Abstract
IntroductionDietary, psychological and physical exercise counseling can affect adherence to healthy guidelines and outcome in obesity. Relationship of these factors were studied.Method40 weeks dietary and physical exercise behavioral counseling was provided to 134 non‐diabetic overweight‐obese patients (F 74, M 60), age 49.81±14.49 years, BMI 29.12±5.82.Measuresinsulin resistance (HOMA), Mediterranean Diet Adherence Score (AMDS; range 0–55) a proxy for healthy guidelines, physical activity (Baecke), self‐efficacy (GSE), stress and HAD questionnaires.ResultsA decrease of body weight (77.68±16.57 to 74.42±15.42, p<0.0001), BMI (29.12±5.82 to 27.66±5.15; p<0.0001) and HOMA (2.68±1.44 to 2.11±1.19) was observed, along with increase of self efficacy (18.05±5.32 to 19.76±5.25; p<0.0001) and of AMDS (28.90±4.65 to 31.03±4.03; p<0.0001). Greater baseline GSE is associated with greater AMDS (OR 15.81; CI 95%: 0.915–3.571); anxiety, depression and perceived stress are associated with lower AMDS. Multiple Linear Regression model (p<0.0001) explains 28.1 % of variance to AMDS by GSE and physical activity increase. Nutritional‐psychological counseling favorable outcome (BMI and HOMA decrease) is explained by GSE and AMDS increase.ConclusionBehavioral counseling focused on physical exercise and self‐efficacy enhances dietary adherence and weight loss in obesity.
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