INDIVIDUO: Results from a patient-centered lifestyle intervention for obesity surgery candidates

Abstract

Results on weight and metabolic control support INDIVIDUO as a valuable clinical tool for obesity surgery candidates counseling. Additionally, intervention associated with perceived competence for weight-control behaviours and autonomous regulation.

Randomized controlled trial protocol: A quanti-quali approach for analyzing the results of an intervention on the waiting list for bariatric surgery

“…To the best of our knowledge, only three prospective, randomized, controlled studies have evaluated the effect of interventions that seek lifestyle changes in obese individuals who are on the waiting list for bariatric surgery [7,16,17]. However, it is important to point out that there is a great heterogeneity between the studies in relation to the characteristics of the intervention (e.g., time, duration, content, health professionals involved) and none investigated the effects of an intervention similar to the one in this study, taking into account the outcomes considered here.…”

“…For the calculation of the sample size, an estimation was performed from the study of Camolas et al [7], a large effect size (Cohen's d=0.90) for body weight loss over a six-month period (behavioral vs. control intervention) of individuals who are candidates for bariatric surgery. Thus, considering a power of 95% and an alpha value of 0.05; the minimum sample size estimated was of 34 patients per group.…”

“…Brazil's Sistema Único de Saúde (SUS, Brazilian Unified Health System) provides this surgical procedure, but the number of surgeries performed is still insufficient [4,5], resulting in a long waiting period, which can last from three to seven years [5,6]. The reduction of 5 to 10% of body weight before bariatric surgery decreases the surgical complications and comorbidities associated with obesity, and in some cases may prevent surgery through the adoption of new habits [4,7,8].…”

“…It is still a challenge in the public health care system to create effective strategies to promote the necessary care for associated chronic diseases, to improve or avoid the aggravation of physical capacity reduction, and to assist in the control of behavioral disorders such as binge eating, depression, anxiety and stress [12][13][14][15]. Few randomized controlled studies have investigated the effects of behavioral interventions on body weight loss in obese patients who are candidates for surgery, with controversial results on effectiveness versus usual treatment [7,16,17]. Therefore, evaluative and controlled studies have been insufficient in this area, resulting in the lack of evidence capable of supporting the implementation of educational interventions as strategies of improving the health conditions of patients with severe obesity, waiting for bariatric surgery.…”

Path taken by morbidly obese people in search of bariatric surgery in the public health system

“…It is emphasized that health professionals need to incorporate patient incentive strategies in their practice so that they can manage their own health, through guidance on the impacts of overweight and bariatric surgery in the medium and long term, providing increased co-responsibility for the treatment and the change in the lifestyle (26) . The effectiveness of these guidelines can be enhanced if professionals consider the patient's experiences, through a horizontal and cooperative relationship that takes place in everyday social interaction, according to the assumptions of Alfred Schütz's social phenomenology (10) .…”