engleski

Five-day educational structured outpatient program for obese patients

Introduction: There are many benefits of weight loss: even small reductions has a profound impact on the health of obese people and their risk of future disease. Methods: Data from 58 obese patients (13 men, 45 women), mean age 45 years (20-68) were analysed. They attended structured weight loss program at the Obesity Treatment Centre at University Hospital Centre Zagreb accredited as Croatian Obesity Treatment Referral Centre and EASO Collaborating Centre for Obesity Management. 5-day program includes daily consultations with a multidisciplinary healthcare team. The team leads experienced endocrinologist-diabetologist and nurse- educator, includes nutritionist, physiotherapist, psychiatrist, psychologists who provide psychological support and facilitate behaviour modifications with other subspecialists. At the baseline and after 3 months anthropometric values (height, weight, BMI) as well as body composition measured by bioelectrical impedance analysis (fat mass, muscle mass) were estimated. Patients filled out screening instruments examining personality traits, coping styles, subjective well-being, depression and anxiety symptoms. Results: Baseline mean body mass was 125 kg (78- 238), BMI was 44.2 kg/ m2 (30-66), fat mass 59.4 kg (25.1-120.4), muscle mass 61.4 kg (43.8- 117) ; after 3 months mean body mass was 119 kg (72.8- 197.3), BMI 42.1 kg/ m2 (27.9-64.4), fat mass 53.6 kg (23.6-103.7), muscle mass 62.3 kg (43.7-107.7). Statistical analyses showed significant decrease in body weight, BMI and body fat mass after 3 months (p = 0.000), but no significant difference in muscle mass (p = 0.969). Patients were divided into two groups ; those who did not lose any weight (≤1 kg) were considered non-responders, others were considered responders. Thirteen patients (22%) were non-responders and 45 patients (78%) were responders. Mean weight loss of responders was 6.2% (1-38). Conclusion: According to FDA Guidance for developing products for weight management the product is effective if there is a statistically significant decrease in body weight of ≥5% beyond the placebo effect or at least 35% of patients lose ≥5% of their body weight at 3 months. Overall response to our program is effective during the 3 months follow-up period. It is fulfilling criteria for weight management products without pharmacotherapy. The weight loss corresponds to fat mass with preserved muscle mass. There are also positive changes in self-esteem, body image and quality of life. Joining a group of unknown individuals can be intimating, but group therapy provides benefits that individual therapy may not ; group acts as a support network where other members help to come up with specific ideas for improving a difficult situation or life challenge.

structured program ; weight loss ; obesity

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