Evaluation of an intervention in women aimed to reduce obesity through counseling in healthy behaviors

Background: Obesity is prevalent in Chile. In 2005, the Ministry of Health promoted a nationwide intervention in health centers based on counseling in healthy lifestyles. Aims: To evaluate if counseling was properly implemented and if women acquired healthy behaviors in physical activity, diet and recovered their pre-gestational weight. Methods: Two cohorts of women identified in health centers: One before (2004: control), and another during (2006-2007: intervened) intervention. Pre-gestational, pregnancy and post partum weight, food intake and physical activity pattern were collected. Changes in eating and physical activity patterns were evaluated (ANOVA and x²). Risk factors (OR and its 95% confidence interval (95% CI)) for post partum weight retention (logistic regression models) were identified, p<0,05 was significant. Focus groups (professionals and women) to analyze perceptions about counseling. Results: Health centers did not implement counseling because of insufficient professionals and counseling training; they focused education and assistance in obese women. Women did not feel empowered about their health; they want the professionals to make decisions for them. Intervened women, ate more calories (600Kcal), carbohydrates (100g) and lipids (50g), less calcium (400mg) and kept seated 2 hours more than controls (p<0,05). All women retained ±5Kg after 6 months of delivery, with the exception of intervened obese women, (-0,5Kg, p<0,05). Age less than 25 years old (OR=0.96; 95%CI:0.93 to 0.99), an interaction between intervention and obesity before pregnancy (OR=0.41; 95%CI:0.22 to 0.76), overweight and obesity at the end of the pregnancy (OR=32.0; 95%CI:13.2 to 77.6) were significant for post partum weight retention. Conclusions and suggestions: To focus assistance and education in obese women increased their weight loss after delivery, though they had no positive impact in healthy behaviors. It is needed to train and increase the number of professionals to implement counseling in health centers. It is important to empower population to make decisions.