Rios Domingos L S, Oliveira Márcia C A M, Braga Sérgio Q, Chamorro Matheus J, Cunha Beatriz L B, Reis Ana C R, Guimarães Ana P, Silva Ana D N, Silva Dandara A R, Araújo Edilene M Q, Pimentel Magno M W
Hospital da Obesidade, Camaçari, Bahia, Brazil.
Departamento de Ciências da Vida, Universidade do Estado da Bahia, Salvador, Bahia, Brazil.
PLoS One. 2025 Jan 2;20(1):e0303489. doi: 10.1371/journal.pone.0303489. eCollection 2025.
Very low-calorie diets with hospitalization have demonstrated promise as a viable therapeutic option for severe obesity and its associated comorbidities. However, large studies providing a comprehensive longitudinal observation of patients undergoing this therapy are lacking. We evaluated the effectiveness of treating severe obesity in hospitalized patients, using very low-calorie diets and clinical support to develop lifestyle changes.
This study was a retrospective cohort comparing exposure variables in a secondary data analysis with a pre-post treatment design. Data were obtained from medical records of patients with severe obesity (grade II or III) treated in a Brazilian obesity specialist hospital from 2016 to 2022. The patients underwent a very low-calorie diet (500-800 kCal/day) and immersive changes in lifestyle habits, monitored by a multidisciplinary team. At 3 months, 777 patients presented complete data and 402 presented complete data at 6 months. The study compared changes in bioimpedance and laboratory tests, between men and women and age groups.
Three months of hospitalization yielded significant reductions in weight, body mass index (BMI), body fat, skeletal muscle mass, glucose, inflammatory, and lipid parameters. These reductions were more pronounced after 6 months, nearly doubling those observed at 3 months. In women, BMI and fat mass reduced by 10.4% and 15.2% at 3 months and 20.4% and 31.3% at 6 months, respectively. In men, BMI and fat mass decreased by 12.9% and 25.3 at 3 months and 23.6% and 45.3% at 6 months, respectively. Elderly individuals (aged ≥ 60 years) had smaller reductions in BMI and fat mass than non-elderly individuals (aged < 60 years) but still presented significant improvements.
This study suggests the viability of treating severe obesity by hospitalization with low-calorie diets and immersive lifestyle changes. This treatment modality significantly improves anthropometric measurements, glucose, lipids, and inflammatory markers, thereby reducing cardiovascular risk.
住院期间的极低热量饮食已被证明是治疗重度肥胖及其相关合并症的一种可行治疗选择。然而，目前缺乏对接受这种治疗的患者进行全面纵向观察的大型研究。我们评估了采用极低热量饮食和临床支持以促进生活方式改变来治疗住院重度肥胖患者的有效性。
本研究是一项回顾性队列研究，在二次数据分析中采用治疗前后设计比较暴露变量。数据来自2016年至2022年在巴西一家肥胖专科医院接受治疗的重度肥胖（II级或III级）患者的病历。患者接受极低热量饮食（500 - 800千卡/天）并在多学科团队的监测下对生活习惯进行全面改变。3个月时，777名患者提供了完整数据，6个月时402名患者提供了完整数据。该研究比较了生物阻抗和实验室检查在男性与女性以及不同年龄组之间的变化。
住院3个月后，体重、体重指数（BMI）、体脂肪、骨骼肌质量、血糖、炎症和血脂参数均显著降低。6个月后这些降低更为明显，几乎是3个月时观察到的降幅的两倍。女性在3个月时BMI和脂肪量分别降低了10.4%和15.2%，6个月时分别降低了20.4%和31.3%。男性在3个月时BMI和脂肪量分别降低了12.9%和25.3%，6个月时分别降低了23.6%和45.3%。老年个体（年龄≥60岁）的BMI和脂肪量降幅比非老年个体（年龄<60岁）小，但仍有显著改善。
本研究表明通过住院采用低热量饮食和全面的生活方式改变来治疗重度肥胖是可行的。这种治疗方式能显著改善人体测量指标、血糖、血脂和炎症标志物，从而降低心血管风险。
