Position statement on nutrition therapy for overweight and obesity: nutrition department of the Brazilian association for the study of obesity and metabolic syndrome (ABESO-2022).

Obesity is a chronic disease resulting from multifactorial causes mainly related to lifestyle (sedentary lifestyle, inadequate eating habits) and to other conditions such as genetic, hereditary, psychological, cultural, and ethnic factors. The weight loss process is slow and complex, and involves lifestyle changes with an emphasis on nutritional therapy, physical activity practice, psychological interventions, and pharmacological or surgical treatment. Because the management of obesity is a long-term process, it is essential that the nutritional treatment contributes to the maintenance of the individual's global health. The main diet-related causes associated with excess weight are the high consumption of ultraprocessed foods, which are high in fats, sugars, and have high energy density; increased portion sizes; and low intake of fruits, vegetables, and grains. In addition, some situations negatively interfere with the weight loss process, such as fad diets that involve the belief in superfoods, the use of teas and phytotherapics, or even the avoidance of certain food groups, as has currently been the case for foods that are sources of carbohydrates. Individuals with obesity are often exposed to fad diets and, on a recurring basis, adhere to proposals with promises of quick solutions, which are not supported by the scientific literature. The adoption of a dietary pattern combining foods such as grains, lean meats, low-fat dairy, fruits, and vegetables, associated with an energy deficit, is the nutritional treatment recommended by the main international guidelines. Moreover, an emphasis on behavioral aspects including motivational interviewing and the encouragement for the individual to develop skills will contribute to achieve and maintain a healthy weight. Therefore, this Position Statement was prepared based on the analysis of the main randomized controlled studies and meta-analyses that tested different nutrition interventions for weight loss. Topics in the frontier of knowledge such as gut microbiota, inflammation, and nutritional genomics, as well as the processes involved in weight regain, were included in this document. This Position Statement was prepared by the Nutrition Department of the Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), with the collaboration of dietitians from research and clinical fields with an emphasis on strategies for weight loss.

Efficacy and tolerability of the association of sibutramine and orlistat for six months in overweight and obese patients.

Objective. To assess the efficacy and tolerability of the association sibutramine (10-20 mg/day) and orlistat (120 mg 2-3 times a day) in the treatment of obesity in a six-month open trial. Methods. 446 overweight and obese patients who sought treatment for obesity in a private clinic were assessed every 2 weeks during a period of 3 and 6 months. Results. After 3 months, the mean weight loss was 10.5 kg (-9.8% of the initial weight, n = 263), and after 6 months, the mean weight loss was 13.9 kg (-12.8% of the initial weight, n = 97). The tolerability of such association was quite acceptable and coherent with the action mechanism of each component. Conclusions. The association of orlistat and sibutramine is quite efficient and it seems to promote a higher rate of weight loss than that reported in clinical studies performed with each drug separately.

Prevalência de risco de sobrepeso e sobrepeso em escolares de 10 a 13 anos da cidade de Säo Paulo / Prevalence of overweight and obesity in 10 to 13-years-old school children in Säo PAulo

A obesidade em adultos vem apresentando crescimento nítido nas últimas décadas. No Brasil, a prevalência atual de sobrepeso somada com a de obesidade é de cerca de 40 porcento. Os dados em crianças ainda näo estäo totalmente esclarecidos. Contudo, sobrepeso e obesidade na infância têm sido associados com morbimortalidade na vida adulta. Neste sentido, foi estudada a prevalência de risco de sobrepeso e sobrepeso em 194 escolares de 10 a 13 anos de escolas públicas e particulares, os quais foram classificados de acordo com dois parâmetros: IMC (tabela HIMES e DIETZ, 1994) e Gráfico de adequaçäo ponderal (NCHS). Através destas classificaçöes, concluiu-se que a prevalência de risco de sobrepeso e sobrepeso é alta (cerca de 30 porcento), quer em escolas particulares, quer em escolas públicas.(au)

Comparaçäo entre o gasto energético basal calculado pela calorimetria indireta e pela fórmula de Harris-Benedict / Basal energy expenditure assessed by indirectcalorimetry compared to that calculated by Harris-Benedict formula

Este estudo consiste na comparaçäo do Gasto Energético Basal (GEB) calculado pela calorimetria indireta com o calculado pela fórmula de Harris-Benedict. Fora analisados 96 pacientes que relataram dificuldade em perder peso. Os pacientes foram submetidos à biopedância elétrica; a partir dos resultados foram traçadas as seguintes relaçöes: o GEB calculado pela calorometria indireta com o peso, com a percentagem de massa magra, com a percentagem de gordura corporal, com o IMC e com a fórmula de Harris-Benedict. Através da análise dos resultados conclui-se que a preciäo aumentada se utilizada em conjunto com a fórmula proposta neste estudo. (au)

Experiência clínica com o uso conjunto de sibutramina e orlistat em pacientes obesos / Clinical experience with the suite use of sibutramine and orlistat in obese patients

Avaliamos a eficácia e a tolerabilidade da associação de sibutramina (10mg) e orlistat (120mg três vezes por dia às refeições) no tratamento da obesidade em um estudo aberto de três meses de duração. O estudo envolveu 114 pacientes não diabéticos com sobrepeso ou obesidade em busca de tratamento em clínica privada. Após dois meses, a perda média de peso foi 7,1kg (- 6,5 por cento) e após três meses, a perda média de peso foi 8,9kg (- 8,2 por cento). A associação de sibutramina e orlistat parece ser uma opção útil de tratamento da obesidade.