OVERWEIGHT AND OBESITY: RELATIONSHIP WITH CHRONIC DISEASES IN PRIMARY HEALTH CARE USERS/GENERAL FAMILY MEDICINE

Abstract

Background: Overweight and obesity affect 53.6% of the Portuguese population and it is growing [1]. Body fat excess increases the risk of developing insulin resistance, cardiovascular, psychological and cancer problems [2], having a negative impact on health and higher costs as the disease sets and worsens [5]. It is urgent to evaluate how this complex disease behaves, so that health services can guarantee an adequate and standardized intervention, correct diagnosis, but also a clinical monitoring and treatment adapted to the needs of each region.

Methods: To assess the prevalence of overweight/obesity and analyze their relationship with the various associated pathologies in the different areas of Portugal, between the years 2015 to 2019, it was made descriptive analysis of data obtained online on the BI-CSP platform, indicators 202, 203, 204, 205, 206, 210, 211, 213, 214, 217, 224 and 234 for the national total, for the different Health Regions and for a representative random sample of Health Care Centers. Quotients between indicators and growth dynamics were calculated.

Results: The North Health Region is the one with the highest proportion of overweight and obesity, with 36.7%, in contrast to Algarve Health Region, the region with the best results, 18.3%. The Alentejo Health Region has the largest fraction of users with non-insulin-dependent diabetes, arterial hypertension, coronary artery disease, myocardial infarction and transient ischemic stroke. It was also found that the overweight and obesity growth, with a growth dynamic of +2.12 and +0.73 between 2015 and 2019 in the total national, respectively, did not reflect a positive growth dynamic of the quotients calculated between indicators.

Discussion: There is a discrepancy between weight values for Health Regions and between the Primary Health Care users and the national values. The increase in overweight or obesity proportions did not lead to an equivalent increase in the higher risk pathologies proportion, which can be justified by the complexity of the disease and the presence of limiting factors not studied, such as age population, educational level, eating habits and physical exercise.

Conclusion: The presence of an increased body mass index is not strictly associated with serious health problems. There must be found an explanation for differences between regions to improve equality. Invest in primary prevention and apply a systematic intervention across health care units that allows a regular assessment of the patient’s nutritional status using reliable anthropometric parameters for early diagnosis, referencing and intervention.