Aldhamin Rabab A, Al-Ghareeb Ghadeer, Al Saif Ahmed, Al-Ahmed Zahra
Preventive Medicine, Al-Ahsa Health Cluster, Al-Ahsa, SAU.
Primary Healthcare, Qatif Health Network, Qatif, SAU.
Cureus. 2023 Jul 10;15(7):e41658. doi: 10.7759/cureus.41658. eCollection 2023 Jul.
Background Health coaching is an increasingly used strategy to help in adopting lifestyle changes for weight loss. While Saudi Arabia has one of the highest obesity prevalences worldwide, research on lifestyle interventions for weight loss is limited. Aim We aimed to investigate the effectiveness of health coaching for weight loss among the Saudi population in real-world primary healthcare settings. Methods This is a retrospective observational study. Secondary data from the health coach national program in the Eastern Health Cluster were retrieved. Obese and overweight individuals aged 15 years or older with weight-related goals who completed at least 12 weeks of coaching were included in the analysis. The primary outcomes are weight change (kg) and weight change percent (%) of the initial weight. We further compared the weight change% between different follow-up methods (i.e., physical, virtual, and hybrid) and studied the factors associated with -5% weight loss. Results In total, 465 participants were included in the analysis, with a female predominance (66.2%) and a median initial weight of 90 kg (interquartile range (IQR): 77, 101). The median follow-up duration was 127 days (IQR: 101, 157), and the median total number of coaching sessions was three (IQR: 2, 5). The mean weight change was -2.68 kg (95% confidence interval (CI): -3.12, -2.24), p<0.001. Comparing each follow-up group, no statistically significant difference was found when controlling for number of visits (p=0.059). The adjusted means for weight change% were -3.77%, -2.59%, and -2.54% for hybrid, physical, and virtual visits, respectively. Factors that were associated with achieving at least -5% weight loss were male sex (adjusted odds ratio (aOR)=1.87, 95% CI: 1.16, 3.02), five or more total coaching visits (aOR=5.23, 95% CI: 2.88, 9.50), longer follow-up duration (aOR=1.09, 95% CI: 1.03, 1.15), and having a weight management goal (aOR=4.5, 95% CI: 1.63, 12.45) as the reason for initial coaching visit. Conclusion We found statistically significant weight change among clients who completed 12 weeks of coaching in primary care settings. The findings in this paper contribute to the importance of lifestyle interventions for weight loss among the Saudi population. However, stronger controlled studies are needed to confirm this finding.
背景 健康指导是一种越来越多地用于帮助人们通过改变生活方式来减肥的策略。虽然沙特阿拉伯是全球肥胖率最高的国家之一，但关于减肥的生活方式干预研究却很有限。
目的 我们旨在调查在现实世界的初级医疗保健环境中，健康指导对沙特人群减肥的有效性。
方法 这是一项回顾性观察研究。我们检索了东部健康集群中健康指导国家项目的二级数据。纳入分析的对象为年龄在15岁及以上、有体重相关目标且完成了至少12周指导的肥胖和超重个体。主要结局指标是体重变化（千克）以及相对于初始体重的体重变化百分比（%）。我们进一步比较了不同随访方式（即面对面、虚拟和混合方式）之间的体重变化百分比，并研究了与体重减轻5%相关的因素。
结果 总共465名参与者被纳入分析，其中女性占多数（66.2%），初始体重中位数为90千克（四分位间距（IQR）：77，101）。随访时间中位数为127天（IQR：101，157），指导课程总数中位数为3节（IQR：2，5）。平均体重变化为 -2.68千克（95%置信区间（CI）：-3.12，-2.24），p<0.001。在控制就诊次数后，比较每个随访组时未发现统计学上的显著差异（p=0.059）。混合、面对面和虚拟随访的体重变化百分比调整均值分别为 -3.77%、-2.59%和 -2.54%。与体重至少减轻5%相关的因素包括男性（调整后的优势比（aOR）=1.87，95%CI：1.16，3.02）、总共进行5次或更多次指导就诊（aOR=5.23，95%CI：2.88，9.50）、更长的随访时间（aOR=1.09，95%CI：1.03，1.15）以及将体重管理目标（aOR=4.5，95%CI：1.63，12.45）作为首次指导就诊的原因。
结论 我们发现，在初级保健环境中完成12周指导的客户中，体重有统计学上的显著变化。本文的研究结果凸显了生活方式干预对沙特人群减肥的重要性。然而，需要更严格的对照研究来证实这一发现。
