Multicomponent Nutritional Approach (NutrirCom) and Its Effects on Anthropometric, Metabolic, and Psychoemotional Outcomes in Women with Obesity: A Three-Arm Randomized Clinical Trial

多组分营养疗法(NutrirCom)及其对肥胖女性人体测量、代谢和心理情绪结果的影响:一项三组随机临床试验

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Abstract

Background/Objectives: Obesity is a multifactorial condition and a major public health challenge. Conventional treatment centers on caloric restriction, which is often unsustainable and may cause stigma and psychoemotional harm. This study aimed to describe the methodology and assess the effects of a multicomponent nutritional intervention not focused on caloric restriction on psychoemotional outcomes. Women were selected as the target population because of the higher prevalence of obesity-related psychoemotional distress, body dissatisfaction, and weight-related stigma in this group, as well as their greater vulnerability to the psychosocial impacts of weight-focused interventions. Methods: This randomised, parallel, open-label trial included 89 obese women from primary care in Viçosa, Brazil. The participants were allocated into three groups: Group 1 (Control), which received a personalised hypocaloric diet (from 500 to 1000 kcal/day); Group 2 (NutrirCom (NutrirCom is a multicomponent, person-centred nutritional intervention protocol that is not focused on caloric restriction, conceived by a group of researchers at the Federal University of Viçosa for the care of women with obesity in Primary Health Care. It integrates nutritional, psychoemotional, behavioural, and social strategies, with an emphasis on promoting eating autonomy, mental health, and quality of life through a humanised, integrated, and sustainable approach, aiming to enhance the effectiveness of health care delivery and clinical practice)), which received 10 individual NutrirCom-based sessions; and Group 3 (NutrirCom + Social Support), which combined individual NutrirCom sessions with monthly group meetings for social support. Randomisation was stratified by body mass index via Excel(®) with concealed allocation. The six-month intervention assessed changes in stress, anxiety, depression, and self-compassion, along with anthropometric and metabolic markers. Results: All groups presented reductions in waist circumference, fasting glucose, and total body fat, with increased lean mass. Anxiety remained unchanged in Group 1 but decreased significantly in Groups 2 (p = 0.002) and 3 (p = 0.005). Only Group 2 showed a significant reduction in depression symptoms (p = 0.023). Self-compassion improved significantly in groups 2 and 3. Conclusions: NutrirCom is a low-cost, scalable, and human-centered intervention that integrates emotional, social, and nutritional aspects of care. This approach shows promise as a sustainable strategy for obesity treatment in primary health care. Registration: Brazilian Registry of Clinical Trials (ReBEC) (no. RBR-87wb8x5).

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