Proposição de um programa para avaliação do sucesso do tratamento da obesidade em adolescentes : Sucevaluation

Abstract

The obesity has become a Public Health concern due to the high number of associated comorbidities, such as hypertension, diabetes mellitus type II, dyslipidemia, metabolic syndrome and the morbidity and mortality increase. Studies that investigated multidisciplinary programs of obesity treatment, focused on lifestyle change, showed positive results related to health, anthropometry, body composition, cardiorespiratory fitness, health-related quality of life, metabolic profile, among others. Notwithstanding, when we look forward to establish the effectiveness of these programs in adolescents through these parameters mentioned above, many of them do not have a totally defined cut-off points for this purpose. In addition, there is not a consensus in the scientific literature on what would be the most relevant parameters to this type of assessment. The common used parameters are the following: Body mass, body mass index (BMI), Z-score of body mass index, although they do not reflect all the relevant clinical changes to the adolescent health and disregard that adolescents can have positive changes on anthropometry and body composition without improvement of the metabolic profile, that can be improvements on the metabolic profile without anthropometric changes and body composition and can still be improvement of the quality of life and self-esteem without anthropometric changes, body composition and metabolic profile. There is also a lack in the literature a program for evaluating the success of obesity treatment in adolescents capable of grouping variables from different domains that represent a general health of adolescents and allows the evaluation of these domains independently. To propose a program for evaluating of the success of the treatment of the obesity in adolescents called SUCEVALUATION that contemplates the physical, physiological, behavioral and psychosocial domains with the possibility of global and partial analysis. The study included 138 adolescents, both sexes (60,9% female), from 14 to 18 years old, with overweight or obesity that agreed in participate of a multidisciplinary program of obesity treatment (98 in the intervention group and 40 in the control group) among the years of 2014 and 2016, lasting 16 weeks. The intervention consists in theoretical lectures of Nutrition, Psychology and Physical Education, and a practical intervention of Physical Education. Both theoretical and practical interventions have a frequency of 3 days per week. The adolescents were assessed before and after their MPOT participation, being included in the study anthropometric data, body composition, health-related physical fitness, metabolic markers, health-related quality of life, and physical activity level of the intervention and control groups. The MPOT was effective for most participants, reducing the degree of obesity and improving various parameters of the general health of adolescents compared to the control group without intervention, which made it possible to develop a program for evaluating the success of obesity treatment in adolescents (SUCEVALUATION) with 12 variables that allow to analyze several domains that evolve independently. Evaluating the effects of an obesity treatment program on adolescents without distinguishing participants according to their level of success may lead to misleading analysis of obesity treatment, since the participants who did not achieve success resembled their results in the control group without intervention. SUCEVALUATION presents as a possibility to evaluate the success of obesity treatment in adolescents, allowing the evaluation of several variables of the physical, physiological, behavioral and psychosocial domains independently, establishing cut-off points for 12 variables commonly investigated among researchers in this area and making possible comparisons between studies