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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 references 27

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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.

           FX Pi-Sunyer (1998)
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            A review of psychosocial pre-treatment predictors of weight control.

            Prompted by the large heterogeneity of individual results in obesity treatment, many studies have attempted to predict weight outcomes from information collected from participants before they start the programme. Identifying significant predictors of weight loss outcomes is central to improving treatments for obesity, as it could help professionals focus efforts on those most likely to benefit, suggest supplementary or alternative treatments for those less likely to succeed, and help in matching individuals to different treatments. To date, however, research efforts have resulted in weak predictive models with limited practical usefulness. The two primary goals of this article are to review the best individual-level psychosocial pre-treatment predictors of short- and long-term (1 year or more) weight loss and to identify research needs and propose directions for further work in this area. Results from original studies published since 1995 show that few previous weight loss attempts and an autonomous, self-motivated cognitive style are the best prospective predictors of successful weight management. In the more obese samples, higher initial body mass index (BMI) may also be correlated with larger absolute weight losses. Several variables, including binge eating, eating disinhibition and restraint, and depression/mood clearly do not predict treatment outcomes, when assessed before treatment. Importantly, for a considerable number of psychosocial constructs (e.g. eating self-efficacy, body image, self-esteem, outcome expectancies, weight-specific quality of life and several variables related to exercise), evidence is suggestive but inconsistent or too scant for an informed conclusion to be drawn. Results are discussed in the context of past and present conceptual and methodological limitations, and several future research directions are described.
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              • Article: not found

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

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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
                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
                © 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.

                Categories
                Original Clinical Research

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