Feasibility and Effectiveness of a Comprehensive Care Program for People Living with Obesity: A Real-World Experience in a Public Hospital in Mexico

Abstract

<b><i>Introduction:</i></b> Existing evidence indicates that the best treatment model for obesity leading to successful weight loss consists of a so-called comprehensive lifestyle intervention program, but the offer, implementation, and coverage of these kinds of programs for the diagnosis, management, and follow-up of people living with obesity are limited. So, the aim of this study was an evaluation of the feasibility and effectiveness of a comprehensive care program for obesity in a public tertiary hospital in Mexico. <b><i>Methods:</i></b> An observational, longitudinal, and retrospective study evaluated a six-month long medium-intensity comprehensive care program (seven visits focused on medical, nutritional, psychological, and psychiatric diagnosis and treatment). A total of 1,017 people living with obesity were recruited for the program. Logistic regression models were used to predict the factors associated with attendance and weight loss. <b><i>Results:</i></b> Of the 1,017 participants, 661 completed the program (65% retention rate) and attended 4.9 ± 1.9 visits each, with 40.1% losing ≥5% of their starting weight (<i>X</i> = 4.3 ± 4.4%). From visit 1 to visit 7, the participants that completed the program had weight decreases of Δ = −4.8 kg and body mass index (BMI) −2.3 kg/m²; <i>p</i> &#x3c; 0.01. Each additional visit increased the likelihood of a 5% weight loss [OR 1.90, 95% CI: 1.51–2.38, <i>p</i> &#x3c; 0.001] and 10% [OR 2.45, 95% CI: 1.49–4.02, <i>p</i> &#x3c; 0.001], becoming statistically significant after attending more than four visits. Each additional year of age increased the likelihood of losing ≥5% body weight [OR 1.01, 95% CI: 1.00–1.03, <i>p</i> &#x3c; 0.05] and increased the likelihood of completing the program [OR 1.02, 95% CI: 1.00–1.03, <i>p</i> &#x3c; 0.01] after controlling for sex, weight, BMI, and psychiatric and weight loss medications. <b><i>Discussion/Conclusion:</i></b> This study demonstrates the feasibility and effectiveness of a six-month comprehensive program for obesity in a public hospital in Mexico.