Summary: In 1120 adults with obesity managed in Brazilian primary health care, a six-month theory-based group nutrition programme (in-person sessions plus phone messages and postcards) was delivered across 350 groups, 13,473 phone calls, and 1973 postcards, achieving a median adherence of 52.4%. These are preliminary process and reach findings; no between-group weight outcome or statistical efficacy comparison was reported.
PICO Summary
| Element | Detail |
|---|---|
| Population | 1120 adults with obesity in Belo Horizonte primary health care units; randomized controlled community trial, Brazil, 2022 to 2023. Mostly women, median age 61.4 years; 45.4% in the maintenance stage of change and 76.1% with high self-efficacy for weight reduction. |
| Intervention | Six-month group-based nutrition programme allocated to non-severe (TG1) or severe obesity (TG2) therapeutic groups: face-to-face sessions (TG1: 7; TG2: 9) plus phone messages and postcards (TG1: 4; TG2: 5). |
| Comparison | Control group receiving usual primary care without the structured group nutrition components. |
| Outcome | Preliminary process and reach measures only: 350 groups held, 13,473 phone calls made, 1973 postcards delivered; median adherence 52.4%. No weight, waist circumference, or other clinical outcome was reported, and no between-group statistical comparison, effect size, 95% CI, or p value was provided in this preliminary report. |
Expert Commentary
This paper should be read as a feasibility and implementation report rather than as evidence of effectiveness. Although the design is a randomized controlled community trial, what is presented here are the operational guidelines and preliminary process metrics: enrolment, group delivery, contact volume, and a median adherence of 52.4%. No weight change, waist circumference, or other clinical endpoint is reported, and no between-group comparison or significance testing is offered, so any claim that the programme improved weight outcomes would be premature. The reach achieved within a public health system is encouraging and suggests the model is deliverable at scale, which is the legitimate contribution of this stage. The principal limitation is that adherence near 50% sets a real ceiling on any future effect, and a cohort that is predominantly older women already in maintenance stage with high self-efficacy is a favourable, self-selected group that may not generalise to less ready patients. Can I use this with my patients? Not yet as a treatment recommendation; the framework is useful for service planning, but efficacy data are still pending. Future reporting of the prespecified weight and metabolic outcomes, with intention-to-treat analysis, is needed before this approach can be endorsed for routine obesity care.
References
Ribeiro e Silva A, Ramos de Carvalho MC, Ferreira NL, Toral N, Kümmel Duarte C, Souza Lopes AC. Guidelines and Preliminary Results of Group-Based Nutrition Interventions for Obesity Management Among Adults in Brazilian Primary Health Care. Int J Environ Res Public Health. 2025;22(7):1093. doi:10.3390/ijerph22071093