PREDICTOR VARIABLES FOR LOW ADHERENCE TO A LIFESTYLE MODIFICATION PROGRAM OF OVERWEIGHT TREATMENT IN PRIMARY HEALTH CARE

Objectives: To identify predictive variables of low adherence to a pilot Lifestyle Modification Program (LMP) for overweight and obesity treatment in primary health care (PC). Material and methods: Sixty subjects with BMI > 27 kg/m(2) were recruited. Health professionals directed the program in a group structure and biweekly, based on nutrition education with individualized dietary guidelines, promotion of physical activity and motivational support. A validated questionnaire on lifestyle habits for overweight and obesity subjects was used to identify variables related with program adherence and anthropometric variables were measured before and 6 months after intervention. Low adherence was considered when patients attended to less than 80% of visits. Results: Twenty-seven subjects (45%) presented high adherence to the program. The variables associated to low adherence were related to baseline with IMC >= 35 kg/m(2) (p < 0.05); ex smoker period <= 4 months (p < 0.01); high caloric diet (p < 0.01) and scarce physical activity (p < 0.05). At 6 months the subjects who finalized the program presented a significant decrease of weight (86.0 +/- 15.6 vs 79.2 +/- 13.4 kg; p < 0,001); fat mass percentage (41,6 +/- 4,6 vs 38.8 +/- 5,4%; p < 0.001), blood glucose (108 +/- 45.48 vs 94.38 +/- 11.97 mg/dl; p < 0.01). It also improved caloric diet profile, above all decreasing the percentage of fat (39.6 +/- 4.8 vs 35.5 +/- 5.6%; p < 0.01). Conclusion: Have recently left smoking, obesity degree two or higher, a high caloric diet and scarce physical activity were basal variables identified as predictive of a low adhesion to a LMP for the treatment of overweight and obesity in primary health care. We do not consider this pilot experience as satisfactory and other new strategies are under development.