[Effectiveness of a therapeutic practice on overweight in primary care]. / Eficacia de una intervención terapéutica sobre el exceso de peso en atención primaria.

OBJECTIVES: To evaluate the effectiveness of an intervention program on overweight to achieve a minimum decrease of 5% or a optimum of 10% of initial weight a year, and to identify the factors associated with slimming. DESIGN: Randomized controlled trial. SETTING: Urban health centre. PARTICIPANTS: Overweight subjects over 18 years old (n=169), wanting treatment or referred by their doctor. They were randomly assigned to the intervention (n=95) or control (n=70) group. INTERVENTIONS: Intervention group: yearly program with consultations every 15-21 days, using a low calorie diet, prescribing physical exercise, changing of habits and health education. CONTROL GROUP: low calorie diet, seen 3 times/year. RESULTS: The minimum weight loss was achieved in 6 months by 37.9% of the intervention group and by 21.4% of the control group. At one year, 45.3% of the intervention subjects and 24.3% of the control group reached this objective. The optimum loss of 10% was higher in the intervention group, but was not statistically significant. The minimum objective was associated with the intervention group (OR=4.5 [1.36-14.49]). It was also associated to the number of visits during therapy (OR=1.85 [1.50-2.29]) and diabetes (OR=10 [1.13-90.9]). CONCLUSIONS: The intervention group had a loss of 5% of initial weight in the first 6 months, 16.5% more than the control group, and 21% more in one year. Achieving the minimum objective was associated with the intervention group, the number of visits and the diagnosis of diabetes.

Eficacia de una intervención terapéutica sobre el exceso de peso en atención primaria / Effectiveness of a therapeutic practice on overweight in primary vare

Objetivos. Evaluar la eficacia de un programa de intervención sobre el exceso de peso para conseguir una disminución mínima del 5% u óptima del 10% del peso inicial al año, e identificar los factores relacionados con el adelgazamiento. Diseño. Ensayo clínico aleatorizado. Emplazamiento. Centro de salud urbano. Participantes. Se incluyeron en el estudio 169 sujetos mayores de 18 años con exceso de peso, que habían demandado tratamiento o que habían sido remitidos por su médico. Fueron asignados aleatoriamente al grupo de intervención (n = 95) o al grupo control (n = 70). Intervenciones. En el grupo de intervención, se realizó un programa anual con consultas cada 15-21 días, mediante dieta hipocalórica, prescripción de ejercicio físico, modificación de hábitos y educación sanitaria. En el grupo control, se realizó dieta hipocalórica con cita 3 veces al año. Resultados. La mínima pérdida de peso fue alcanzada por el 37,9% de los participantes intervenidos y por el 21,4% del grupo control en 6 meses. Al cabo de un año, el 45,3% de los sujetos intervenidos y el 24,3% del grupo control consiguieron este objetivo. La pérdida óptima del 10% fue mayor en el grupo de intervención, sin significación estadística. El objetivo mínimo se relacionó con el grupo de intervención (odds ratio [OR] = 4,5 [1,36-14,49]). También se relacionó el número de visitas durante la terapia (OR = 1,85 [1,50-2,29]) y la diabetes (OR = 10 [1,13-90,9]). Conclusiones. El grupo de intervención experimentó una pérdida del 5% del peso inicial un 16,5% superior que el grupo control los primeros 6 meses y un 21% más en un año. La consecución del objetivo mínimo se relaciona con el grupo del ensayo, el número de consultas y el diagnóstico de diabetes

Objectives. To evaluate the effectiveness of an intervention program on overweight to achieve a minimum decrease of 5% or a optimum of 10% of initial weight a year, and to identify the factors associated with slimming. Design. Randomized controlled trial. Setting. Urban health centre. Participants. Overweight subjects over 18 years old (n=169), wanting treatment or referred by their doctor. They were randomly assigned to the intervention (n=95) or control (n=70) group. Interventions. Intervention group: yearly program with consultations every 15-21 days, using a low calorie diet, prescribing physical exercise, changing of habits and health education. Control group: low calorie diet, seen 3 times/year. Results. The minimum weight loss was achieved in 6 months by 37.9% of the intervention group and by 21.4% of the control group. At one year, 45.3% of the intervention subjects and 24.3% of the control group reached this objective. The optimum loss of 10% was higher in the intervention group, but was not statistically significant. The minimum objective was associated with the intervention group (OR=4.5 [1.36-14.49]). It was also associated to the number of visits during therapy (OR=1.85 [1.50-2.29]) and diabetes (OR=10 [1.13-90.9]). Conclusions. The intervention group had a loss of 5% of initial weight in the first 6 months, 16.5% more than the control group, and 21% more in one year. Achieving the minimum objective was associated with the intervention group, the number of visits and the diagnosis of diabetes