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Comparación de estrategias para mantener la pérdida de peso: el ensayo controlado aleatorizado de mantenimiento de
Laura P Svetkey1, Victor J Stevens, Phillip J Brantley
1Division of Nephrology, Department of Medicine, Duke Hypertension Center and Sarah W. Stedman Nutrition and Metabolism Center, Duke University Medical Center, Durham, North Carolina 27710, USA. Svetk001@mc.duke.edu
JAMA
|March 13, 2008
Resumen
El contacto personal mensual mejoró modestamente el mantenimiento de la pérdida de peso en comparación con el control autodirigido. La tecnología interactiva ofreció beneficios tempranos pero no sostenidos de pérdida de peso en adultos obesos.
Área de la Ciencia:
- Investigación de la obesidad.
- La medicina del comportamiento es la medicina del comportamiento.
- Los ensayos clínicos son ensayos clínicos.
Sus antecedentes:
- Las intervenciones conductuales para la pérdida de peso a menudo dan como resultado un éxito a corto plazo, con una re-ganancia de peso común.
- Las estrategias efectivas para el mantenimiento del peso a largo plazo son cruciales para la salud pública.
Objetivo del estudio:
- Para comparar la eficacia de dos intervenciones distintas de mantenimiento de la pérdida de peso frente a un grupo de control autodirigido.
- Evaluar el impacto a largo plazo del contacto personal frente a la tecnología interactiva en la recuperación de peso.
Principales métodos:
- Un ensayo en dos fases que involucró a 1032 adultos con sobrepeso u obesidad con comorbilidades.
- Los participantes que perdieron al menos 4 kg fueron asignados al azar a contacto personal mensual, tecnología interactiva o control autodirigido durante 30 meses.
- El resultado primario fue el cambio en el peso de la aleatorización.
Principales resultados:
- Después de la pérdida de peso inicial, los participantes en el grupo de contacto personal recuperaron significativamente menos peso (4,0 kg) que el grupo autodirigido (5,5 kg) a los 30 meses.
- El grupo de tecnología interactiva mostró beneficios tempranos a los 18 y 24 meses, pero no hubo diferencias significativas en la recuperación del peso a los 30 meses en comparación con el grupo de control.
- En general, el 71% de los participantes mantuvieron un peso por debajo de su nivel de entrada inicial.
Conclusiones:
- La mayoría de las personas que completan con éxito un programa inicial de pérdida de peso conductual pueden mantener el peso por debajo de su punto de partida.
- El contacto personal mensual ofrece un beneficio modesto y sostenido para el mantenimiento de la pérdida de peso.
- Las intervenciones basadas en tecnología interactiva proporcionan beneficios transitorios, lo que pone de relieve la necesidad de estrategias de participación sostenida.
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