engleski

OBESITY TREATMENT: HOSPITAL VS PRIVATE NUTRITION COUNSELING

Objective: The purpose of our study was to examine the role of financial incentives in effectiveness of medical nutrition therapy to produce weight loss. We compared two groups of subjects referred for nutritional counseling: hospital counseling, whose costs were covered by the Croatian health insurance fund (n=54) and private one whose costs were covered by the users themselves (n=224). Both groups of participants were treated by the same examiner and identical methods of education and counseling were used. Methods: Body mass was analyzed by the Omronbody analyzer. 24-hour questionnaire and FFQ test were used to examine the respondents’ nutritional habits. Basic data on the subjects were collected, on the basis of which an individual nutrition plan was prepared and education was carried out. Participants from both groups came to the check–up between 3 and 7 times within three months period. Results: Nutrition counseling had high success rate showing that 92% of participants achieved body mass loss (100% in self financing group and 74% in hospital group). Subjects were subdivided by sex. Weight decreased in men by 7.7 kg (7, 1 %) and BMI decreased by 2.4 kg/m² (7.2 %) in self financing group vs. 2, 7 kg (1, 4 %) and 1, 4 kg/m² (1, 4 %) in hospital group, the difference between groups was were highly significant (p<0.00000 respectively). Weight decreased in women by 6, 3 kg (6, 9%) and BMI decreased by 2.3 kg/m² (6.9%) in self financing group vs. 3.3 kg (2.9%) and 0, 99 kg/m² (2, 8%) in hospital group, the difference between groups was were highly significant (p<0.00000 respectively). There was a significant positive correlation between weight loss and the number of check-ups. There was no correlation between weight loss and exercise, but there was a significant improvement in fat tissue loss in subjects who are physically active. Conclusions: Our results indicated that financial incentives are a possible motivation for greater life style change. Self financing patients, regardless of social status, were better informed about benefits of nutrition counseling and had greater level of personal health awareness which implies that widening awareness of nutritionists’ role in health care would be beneficial.

obesity, diabetes, nutrition

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