Overweight and obesity are among the most serious health problems of our time. A majority of patients with overweight and obesity will first get in touch with health services through primary care. This makes it crucial to develop strategies to enable physicians in primary care to help and treat patients with overweight and obesity. The physicians tend to avoid this subject. The main reason is reported to be lack of knowledge and education, and that they have nothing concrete to offer their patients. We wanted to examine if a simple method with specific measures could be used in Norwegian general practice and achieve meaningful weight loss. 23 physicians and 210 patients participated in the study. The physicians who participated were cluster randomised into either control group or intervention group. The physicians in the control group were told to follow their usual approach, while the physicians in the intervention group followed a fixed plan with specific diets given orally and in writing to the patients. The inclusion criteria for both groups were: body mass index (BMI)>30 kg/m2, or BMI>25 kg/m2 with at least one weight-related condition. Weight was measured at the start, then after 1 year and finally after 2 years in both groups. We found no significant weight loss in the control group. In the intervention group, there was a weight loss of at least 10% by 25.5% after the first year and 24.2% after the entire observation period. 53.5% of the patients lost at least 5% of their weight in the first year and nearly 45% after the entire observation period. We conclude that a simple tool with a specific diet and activity plan is feasible in general practice and may produce significant weight loss. Trial registration number: [NCT03000062][1]. Data are available in a public, open access repository. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT03000062&atom=%2Fbmjnph%2F6%2F2%2F326.atom

中文翻译：

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一般实践中超重和肥胖的治疗：整群随机试验


超重和肥胖是当今时代最严重的健康问题之一。大多数超重和肥胖患者首先会通过初级保健获得卫生服务。这使得制定策略使初级保健医生能够帮助和治疗超重和肥胖患者变得至关重要。医生往往回避这个话题。据报道，主要原因是缺乏知识和教育，而且他们没有为患者提供任何具体的东西。我们想要研究是否可以在挪威的一般实践中使用一种带有具体措施的简单方法并实现有意义的减肥。 23 名医生和 210 名患者参与了这项研究。参与的医生被随机分为对照组或干预组。对照组的医生被告知遵循他们通常的方法，而干预组的医生则遵循固定的计划，通过口头和书面形式向患者提供特定的饮食。两组的纳入标准均为：体重指数（BMI）>30 kg/m2，或BMI>25 kg/m2且至少有一种与体重相关的状况。两组均在开始时、1年后和2年后测量体重。我们发现对照组没有明显的体重减轻。在干预组中，第一年后体重减轻了至少 10%，体重减轻了 25.5%，整个观察期后体重减轻了 24.2%。 53.5% 的患者在第一年体重减轻了至少 5%，在整个观察期后体重减轻了近 45%。我们的结论是，具有特定饮食和活动计划的简单工具在一般实践中是可行的，并且可能会产生显着的减肥效果。试用注册号：[NCT03000062][1]。 数据可在公共、开放访问存储库中获取。 [1]：/lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT03000062&atom=%2Fbmjnph%2F6%2F2%2F326。原子