The Certificate of Cause of Death (CCOD) is an important legal document. The statutory duty of completing the CCOD is imposed upon a licensed medical practitioner by the Registration of Births and Deaths Act. The family physician is often in the best position to certify the cause of death when the death occurs in the community. Medical practitioners are permitted to issue CCODs ONLY when the cause of death is known and natural and if the deceased is not in statutory care. Deaths that are reportable to the Coroner include deaths from unnatural causes, iatrogenic events, or if circumstances surrounding the death are unknown or suspicious. Proper certification of cause of death is essential to avoid problems with the authorities and added grief to the family of the deceased. However, with better understanding of the process of completing the CCOD, the family physician can more confidently perform this duty and render a final professional service to their patients.

INTRODUCTIONWeight management programmes (WMPs) can help overweight individuals lose weight, and thus prevent complications associated with obesity. Herein, we describe the demographic profile, clinical characteristics, motivations and expectations, and outcomes of patients enrolled in a nonsurgical WMP.

METHODSThis was a retrospective study of consecutive patients with a body mass index (BMI) of > 23 kg/m2 enrolled in the four-month WMP at the Health For Life Clinic, Alexandra Hospital, Singapore, between 1 and 31 August 2009. Demographic data, medical history and source of referral were recorded. Details on personal motivations and weight loss goals were obtained from the completed self-administered questionnaires of the WMP participants. Weight, waist circumference, fat percentage and BMI were measured at the start and end of the WMP. A weight loss of ≥ 5% was deemed as a successful outcome.

RESULTSA total of 58 patients (mean age 37.2 years) were included in our study. Of these 58 patients, 58.6% were of Chinese ethnicity and 55.2% were male. Many patients (32.8%) attributed their weight gain to work- or study-related stress, and a minority to poor eating habits (12.1%) or a lack of exercise (10.3%). Patients' motivations included a desire for better health (53.4%) and better fitness (15.5%). However, only 53.4% patients scored their motivation as high (i.e. a score of > 7). The mean expected weight loss was 9.9 kg at 4 months, and 14.1 kg at 12 months. Among the 40 patients (69.0%) who completed the programme, the mean percentage weight loss was 1.8 ± 4.3%. A weight loss of ≥ 5% was achieved by 8 (13.8%) patients.

CONCLUSIONAlthough the patients in our study cohort were young and educated, only a portion of them appeared to be highly motivated to lose weight, despite joining the WMP. There is a need for patients to be guided on how to set realistic weight loss goals.

Adult ; Aged ; Body Mass Index ; Female ; Humans ; Male ; Middle Aged ; Motivation ; Obesity ; psychology ; therapy ; Overweight ; psychology ; therapy ; Retrospective Studies ; Singapore ; Surveys and Questionnaires ; Treatment Outcome ; Weight Loss ; Weight Reduction Programs ; methods ; Young Adult