Good emotional health can lead to better heart health in obese people: Study

A new study shows that obese people who participated in a non-judgmental and personalized lifestyle change program improved their cardiovascular and mental health in just 10 weeks.

The study was presented at EuroHeartCare – ACNAP Congress 2021, the European Society of Cardiology’s (ESC) online scientific conference. Participants lost weight and experienced benefits in areas of anxiety and depression, as well as body measurements including blood pressure.

This is the result of the research

“We focused on changing people’s behavior and improving people’s relationship with food,” said study author Aisling Harris, a heart and weight management nutritionist at the Croy Heart and Stroke Center in Galway, Ireland. “Many participants have tried strictly prescribed diets and are terrified of the foods they can’t eat. There are no diets or meal plans in our program, and no foods are excluded. Everyone sets their own goals, which are reviewed weekly, and our approach is non-judgmental, which builds rapport and earns trust.”

“Obesity occurs for a variety of reasons, and blaming someone for their weight can prevent them from accessing healthcare and advice,” says 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 work, caring responsibilities, external pressures, etc. For some people, joining a group like this may be their only social contact for a week or years. People share experiences and support their peers.”

Both being overweight and obese increase the risk of death from cardiovascular disease. 2 Losing weight is recommended to lower blood pressure, blood lipids and the risk of type 2 diabetes, thereby reducing the likelihood of heart disease. This study analyzed the impact of a community-based lifestyle change program on the physical and mental health of patients with obesity referred to the specialist bariatric service at University Hospital Galway. Researchers reviewed data from 1,122 participants between 2013 and 2019.

The 10-week Croi CLANN (Lifestyle Change through Activity and Nutrition) program begins with an assessment by a nurse, nutritionist and physiotherapist, with baseline measurements of weight, blood pressure, cholesterol, blood sugar, health status and anxiety and depression levels. Work with each patient to agree on individualized goals and management plan.

Participants attended 2.5-hour sessions per week for 8 weeks. The first 30 minutes are spent on one-on-one goal setting. This is followed by a 1-hour exercise session led by a physiotherapist. This was followed by a 1-hour health promotion lecture on topics such as healthy eating, portion size, reading food labels, emotional versus physical hunger, stress management techniques (e.g., meditation), physical activity, sedentary behavior, cardiovascular risk factors, and making and sustaining changes. Participants used activity trackers and kept food diaries to identify triggers for emotional eating.

Last week, patients had end-of-program evaluations with nurses, nutritionists and physical therapists to observe results. They were later transferred back to the hospital.

Poor emotional health can lead to serious other problems

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

More than three-quarters of participants (78%) completed the program. Psychosocial health status was assessed using the 21-point Hospital Anxiety and Depression Scale (HADS), in which 0-7 is normal, 8-10 is mild, 11-15 is moderate, and 16-21 is severe. Anxiety and depression scores decreased by 1.5 points and 2.2 points, respectively, throughout the program. The proportion of anxiety scores greater than 11 dropped from 30.8% at the beginning to 19.9%; the corresponding proportion of depression dropped from 21.8% to 9.5%.

Overall weight loss averaged 2.0 kg, with 27.2% of participants losing more than 3% of their initial weight. The proportion meeting recommended levels of physical activity increased by 31%. Total cholesterol, low-density lipoprotein (LDL) cholesterol, and blood pressure were significantly reduced. The proportion with hypertension decreased from 37.4% at baseline to 31.1% at 10 weeks. Among patients with type 2 diabetes, the proportion meeting recommended blood glucose targets increased from 47.6% to 57.4%.

Harris concluded: “Nearly eight in 10 people completed the program, which shows that the content and format of the program are acceptable. We observed improvements in all psychosocial and health outcomes in a relatively short period of time, suggesting that this could become a model for services delivered in other centres.”