Adherence to an overweight and obesity treatment: how to motivate a patient?

Abstract

Objective. To explore anthropometric changes in normal-weight, overweight and obese subjects who did not dropout or fail a weight loss program over the 16 treatment weeks to improve patient motivation and treatment adherence.Methods. A clinical intervention study was conducted among 271 (including 100 dropouts and/or failures) obese and overweight patients who consulted a nutrition clinic in Barranquilla (Colombia) for the purpose of nutritional assessment. They were subject to a personalized weekly follow-up consultation over the course of 16 weeks in which initial and the final Body Mass Index (BMI, kg/m2), photographs, food consumption patterns, percentage weight loss, waist and hip circumference were registered and grouped according to BMI, measuring treatment response. Data’s nonparametric statistical comparison was made.Results. In 62 patients from the BMI < 25 group, there is weight loss of 2.6% (3.1 SD), 5.5% (3.3 SD) in waist circumference and 3.0% (2.5 SD) in hip circumference. In 67 patients from the 25 ≥ BMI < 30 group, there is weight loss of 3.8% (4.1 SD), 5.7% (4.5 SD) in waist circumference loss and 3.7% (3.0 SD) in hip circumference loss. In 42 patients from the BMI > 30 group, there is weight loss of 4.8% (3.7 SD), 7.0% (3.6 SD) in waist circumference loss and 3.9% (2.4 SD) in hip circumference loss. Monitoring is done every 4 weeks by the Friedman test, with significant differences between the three groups (p < 0.001). Patients do not drop out of treatment because they start to see physical results in waist decrease. When comparing final values of initial waist/hip circumference ratios and waist/height ratios, a clear decrease in the three BMI groups was observed (p < 0.001).Conclusion. After three weeks of continuous treatment patients improved in all overweight and obesity parameter indicators; there were not statistically significant differences in hip circumference (HC) and waist loss (WC) (%) among the three BMI groups (normal-weight, overweight, and obesity). In contrast, there were statistically significant differences in weight loss (%) and waist-to-hip ratios. Based on anthropometric outcomes and patient perception of their body image it can be concluded that the waist circumference loss is the parameter that retains obese patients in the weight loss program.

Effectiveness of telenutrition in a women's weight loss program

“…Weight loss results in patients could be seen in 16 weeks 5 . The study included an initial in-person consultation with complete medical record (date accessed, date of birth, personal identification data including e-mail and messenger service, socioeconomic status, educational level, personal medical history, toxic precedents, etc.)…”

Effectiveness of telenutrition in a women’s weight loss program

“…It is known that the prevalence of obesity has experienced an alarming worldwide increase (Kuzmar, Rizo & Cortés-Castell, 2014); therefore, we can say that we are in the midst of a global obesity epidemy (Flegal et al, 2012). The physiology of obesity is based on an imbalance between caloric intake and energy expenditure (Kuzmar, Cortés & Rizo, in press).…”

“…The appearance or perception of body image is defined as the body shape that is made by the mind plus the subjective representations of physical appearance (Alwan et al, 2011). The concept of body image varies throughout one’s life, depending on the social influences and life situations that affect the behavior (Kuzmar, Rizo & Cortés, 2014b). Dissatisfaction with physical appearance related to body weight is higher in women, than in men, and varies across ethnic groups in relation to the cultural integration degree (Fallon, Harris & Johnson, 2014).…”

Effectiveness of telenutrition in a women's weight loss program

“…It is known that the prevalence of obesity has experienced an alarming worldwide increase 5 ; therefore, we can say that we are in the midst of a global obesity epidemy 6 . The physiology of obesity is based on an imbalance between caloric intake and energy expenditure 7 .…”