Focus On Emotions Key To Improving Heart Health In Obese People

WASHINGTON — According to a new study, obese people who attended a non-judgemental and personalized lifestyle modification program improved their cardiovascular and mental health during just ten weeks.

The study was presented at Euro Heart Care — ACNAP Congress 2021, an online scientific congress of the European Society of Cardiology (ESC). Its participants lost weight and achieved benefits in anxiety and depression and physical measurements, including blood pressure.

“We focus on changing behaviors and improving people’s relationship with food,” said Aisling Harris, study author, cardiac and weight management dietitian, Croi Heart and Stroke Centre, Galway, Ireland.

“Many participants have tried diets with strict rules and have fears about foods they can’t eat. Our program has no diet or meal plan, and no foods are excluded. Each person sets their own goals, which are reviewed weekly, and our approach is non-judgemental, which builds rapport and gains trust.”

“Obesity develops for multiple reasons, and blaming someone for their weight can stop them from getting healthcare and advice,” said Harris.

“It can lead to emotional eating and feeling too self-conscious to exercise. By identifying each person’s triggers, we can develop alternative coping strategies, all within the context of their job, caring responsibilities, external stresses, and so on. For some people, coming to a group like this might be the only social contact that they’ve had in the week or that they’ve had in years. People share experiences and support their peers.”

Weight loss is recommended to reduce blood pressure, blood lipids, and the risk of developing type 2 diabetes, thus lowering heart disease.

This study analyzed the impact of a community-based lifestyle modification program on the physical and mental health of people living with obesity referred from a specialist bariatric service at Galway University Hospital. The researchers reviewed data from 1,122 participants between 2013 and 2019.

The 10-week Croi CLANN (Changing Lifestyle with Activity and Nutrition) program started with an assessment by a nurse, dietitian, and physiotherapist and baseline measurements of weight, blood pressure, cholesterol, blood glucose, fitness, and levels of anxiety and depression. Then, personalized goals and a management plan were agreed upon in collaboration with each patient.

Participants attended a 2.5-hour session each week for eight weeks. The first 30 minutes were devoted to one-to-one goal setting. Next was a 1-hour exercise class led by the physiotherapist.

Finally, a 1-hour health promotion talk followed healthy eating, portion sizes, reading food labels, emotional versus physical hunger, stress management techniques (e.g., meditation), physical activity, sedentary behavior, cardiovascular risk factors, and making and maintaining changes.

Participants used activity trackers and kept food diaries to identify triggers for emotional eating. Last week, patients had an end-of-program assessment with the nurse, dietitian, and physiotherapist to look at outcomes. They were then referred back to the hospital.

At baseline, the average body mass index (BMI) was 47.0 kg/m2, and 56.4 percent of participants had a BMI above 45 kg/m2. In addition, 26.7 percent had type 2 diabetes, and 31.4 percent had a history of depression.

More than three-quarters of participants (78 percent) completed the program. Psychosocial health was assessed using the 21-point Hospital Anxiety and Depression Scale (HADS), where 0-7 is average, 8-10 is mild, 11-15 is moderate, and 16-21 is severe. Anxiety and depression scores decreased by 1.5 and 2.2 points, respectively, throughout the program.

For example, the proportion with an anxiety score greater than 11 at the start was 30.8 percent and reduced to 19.9 percent; for depression, the corresponding ratios were 21.8 percent, falling to 9.5 percent.

The average reduction in body weight was 2.0 kg overall, with 27.2 percent of participants losing more than 3 percent of their initial weight. The proportion achieving recommended physical activity levels rose by 31 percent.

There were significant reductions in total cholesterol, low-density lipoprotein (LDL) cholesterol, and blood pressure. The proportion with high blood pressure fell from 37.4 percent at baseline to 31.1 percent at ten weeks. In those with type 2 diabetes, the proportion achieving the recommended blood sugar target rose from 47.6 to 57.4 percent.

“Nearly eight in ten people finished the program, which suggests that the content and format were acceptable. In addition, we observed improvements across all psychosocial and health outcomes during a relatively short period indicating that this could be a model of service delivery for other centers,” Harris concluded.

(With inputs from ANI)

(Edited by Anindita Ghosh and Ojaswin Kathuria)