肥満と減量療法のジャーナル

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Six Month Outcomes of a Primary Care-Based Weight Loss Trial Using a Lay-Trained Counselor

Adam Gilden Tsai and Sue Felton

Background: Obesity remains an important problem in primary health care settings. Intensive counseling from trained nutrition professionals has proven efficacy but is resource intensive. Trials have begun to assess the effectiveness of lower cost counselors. Methods: This paper describes the 6-month outcomes of a high intensity counseling intervention on weight (primary outcome), as well as cardiovascular disease risk factors and health-related quality of life (secondary outcomes). We also sought to assess whetherbaseline characteristics were associated with 6-month weight change. Participants (n=106) had obesity and at least one co-morbid medical condition. The trial used a trained layperson counselor and provided study participants with subsidized access to an evidence-based regimen of portion-controlled foods. Weight change data were analyzed using intention-to-treat analysis. Participants who dropped out prior to 6 months were assumed to have regained weight. Results: Average weight loss after 6 months was 7.0 kg, equal to 6.5% of initial weight. Significant improvements were noted in blood pressure, waist circumference, glycemic control, mood, and overall health-related quality of life. Most baseline characteristics were not associated with weight loss after 6 months. Conclusions: An intensive lifestyle intervention, using a trained layperson and portion-controlled foods, produced clinically significant weight loss at 6 months.Improvements were also noted in cardiovascular disease risk factors and in quality of life