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.
Highlights
IntroductionIn some cases appetite suppressants that increase anorexigenic neurotransmitters in the central nervous system (Yanovski & Yanovski, 2002) such as sibutramine (National Institute for Clinical Excellence, 2001) and orlistat have been used, but the suppressants were only continued if patients lost weight and maintained the weight loss without significant side effects (Noel & Pugh, 2002)
There is a close relationship between waist circumference and cardiovascular risk in obesity (Masiaet al., 1998); concerned men and women commonly lose weight by consuming less fat but not fewer calories rather than practicing the recommended combination of hypocaloric diet associated with physical activity (Serdula et al, 1999; Wadden, 1993) to achieve permanent changes in lifestyle (SIGN, 1996; NHS, 1997) allowing better obesity control (Benıtez Guerrero et al, 2009)
The 63.1% of patients with successful loss in all the studied variables were analysed. 36.9% of patients dropped out during the first three visits with no known medical reason or significant relationships to sex and BMI; we assumed that patients discontinued the treatment because they did not get the immediate results in waist loss they expected
Summary
In some cases appetite suppressants that increase anorexigenic neurotransmitters in the central nervous system (Yanovski & Yanovski, 2002) such as sibutramine (National Institute for Clinical Excellence, 2001) and orlistat have been used, but the suppressants were only continued if patients lost weight and maintained the weight loss without significant side effects (Noel & Pugh, 2002). These drugs are suspended (Hernandez Garcıa, 2010) and are under consumption alerts (Heitmann Ghigliotto, 2010)
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