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[Weight management in general practice].

Weight excess is an increasingly frequent disorder of nutritional origin in industrialized areas. In Belgium, 40% of the population suffers from weight overload (BMI between 25 and 29.9 kg/m2) and 10 to 15% are obese (BMI > or = 30 kg/m2). The overweight is responsible for increased morbidity, in particular cardiovascular, and surmortality mainly among patients less than 60 years. The causes of the overweight are related to many interdependent determinants: food, sedentarity, socio-economical environment, genetic, psychological and behavioral characteristics. This complexity explains partly the difficulties of the medical follow-up of these patients. The role of the general practitioner (GP) in this Community health problem is essential at two levels: 1) Treatment of weight excess: a moderate and sustained loss, such as of 5 to 10% of the initial body weight, already significantly decreases the risks of morbi-mortality. The first role of GP will be to target the patients at particular risk and to treat them while adapting to their motivation. 2) Systematic prevention: all patients, all families, must have access through their GP to information of quality concerning the nutrition and the management of weight. This information should be adapted to each patient, according to the various stages of life. Nutritional imbalances and sedentarity should be detected systematically.