The authors declare that they have no competing interests.
CC contributed to data analysis and interpretation and to writing the manuscript. IG led the design and implementation of the programme, assisted with data analysis and interpretation and writing the manuscript. KC helped to deliver the programme, acquire the data and write the manuscript. CK helped to deliver the programme, acquire the data and write the manuscript. CC helped to deliver the programme, acquire the data and write the manuscript. JW helped to deliver the programme, acquire the data and write the manuscript. POS supervised the analyses of laboratory samples and helped to write the manuscript. MH contributed to patient educational sessions during the programme and helped to write the manuscript. BMG helped with interpretation of the data and drafting the manuscript. KK helped with interpretation of the data and drafting the manuscript. HG helped with patient enrolment and follow-up and drafting the manuscript. TOB helped with patient enrolment, interpretation of the data and drafting the manuscript. JJ helped to design and implement the programme, assisted the analysis and interpretation of the data and helped to draft the manuscript. FF contributed to funding the programme, helped to design it, provided clinical oversight and governance for the programme, helped with data acquisition, analysis and interpretation and supervised the writing of the manuscript. All authors read and approved the final manuscript.
Lifestyle modification is fundamental to obesity treatment, but few studies have described the effects of structured lifestyle programmes specifically in bariatric patients. We sought to describe changes in anthropometric and metabolic characteristics in a cohort of bariatric patients after participation in a nurse-led, structured lifestyle programme.
We conducted a retrospective, observational cohort study of adults with a body mass index (BMI) ≥40 kgm−2 (or ≥35 kgm−2 with significant co-morbidity) who were attending a regional bariatric service and who completed a single centre, 8-week, nurse-led multidisciplinary lifestyle modification programme. Weight, height, waist circumference, blood pressure, HbA1c, fasting glucose and lipid profiles as well as functional capacity (Incremental Shuttle Walk Test) and questionnaire-based anxiety and depression scores before and after the programme were compared in per-protocol analyses.
Of 183 bariatric patients enrolled, 150 (81.9 %) completed the programme. Mean age of completers was 47.9 ± 11.2 years. 34.7 % were male. There were statistically significant reductions in weight (129.6 ± 25.9 v 126.9 ± 26.1 kg, p < 0.001), BMI (46.3 ± 8.3 v 44.9 ± 9.0 kgm−2, p < 0.001), waist circumference (133.0 ± 17.1 v 129.3 ± 17.5 cm in women and 143.8 ± 19.0 v 135.1 ± 17.9 cm in men, both p < 0.001) as well as anxiety and depression scores, total- and LDL-cholesterol and triglyceride levels, with an increase in functional capacity (5.9 ± 1.7 v 6.8 ± 2.1 metabolic equivalents of thermogenesis (METS), p < 0.001) in completers at the end of the programme compared to the start. Blood pressure improved, with reductions in systolic and diastolic blood pressure from 135 ± 16.2 to 131.6 ± 17.1 (p = 0.009) and 84.7 ± 10.2 to 81.4 ± 10.9 mmHg (p < 0.001), respectively. The proportion of patients achieving target blood pressure increased from 50.3 to 59.3 % (p = 0.04). The proportion of patients with diabetes achieving HbA1c <53 mmol/mol increased from 28.6 to 42.9 %, p = 0.02.
Bariatric patients completing an 8 week, nurse-led structured lifestyle programme had improved adiposity, fitness, lipid profiles, psychosocial health, blood pressure and glycaemia. Further assessment of this programme in a pragmatic randomised controlled trial seems warranted.
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- Effects of an eight-week supervised, structured lifestyle modification programme on anthropometric, metabolic and cardiovascular risk factors in severely obese adults
Paula M. O′Shea
Francis M Finucane
- BioMed Central
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