Effect of behavioral approach on weight loss in overweight and obese women at the primary care

BACKGROUND: In the management of overweight and obesity permanent lifestyle changes are essential. We aimed to evaluate the effect of a practical behavioral model created to be used in the Obesity Counseling Unit (OCU) at the primary care on weight loss in overweight and obese women. METHODS: This is a prospective interventional study. Women aged 25 to 64 years with a body mass index (BMI) between 25.0 and 39.9 kg/m2 who were admitted to the OCU at Balçova Community Health Center from December 2013 to July 2014 were included. Women who is pregnant or lactating, and those with a physical or mental disability to egzersize were excluded. By defining 1.5 kg/m² reduction in BMI as the expected effect of behavioral intervention and considering a 25% loss to follow-up, a sample size of 80 was estimated. Patients were interviewed at the beginning and at days 15, 30, 45, 60, 90 , 120, 150 and 180. A behavioral model consisting of self-monitoring, setting a weight loss goal, stimulus control, developing alternative behaviour, social support, and self-rewarding was applied to all subjects at each visit in order to increase physical activity and to acquire healthy eating habits. Data including eating habits, amount of physical activity, and antropometric measures of the subjects were recorded at baseline and at month six. To analyse the data, descriptive statistics and Wilcoxon Signed Rank Test were used. RESULTS: A total of 103 overweight/obese women who fulfilled the inclusion criteria were enrolled. Eighteen patients were excluded because of loss to follow up and 85 patients (82.5%) completed the study. Mean age was 47.8±9.1 years. The mean body weight was 82.7±10.8 kg at baseline and it decreased significantly to a mean of 79.9±10.7 kg at month six (p<0.05). Similarly, the mean BMI was 32.1±3.9 kg/m2 at baseline and it decreased significantly to a mean 31.0±3.9 kg/m2 at month six (p<0.05). CONCLUSION: By increasing physical activity and acquiring healthy eating habits, a behavioral approach consisting of behavioral modification techniques which can be applied by general practitioners and primary care health professionals can help overweight/obese individuals to lose weight. Key words: Overweight, obesity, behavioral approach, primary care.