RESUMO
To assess the effectiveness of physical activity counseling by a dietitian for obese sedentary women attending nutrition clinic for weight management over 12 weeks and barriers for increasing physical activity level. Randomized controlled trial with a 3-month follow-up from October 2006 to January 2007. El Majory outpatient nutrition clinic as one of the public nutrition clinics at Benghazi city, Libya. Eighty seven obese healthy sedentary women . Eligible participants were randomly assigned to brief verbal advice; [n= 38] and counseling group [intervention] [n = 49] receiving physical activity counseling [the five as model]. Assessment visits were scheduled for both groups at baseline and weeks 2, 4, 8, 12. The main outcome measures were change in body weight and physical activity level. Participants [n = 87] were randomized to counseling [n = 49] and verbal advice group [n-38]. Attrition was 25.3% at week 4 visit increased to 31% at both weeks 8 and 12. Significant change-by-time interaction for percentage reduction in initial weight was found within participants of both groups [p <0.001]. No significant weight change differences were observed between the two groups at week 4 and 8 visits [p - 0.09] however, results of last observation -carried forward and completers analysis found that counseling group participants lost significantly more weight at week 12 than those of verbal advice group [p = 0.04]. Lack of time due to family responsibilities and child care was the main participants barrier to increasing their physical activity level [32.2%] followed by lack of energy to exercise [28.7%]. The reported barriers were not significantly changed as a result of counseling intervention. Physical activity levels of the counseling intervention group were significantly increased from initial sedentary to moderate and high active compared to the brief verbal advice group [p = 0.01]. Physical activity counseling [the five as model] conducted by dietitian appoars to positively influence levels of physical activity and weight loss changes in healthy obese sedentary women attending nutrition clinics. There is obvious need for an effective activity counseling to be incorporated in the treatment plan for obese clients