Lifestyle intervention program improves CV, mental health in obesity
Patients with obesity experienced improved CV and mental health after attending a nonjudgmental and personalized lifestyle modification program, according to a study presented at EuroHeartCare.
“Obesity develops for multiple reasons and blaming someone for their weight can stop them from getting health care and advice. It can lead to emotional eating and feeling too self-conscious to exercise,” Aisling Harris, cardiac and weight management dietitian at Croí Heart and Stroke Centre in Galway, Ireland, said in a press release. “By identifying each person’s triggers, we can develop alternative coping strategies, all within the context of their job, caring responsibilities, external stresses and so on. For some people, coming to a group like this might be the only social contact that they’ve had in the week or that they’ve had in years. People share experiences and support their peers.”
Harris and colleagues conducted a community-based, lifestyle modification program, Changing Lifestyle with Activity and Nutrition, concerning CVD risk factors for people with obesity. From 2013 to 2019, 1,122 Irish patients who were referred by a specialist bariatric service participated in the 10-week program. A nurse, dietitian and physical therapist led weekly, group-based exercise sessions and health workshops on topics such as nutrition, food labels, emotional eating, exercise and sedentary behavior, stress management and CVD risk reduction. The researchers recorded primary outcomes at baseline and at the conclusion of the program.
Among the 1,122 original participants, 78% completed the program. Overall, 26.7% had type 2 diabetes and 37.3% were at high or very high risk for CVD. Also, 44.7% were hypertensive and 31.4% reported a history of depression. The average BMI was 47 kg/m²; 56.7% had a BMI greater than 45 kg/m².
Harris and colleagues found the program had a significant and positive effect on patients’ psychosocial health, lipid profiles, BP, adiposity and CV health. Scores of anxiety and depression using the Hospital Anxiety and Depression Scale decreased by 1.5 and 2.2 points, respectively (P < .001 for both), according to the researchers.
The cohort also experienced decreases in total cholesterol, from 4.69 mmol/L to 4.54 mmol/L, and LDL, from 2.79 mmol/L to 2.64 mmol/L (P < .001 for both).
BP improved by 15.7 mm Hg systolic and 1.4 mm Hg diastolic (P < .001 for both).
Among those with type 2 diabetes, 57.4% achieved the HbA1c target of less than 53 mmol/L at the end of the program compared with 47.6% at baseline (P < .001), according to the researchers.
The cohort lost an average of 2 kg (P < .001). Also, 27.2% of patients lost more than 3% of their initial body weight and 31% achieved the recommended activity guidelines compared with baseline (P < .001).
“Nearly 8 in 10 people finished the program, which suggests that the content and format were acceptable. We observed improvements across all psychosocial and health outcomes during a relatively short period, indicating that this could be a model of service delivery for other centers,” Harris said in the release.
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Harris A, et al. Abstract 90123. Presented at: EuroHeartCare – ACNAP Congress 2021; June 17-19, 2021 (virtual meeting).
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