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基于临床显著体重减轻的成人严重肥胖多学科治疗方案的有效性。

Effectiveness of a Multidisciplinary Treatment Program for Severe Obesity in Adults Based on the Clinically Significant Weight Loss.

作者信息

Westphal-Nardo Greice, Marques Mincache Angélica Sbrolini, Franzini Paulo César, Pascoini Dos Santos Mara Jane, Nicchio Rocha Gisele, Candido Ieda Carla, Herrera-Santelices Andrea, Ferraz Grizzo Felipe Merchan, Chaput Jean-Philippe, Nardo Junior Nelson

机构信息

Department of Physical Education, Associate Graduate Program in Physical Education UEM/UEL, Health Sciences Center, State University of Maringa, Maringa 87020-900, Parana, Brazil.

Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada.

出版信息

J Funct Morphol Kinesiol. 2025 Jun 11;10(2):225. doi: 10.3390/jfmk10020225.

Abstract

Obesity is a chronic and complex disease; by its nature, it represents an enormous challenge to be solved and managed. For that matter, several guidelines have been published, but there is still a long way to go until concrete scaled results can be presented. Adults with obesity, and especially severe obesity, need to have access to treatment programs, but they are not available for the vast majority of the population. The aim of this study is to evaluate the effectiveness of a multidisciplinary treatment program for obesity (MTPO) offered to adults (ages 18 to 50 years old) with a BMI over 30 kg/m. Participants were invited through media ads, resulting in 404 participants for the first phase of that study, from whom the risk profile was assessed. After that, 180 participants (82.8% with severe obesity) concluded the MTPO, which consisted of 48 sessions of exercises and the same number of professional orientations about a healthy lifestyle, including the importance of being physically active, how to improve their eating habits, and how to control their emotions. For the analysis of results, participants were grouped according to their weight loss in terciles, with the first, tercile presenting an average weight loss of 7.6%, which is considered clinically significant. In the same way, the average percental variations were even higher in this group for body fat (12.7%) and the lean mass to fat mass ratio (LM/FM), which increased by 14.3%. The homeostatic model assessment for insulin resistance, HOMA-IR, was around 3 times the variation of body mass, whereas the triglycerides (TG) and the hemoglobin A1C (H1Ac) were around twice that rate. These results made clear the effectiveness of the MTPO, which needs to be tested in public health services.

摘要

肥胖是一种慢性复杂疾病;就其本质而言,它是一个亟待解决和管理的巨大挑战。就此而言,已经发布了多项指南,但要得出具体的规模化成果仍有很长的路要走。肥胖的成年人,尤其是重度肥胖者,需要获得治疗项目,但绝大多数人无法获得此类项目。本研究的目的是评估为体重指数(BMI)超过30 kg/m²的18至50岁成年人提供的多学科肥胖治疗项目(MTPO)的有效性。通过媒体广告邀请参与者,该研究第一阶段有404名参与者,对他们进行了风险评估。之后,180名参与者(82.8%为重度肥胖)完成了MTPO,该项目包括48节锻炼课程以及相同数量的关于健康生活方式的专业指导,包括身体活动的重要性、如何改善饮食习惯以及如何控制情绪。为了分析结果,参与者根据体重减轻情况分为三个三分位数组,第一三分位数组的平均体重减轻7.6%,这被认为具有临床意义。同样,该组身体脂肪的平均百分比变化(12.7%)和瘦体重与脂肪量之比(LM/FM)甚至更高,增加了14.3%。胰岛素抵抗的稳态模型评估(HOMA-IR)的变化约为体重变化的3倍,而甘油三酯(TG)和糖化血红蛋白(H1Ac)的变化约为体重变化的2倍。这些结果明确了MTPO的有效性,该项目需要在公共卫生服务中进行测试。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c4b/12194354/4c1d9a31291a/jfmk-10-00225-g001.jpg

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