Abstract:

Objective To establish a multidisciplinary clinic for overweight or obese patients coordinated by specialized nurses，evaluate its effectiveness，and provide insights for optimizing multidisciplinary collaboration and improving patients’ weight management outcomes. Methods A tertiary hospital in Hangzhou established a multidisciplinary collaborative management clinic for overweight or obese patients in 2025. The hospital selected specialized nurses，built an information platform，and defined the nurses’ responsibilities，including health assessment and triage，coordinating care transitions，establishing patient records，conducting weight management follow-ups，and delivering health education. Patients who attended this outpatient clinic from April 10 to August 31，2025，and had received 3 months of multidisciplinary management were consecutively enrolled as study subjects. This study compared changes in the proportion of patients with normal anthropometric，body composition，physiological and metabolic indicators before and after the 3-month intervention. In addition，patient compliance，follow-up rates and satisfaction scores were collected. Results A total of 139 patients were ultimately included in the study. Compared with pre-treatment measurements，the patients exhibited statistically significant reductions in body weight，BMI，abdominal circumference，waist circumference，body fat percentage，and visceral fat area at 3 months post-treatment. Concurrently，the proportion of patients who achieved normal levels of blood pressure，fasting blood glucose，total cholesterol，triglycerides，LDL cholesterol，and uric acid increased significantly（P<0.05）. The patient completion rate for the treatment pathway was 100%，with dietary adherence at 84.17%，exercise adherence at 69.06%，and medication adherence at 92.09%. The follow-up and satisfaction rates both reached 100%. Conclusion Under the coordination of specialized nurses，multidisciplinary weight management clinics for overweight and obese patients exhibit high clinical efficacy. This approach helps reduce patients’ obesity severity，improve metabolic health.

Key words: Overweight, Obesity, Multidisciplinary Team, Specialist Nurses, Outpatient, Nursing Administration Research

摘要：

目的 建设专科护士协调下超重或肥胖患者多学科管理门诊，并评价其实践成效，为优化多学科协作、改善患者的体重管理效果提供参考。 方法 杭州市某三级甲等医院于2025年设立超重或肥胖患者多学科协作管理门诊，筛选专科护士、构建信息化平台，同时明确专科护士的工作内容，包括健康评估及分诊、诊疗衔接与协调、建立患者档案、体重管理随访、健康教育等。连续选取2025年4月10日—8月31日在该门诊就诊且已接受3个月多学科管理的患者作为研究对象，比较就诊前及就诊3个月后患者的人体测量与身体成分指标、生理及代谢指标正常比例，并收集患者的依从性、随访率及满意度。 结果 最终纳入139例患者，与就诊前比较，就诊3个月后患者的体重、BMI、腹围、腰围、体脂率及内脏脂肪面积等指标均降低，血压、空腹血糖、总胆固醇、甘油三酯、低密度脂蛋白、尿酸等指标正常比例均升高，差异具有统计学意义（P<0.05）。患者的诊疗路径完成率为100%、饮食依从性为84.17%、运动依从性为69.06%、用药依从性为92.09%、随访率为100%、满意度为100%。 结论 在专科护士协调下，超重或肥胖患者多学科管理门诊的诊疗效率较高，有助于减轻患者的肥胖程度，提高代谢水平。

关键词: 超重, 肥胖, 多学科协作, 专科护士, 门诊, 护理管理研究