Time to tip the scales: tackling overweight and obesity in primary care

Hout, W.J. van den (2026)

Doctoral Thesis

Obesity management in primary care needs to adapt to the increasing prevalence of obesity: Time to tip the scales on obesity and find balance.
This dissertation aims to provide a contribution to the improvement of obesity management in primary care by focusing on the current practices of obesity management in primary care and the identification of patients with obesity at increased risk of further long-term weight gain or cardiovascular disease.
We concluded that body mass index and waist circumference are currently rarely recorded in primary healthcare records. Overcoming the barriers for general practitioners to discussing weight, diagnosing and referring patients with obesity requires not only improving knowledge and skills, but also establishing long-term relationships, creating a supportive environment and addressing their beliefs about consequences. Proactive attention is needed for patients with depressive symptoms and patients who have experienced negative life events, as they are more likely to gain weight over time. In addition, we recommend measuring waist circumference in primary care, as it is a cost-effective and simple measurement that identifies patients at increased risk of developing cardiovascular disease. Ultimately, obesity management should focus more on prevention rather than treating its effects.

• Primary care
• Obesity
• Overweight
• Electronic healthcare records
• Routine primary care date
• General practice

• All authors: Hout, W.J. van den
• Supervisor: Numans, M.E.
• Co-supervisor: Peet, P.G. van; Mook-Kanamori, D.O.
• Committee: Adriaanse, M.A.; Cannegieter, S.C.; Geersing, G.J.; Seidell, J.C.
• Qualification: Doctor (dr.)
• Awarding Institution: Faculty of Medicine, Leiden University Medical Center (LUMC), Leiden University
• Date: 2026-01-16
• ISBN (print): 9789465227252