Portion control for the treatment of obesity in the primary care setting

Rebecca L Kesman, Jon O Ebbert, Katherine I Harris, Darrell R Schroeder, Rebecca L Kesman, Jon O Ebbert, Katherine I Harris, Darrell R Schroeder

Abstract

Background: The increasing prevalence of obesity is a significant health threat and a major public health challenge. A critical need exists to develop and evaluate practical methods for the treatment of obesity in the clinical setting. One of the factors contributing to the obesity epidemic is food portion sizes. Limited data are available on the efficacy of visual or tactile devices designed to enhance patient understanding and control of portion sizes. A portion control plate is a commercially-available product that can provide visual cues of portion size and potentially contribute to weight loss by enhancing portion size control among obese patients. This tool holds promise as a useful adjunct to dietary counseling. Our objective was to evaluate a portion control intervention including dietary counseling and a portion control plate to facilitate weight loss among obese patients in a primary care practice.

Findings: We randomized 65 obese patients [body mass index (BMI) ≥ 30 and < 40] to an intervention including counseling by a dietitian incorporating a portion control plate or to usual care. Following initial consultation, patients in the intervention arm were contacted at 1, 3, and 5 months by the dietician for brief follow-up counseling. Usual care subjects received instructional handouts on diet and exercise. Forty-two (65%) subjects returned to have weight assessed at 6 months. Subjects in the portion control intervention had a greater percentage change (± SD) in weight from baseline at 3 months (-2.4% ± 3.7% vs. -0.5% ± 2.2%; p = 0.041) and a non significant trend in weight change from baseline at 6 months (-2.1% ± 3.8% vs. -0.7% ± 3.7%; p = 0.232) compared with usual care. Nearly one-half of patients assigned to the portion control intervention who completed the study reported the overall intervention was helpful and the majority would recommend it to others.

Conclusions: Our findings suggest that a portion control intervention incorporating dietary counseling and a portion control plate may be effective for enhancing weight loss among obese subjects. A portion control intervention deserves further evaluation as a weight control strategy in the primary care setting.

Trial registration: Current controlled trials NCT01451554.

References

    1. Flegal KM, Carroll MD, Ogden CL, Curtin LR. Prevalence and trends in obesity among US adults, 1999-2008. JAMA. pp. 235–241.
    1. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults.
    1. Danaei G, Ding EL, Mozaffarian D, Taylor B, Rehm J, Murray CJ, Ezzati M. The preventable causes of death in the United States: comparative risk assessment of dietary, lifestyle, and metabolic risk factors. PLoS Med. 2009;6(4):e1000058. doi: 10.1371/journal.pmed.1000058.
    1. Li Z, Maglione M, Tu W, Mojica W, Arterburn D, Shugarman LR, Hilton L, Suttorp M, Solomon V, Shekelle PG. et al.Meta-analysis: pharmacologic treatment of obesity. Ann Intern Med. 2005;142(7):532–546.
    1. Shaw K, Gennat H, O'Rourke P, Del Mar C. Exercise for overweight or obesity. Cochrane Database Syst Rev. 2006. p. CD003817.
    1. Shaw K, O'Rourke P, Del Mar C, Kenardy J. Psychological interventions for overweight or obesity. Cochrane Database Syst Rev. 2005. p. CD003818.
    1. Rolls BJ, Morris EL, Roe LS. Portion size of food affects energy intake in normal-weight and overweight men and women. Am J Clin Nutr. 2002;76(6):1207–1213.
    1. Pedersen SD, Kang J, Kline GA. Portion control plate for weight loss in obese patients with type 2 diabetes mellitus: a controlled clinical trial. Arch Intern Med. 2007;167(12):1277–1283. doi: 10.1001/archinte.167.12.1277.
    1. Ford AL, Bergh C, Sodersten P, Sabin MA, Hollinghurst S, Hunt LP, Shield JP. Treatment of childhood obesity by retraining eating behaviour: randomised controlled trial. BMJ. 2010;340:b5388.
    1. Wadden TA, Foster GD. Behavioral treatment of obesity. Med Clin North Am. 2000;84(2):441–461. doi: 10.1016/S0025-7125(05)70230-3. vii.
    1. Volkmar FR, Stunkard AJ, Woolston J, Bailey RA. High attrition rates in commercial weight reduction programs. Arch Intern Med. 1981;141(4):426–428. doi: 10.1001/archinte.141.4.426.
    1. Bautista-Castano I, Molina-Cabrillana J, Montoya-Alonso JA, Serra-Majem L. Variables predictive of adherence to diet and physical activity recommendations in the treatment of obesity and overweight, in a group of Spanish subjects. Int J Obes Relat Metab Disord. 2004;28(5):697–705. doi: 10.1038/sj.ijo.0802602.
    1. .
    1. Ogden J. The correlates of long-term weight loss: a group comparison study of obesity. Int J Obes Relat Metab Disord. 2000;24(8):1018–1025. doi: 10.1038/sj.ijo.0801354.

Source: PubMed

Szponzorok és közreműködők

Egészségi állapot

Kábítószer-beavatkozások

3
Iratkozz fel