Effectiveness of non-surgical weight loss treatment for severely obese patients

Ana Paula dos Santos Rodrigues, Erika Aparecida Silveira

Resumo


Purpose: Severe obesity is a worldwide public health problem. We aimed to evaluate the effectiveness of non-surgical treatment on weight, body mass index (BMI), food consumption, and physical activity practice of severely obese outpatients. Methods: Fifty-three severely obese adults were included in the study. Nutritional treatment with a tailored food plan was applied. Patients were followed through nine monthly visits. At statistical analysis, it was observed that some patients were using anti-obesity drugs, thus patients were stratified as follows: nutritional treatment (NT) group (n = 26), those who received only the nutritional intervention; and nutritional treatment plus medicine (NM) group (n = 27), those under NT and anti-obesity drugs. Results: Both groups presented linear reduction on weight and BMI means throughout the follow-up (P < 0.001). NT had lower mean weight values compared to NM in the last three visits (seventh: P = 0.036, eighth: P = 0.020, ninth: P = 0.025). Both interventions promoted clinically significant weight loss with no statistical difference between groups (weight loss %: NT = 7.2 ± 9.0%; NM = 5.9 ± 4.5%; P = 0.491). A qualitative improvement in overall food consumption was observed. NT showed a significant increase in vegetable consumption compared to NM in the sixth visit (P = 0.044). NM had greater adherence to physical activity practice (P < 0.001). Conclusions: The non-surgical treatment program was effective on weight and BMI reduction in severely obese patients with and without anti-obesity drugs, and the food consumption and physical activity practice improved.

 

RESUMO 

Eficácia do tratamento de perda de peso não-cirúrgico para pacientes obesos graves

Objetivo: A obesidade grave é um problema de saúde pública mundial. O objetivo do estudo foi avaliar a efetividade do tratamento não-cirúrgico com relação ao peso, Índice de Massa Corporal (IMC), consumo alimentar e prática de atividade física em pacientes obesos graves. Métodos: Cinquenta e três obesos graves foram incluídos no estudo. Foi realizado tratamento nutricional com plano alimentar personalizado. Os pacientes foram acompanhados por nove consultas mensais. Na análise estatística, observou-se que alguns pacientes usavam medicamentos anti-obesidade, sendo estratificados da seguinte forma: grupo tratamento nutricional (TN) (n = 26), pacientes apenas sob intervenção nutricional; e tratamento nutricional mais medicamento (TM) (n = 27), aqueles sob TN e medicamentos anti-obesidade. Resultados: Ambos grupos apresentaram redução linear de peso e IMC durante o seguimento (P <0,001). TN apresentou médias de peso menores que TM nas últimas três consultas (sétima: P = 0,036, oitava: P = 0,020, nona: P = 0,025). Ambas intervenções promoveram perda de peso clinicamente significativa sem diferença entre os grupos (% perda de peso: TN = 7,2 ± 9,0%; TM = 5,9 ± 4,5%; P = 0,491). Observou-se uma melhora qualitativa geral no consumo de alimentos. TN demostrou aumento significativo no consumo de vegetais comparado a NM na sexta consulta (P = 0,044). TM teve maior adesão à prática de atividade física (P <0,001). Conclusões: O tratamento não-cirúrgico foi efetivo na redução do peso e IMC de obesos graves com ou sem o uso de medicamentos anti-obesidade, e o consumo de alimentos e a prática de atividade física melhoraram.


Palavras-chave


Severe obesity; Diet therapy; Weight loss; Food habit; Physical activity

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