Position statement on nutrition therapy for overweight and obesity: nutrition department of the Brazilian association for the study of obesity and metabolic syndrome (ABESO—2022)

Abstract

Obesity is a chronic disease resulting from multifactorial causes mainly related to lifestyle (sedentary lifestyle, inadequate eating habits) and to other conditions such as genetic, hereditary, psychological, cultural, and ethnic factors. The weight loss process is slow and complex, and involves lifestyle changes with an emphasis on nutritional therapy, physical activity practice, psychological interventions, and pharmacological or surgical treatment. Because the management of obesity is a long-term process, it is essential that the nutritional treatment contributes to the maintenance of the individual’s global health. The main diet-related causes associated with excess weight are the high consumption of ultraprocessed foods, which are high in fats, sugars, and have high energy density; increased portion sizes; and low intake of fruits, vegetables, and grains. In addition, some situations negatively interfere with the weight loss process, such as fad diets that involve the belief in superfoods, the use of teas and phytotherapics, or even the avoidance of certain food groups, as has currently been the case for foods that are sources of carbohydrates. Individuals with obesity are often exposed to fad diets and, on a recurring basis, adhere to proposals with promises of quick solutions, which are not supported by the scientific literature. The adoption of a dietary pattern combining foods such as grains, lean meats, low-fat dairy, fruits, and vegetables, associated with an energy deficit, is the nutritional treatment recommended by the main international guidelines. Moreover, an emphasis on behavioral aspects including motivational interviewing and the encouragement for the individual to develop skills will contribute to achieve and maintain a healthy weight. Therefore, this Position Statement was prepared based on the analysis of the main randomized controlled studies and meta-analyses that tested different nutrition interventions for weight loss. Topics in the frontier of knowledge such as gut microbiota, inflammation, and nutritional genomics, as well as the processes involved in weight regain, were included in this document. This Position Statement was prepared by the Nutrition Department of the Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), with the collaboration of dietitians from research and clinical fields with an emphasis on strategies for weight loss.

Obesity and Nutrigenetics Testing: New Insights

“…The Academy of Nutrition and Dietetics (USA) and the Brazilian Society of Food and Nutrition (Brazil) do not recommend the isolated use of nutrigenetic tests for the development of dietary plans and the prescription of dietary supplements [ 52 , 62 , 99 ]. ABESO also does not recommend using isolated nutrigenetic tests to treat obesity due to insufficient scientific evidence [ 120 ]. Therefore, more research should be carried out attempting to use nutrigenetic tests in each country and evaluate their use in the prevention and treatment of diseases.…”

“…Anthropometry is essential for diagnosing and assessing obesity, including body mass index (BMI), weight history, and body composition [32]. Using the BMI, it is possible to identify obesity (≥30 kg/m 2 ), overweight (25-29.9 kg/m 2 ), or eutrophy (18.5-24.9 kg/m 2 ) [15].…”

“…For people with an increased BMI, waist circumference can identify increased visceral adiposity and cardiometabolic risk [16,33]. Furthermore, family history, clinical history, and biochemical data can make obesity treatment more individualized [32].…”

“…Some professional associations, such as the Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO) [32] and the Academy of Nutrition and Dietetics [52] do not endorse the use of dietary recommendations based on nutrigenetics testing in clinical practice.…”

Dropout in cognitive behavioral treatment in adults living with overweight and obesity: a systematic review

“…According to a different position statement from the Obesity Management Task Force of the European Association for the Study of Obesity ( 18 ) and from the Brazilian Association for the Study of Obesity and metabolic syndrome (ABESO), Cognitive Behavioral Therapy (CBT) should be used for weight management in patients with overweight and obesity (class of recommendation I; level of evidence A) ( 18 , 19 ). CBT is the oldest and most studied behavior change theory used in nutrition counseling.…”