with hypertension, dyslipidemia, and/or type 2 diabetes mellitus were randomly assigned to the intervention or control group. At every consultation, body weight in the intervention group was measured by a family physician who provided weight reduction advice in addition to usual care. The primary outcome was body weight change at 1-year follow up. Analysis was done by intention to treat.

Result

We randomly assigned 29 participants to the intervention group and 21 to the control group. Forty participants (80 %) remained in the trial until the 1-year follow up. At follow up, the median body weight change from baseline was not significantly different between the groups (p = 0.68), at −0.8 (interquartile range [IQR] −2.5 to 1.0) kg in the intervention group and 0.2 (IQR −2.4 to 0.8) kg in the control group.

Conclusion

We devised an intervention method for physicians to measure body weight and advise on weight reduction during routine consultations. In our setting, this method did not extend the consultation time, but also had no significant additional effects on body weight reduction in moderately obese patients.

Trial registration

This trial is registered with the UMIN Clinical Trial Registry (UMIN000002967).
Literature
1.
2.
Mokdad AH, Ford ES, Bowman BA, Dietz WH, Vinicor F, Bales VS, et al. Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA. 2003;289:76–9.CrossRefPubMed
3.
Xiao J, Yang W. Weight loss is still an essential intervention in obesity and its complications: a review. J Obes. 2012;2012:1–6.CrossRef
4.
World Health Organization. Obesity and overweight WHO fact sheet No311. 2013.
5.
6.
Kanazawa M, Yoshiike N, Osaka T, Numba Y, Zimmet P, Inoue S. Criteria and classification of obesity in Japan and Asia-Oceania. Asia Pac J Clin Nutr. 2002;11 Suppl 8:S732–7.CrossRef
7.
World Health Organization. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363:157–63.CrossRef
8.
Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA, et al. 2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation. 2014;129(25 Suppl 2):S102–38. doi:10.1161/01.cir.0000437739.71477.ee. Epub 2013 Nov 12.S102-38.CrossRefPubMed
9.
Galuska DA, Will JC, Serdula MK, Ford ES. Are health care professionals advising obese patients to lose weight? JAMA. 1999;282:1576–8.CrossRefPubMed
10.
Stecker T, Sparks S. Prevalence of obese patients in a primary care setting. Obesity (Silver Spring). 2006;14:373–6.CrossRef
11.
12.
13.
Wadden TA, Volger S, Sarwer DB, Vetter ML, Tsai AG, Berkowitz RI, et al. A two-year randomized trial of obesity treatment in primary care practice. N Engl J Med. 2011;365:1969–79.CrossRefPubMedCentralPubMed
14.
Nanchahal K, Townsend J, Letley L, Haslam D, Wellings K, Haines A. Weight-management interventions in primary care: a pilot randomised controlled trial. Br J Gen Pract. 2009;59:157–66.CrossRef
15.
ter Bogt NCW, Bemelmans WJE, Beltman FW, Broer J, Smit AJ, van der Meer K. Preventing weight gain by lifestyle intervention in a general practice setting: three-year results of a randomized controlled trial. Arch Intern Med. 2011;171:306–13.PubMed
16.
Bennett GG, Herring SJ, Puleo E, Stein EK, Emmons KM, Gillman MW. Web-based weight loss in primary care: a randomized controlled trial. Obesity. 2009;18:308–13.CrossRefPubMedCentralPubMed
17.
Appel LJ, Clark JM, Yeh H-C, Wang N-Y, Coughlin JW, Daumit G, et al. Comparative effectiveness of weight-loss interventions in clinical practice. N Engl J Med. 2011;365:1959–68.CrossRefPubMedCentralPubMed
18.
Suzuka T. The needs assessment of nutrition counseling in primary internal medicine clinic. Kyoto Igakukai Zassi. 2008;55:173–6 [in Japanese].
19.
Christian JG, Bessesen DH, Byers TE, Christian KK, Goldstein MG, Bock BC. Clinic-based support to help overweight patients with type 2 diabetes increase physical activity and lose weight. Arch Intern Med. 2008;168:141–6.CrossRefPubMed
20.
Martin PD, Dutton GR, Rhode PC, Horswell RL, Ryan DH, Brantley PJ. Weight loss maintenance following a primary care intervention for low-income minority women. Obesity. 2012;16:2462–7.CrossRef
21.
Wooldridge AN, Arató N, Sen A, Amenomori M, Fetters MD. Truth or fallacy? Three hour wait for threeminutes with the doctor: findings from a privateclinic in rural Japan. Asia Pac Fam Med. 2010;9:11. doi:10.1186/s12930-014-0011-2.CrossRefPubMedCentralPubMed
22.
23.
24.
25.
26.
Vanina Y, Podolskaya A, Sedky K, Shahab H, Siddiqui A, Munshi F, et al. Body weight changes associated with psychopharmacology. Psychiatr Serv. 2002;53:842–7.CrossRefPubMed
27.
Espeland MA, Stefanick ML, Kritz-Silverstein D, Fineberg SE, Waclawiw MA, James MK, et al. Effect of postmenopausal hormone therapy on body weight and waist and hip girths. Postmenopausal Estrogen-Progestin Interventions Study Investigators. J Clin Endocrinol Metab. 1997;82:1549–56.PubMed
28.
Committee to Evaluate Diagnostic Standards for Metabolic Syndrome. Definition and the diagnostic standard for metabolic syndrome--Committee to Evaluate Diagnostic Standards for Metabolic Syndrome. Nippon Naika Gakkai Zasshi. 2005;94:794–809. in Japanese.CrossRef
29.
Grundy SM. Diagnosis and management of the metabolic syndrome: an American heart association/national heart, lung, and blood institute scientific statement. Circulation. 2005;112:2735–52.CrossRefPubMed
30.
Japan Society for the Study of Obesity. Obesity disease treatment guideline 2006. Himan Kenkyu. 2006;12(suppl):1–91. in Japanese.
31.
Ogihara T, Kikuchi K, Matsuoka H, Fujita T, Higaki J, Horiuchi M, et al. The Japanese society of hypertension guidelines for the management of hypertension (JSH. Hypertens Res. 2009;2009:3–107.
32.
Japan Atherosclerosis Society. Japan Atherosclerosis Society (JAS) Guidelines for Prevention of Atherosclerotic Cardiovascular Disease 2007. Tokyo: Kyowa Kikaku; 2007. in Japanese.
33.
The Japan Diabetes Society. Evidence-based practice guideline for the treatment of diabetes in Japan 2010. Tokyo: Nankodo; 2010. in Japanese.
34.
Tsai AG, Wadden TA, Rogers MA, Day SC, Moore RH, Islam BJ. A primary care intervention for weight loss: results of a randomized controlled pilot study. Obesity. 2009;18:1614–8.CrossRefPubMed
35.
Stead LF, Buitrago D, Preciado N, Sanchez G, Hartmann-Boyce J, Lancaster T. Physician advice for smoking cessation. Cochrane Database Syst Rev. 2013;5:CD000165.PubMed
36.
37.
NHLBI Obesity Education Initiative Expert Panel on the Identification, Evaluation, and Treatment of Obesity in Adults: Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. Bethesda; 1998
38.
Jakicic JM, Tate DF, Lang W, Davis KK, Polzien K, Rickman AD, et al. Effect of a stepped-care intervention approach on weight loss in adults: a randomized clinical trial. JAMA. 2012;307:2617–26.CrossRefPubMedCentralPubMed
39.
Wu T, Gao X, Chen M, van Dam RM. Long-term effectiveness of diet-plus-exercise interventions vs. diet-only interventions for weight loss: a meta-analysis. Obes Rev. 2009;10:313–23.CrossRefPubMed
40.
Butryn ML, Phelan S, Hill JO, Wing RR. Consistent self‐monitoring of weight: a key component of successful weight loss maintenance. Obesity. 2007;15:3091–6.CrossRefPubMed
41.
Metadata
Title
Interventions for body weight reduction in obese patients during short consultations: an open-label randomized controlled trial in the Japanese primary care setting
Authors
Satoshi Kanke
Takumi Kawai
Naomi Takasawa
Yukiko Mashiyama
Atsushi Ishii
Ryuki Kassai
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Asia Pacific Family Medicine / Issue 1/2015
Electronic ISSN: 1447-056X
DOI
https://doi.org/10.1186/s12930-015-0022-7

Other articles of this Issue 1/2015

Asia Pacific Family Medicine 1/2015 Go to the issue

Case study

The cultural context of teaching and learning sexual health care examinations in Japan: a mixed methods case study assessing the use of standardized patient instructors among Japanese family physician trainees of the Shizuoka Family Medicine Program

Research

A pilot study to assess the utility and perceived effectiveness of a tool for diagnosing feeding difficulties in children

Short report

The impact of an early_exposure program on medical students’ interest in and knowledge of rural medical practices: a questionnaire survey

Research

Perception of hypertension management by patients and doctors in Asia: potential to improve blood pressure control

Research

Impact of chronic obstructive pulmonary disease (COPD) in the Asia-Pacific region: the EPIC Asia population-based survey

Research

Describing the factors that influence the process of making a shared-agenda in Japanese family physician consultations: a qualitative study