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      Motivational Intervention of Obesity in Primary Care Through Physical Activity Program

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          Abstract

          Summary

          Obesity and overweight are significant public health problems, worldwide. Hence, there is the importance of developing and applying strategies that reduce weight in this population. We set out to evaluate the effectiveness of obesity intervention with three different approaches—one of them with a platform that promotes physical activity.

          Methods

          Randomized, controlled, parallel clinical trial that compared three arms, multicenter study in overweight or obese patients, with a 12-month follow-up. The patients were randomized into three groups: Intervention in the primary care center with intervention G1: Control group, which received the usual recommendations of losing weight following the SEEDO 2000 (Sociedad Española para el Estudio de la Obesidad) Consensus, G2: Motivational intervention of obesity (IMOAP) with a trained nurse and small periodic work groups, and G3: IMOAP adding the use of a digital platform to record physical activity, monitors it, and, in turn, favors the practice of this (aka iwopi: the concept that physical activity has a positive impact beyond the activity). Variables collected included: weight, height, body mass index (BMI), waist circumference, lipid parameters, blood pressure, and glycosylated hemoglobin. After the interventions, clinical relevance indicators were studied. Relative risk (RR), absolute risk reduction (ARR), relative risk reduction (RRR), and number needed to treat (NNT), both for intention to treat and for biological efficacy.

          Results

          Cholesterol levels in three groups were reduced. The BMI showed a general average reduction. Total cholesterol levels were reduced in all groups, with the largest decrease in G3. Triglyceride levels were significantly reduced in two groups. Glycosylated hemoglobin showed a slight decrease that did not reach a statistically significant value.

          Conclusions

          The digital health platform that stimulates physical activity added to an interventionist motivation in patients with overweight or obesity is a significant additional benefit in terms of weight loss results, BMI reduction, and lipid profile in patients affected by overweight or obesity, and a most effective cost.

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          Most cited references27

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          Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults--The Evidence Report. National Institutes of Health.

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            Lifestyle modification for obesity: new developments in diet, physical activity, and behavior therapy.

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              One-year weight losses in the Look AHEAD study: factors associated with success.

              This report provides a further analysis of the first year weight losses in the Look AHEAD (Action for Health in Diabetes) study and identifies factors associated with success. Participants were a total of 5,145 men and women with type 2 diabetes who were recruited at 16 sites and randomly assigned to an intensive lifestyle intervention (ILI) or a control condition, Diabetes Support and Education (DSE). During year 1, participants in ILI received comprehensive diet and physical activity counseling in a total of 42 group and individual sessions, compared with three educational sessions for DSE participants. As reported previously, at the end of the year, ILI participants lost 8.6% of initial weight, compared to 0.7% for DSE (P 5.5%), although there were significant differences among groups. For the year, ILI participants attended an average of 35.4 treatment sessions and reported exercising a mean of 136.6 min/week and consuming a total of 360.9 meal replacement products. Greater self-reported physical activity was the strongest correlate of weight loss, followed by treatment attendance and consumption of meal replacements. The use of orlistat, during the second half of the year, increased weight loss only marginally in those ILI participants who had lost <5% of initial weight during the first 6 months and chose to take the medication thereafter as a toolbox option. The lifestyle intervention was clinically effective in all subsets of an ethnically and demographically diverse population.
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                Author and article information

                Journal
                TMT
                Telehealth and Medicine Today
                Partners in Digital Health
                2471-6960
                22 October 2019
                2019
                : 5
                : 10.30953/tmt.v5.157
                Affiliations
                [1 ]EAP Zone 5A, Albacete, Spain
                [2 ]FUFOSA, Madrid, Spain
                [3 ]University Miguel Hernandez, Alicante, Spain
                [4 ]Fufosa, Barcelona, Spain
                [5 ]Clinic Hospital, Zaragoza, Spain
                [6 ]ABS, Barcelona, Spain
                [7 ]University Castilla la Mancha, Spain
                Author notes
                Corresponding Author: Pedro J. Tárraga López, pjtarraga@ 123456sescam.jccm.es
                Article
                157
                10.30953/tmt.v5.157
                a3d74c80-792f-4e62-8ed0-5cfc38c19d91
                © 2019 Pedro J. Tárraga López

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, adapt, enhance this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.

                History
                Categories
                Original Clinical Research

                Social & Information networks,General medicine,General life sciences,Health & Social care,Public health,Hardware architecture
                Physical Activity,Motivational Intervention,Telemedicine,Obesity

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