Effect of the Educational Intervention “NutrIMSS” for Weight Loss in a Primary Care Center in Tijuana Mexico

Research Article

J Fam Med. 2020; 7(7): 1223.

Effect of the Educational Intervention “NutrIMSS” for Weight Loss in a Primary Care Center in Tijuana Mexico

Gonzalez-Montiel E*, Bermudez-Villalpando VI, Antunez-Ruiz VC, Banuelos-Cisneros M, Rodriguez-Jimenez CB and Martínez-Carrasco BA

Department of Family Medicine, Family Medicine Unit

#27 (IMSS), Baja California Delegation, Mexico

*Corresponding author: Gonzalez-Montiel Elizabeth, Department of Family Medicine, Family Medicine Unit #27 (IMSS), Baja California Delegation, Mexico

Received: October 12, 2020; Accepted: October 27, 2020; Published: November 03, 2020


Background: Obesity in multifactorial origin increases the risk of developing chronic diseases. Mexico occupies one the first places of prevalence worldwide.

Aim: The purpose of this study is to evaluate the effect of the educational intervention "NutrIMSS" for weight loss at the Family Medicine Unit #27 in Tijuana, Mexico.

Design and Setting: Analytic cross-sectional study.

Methods: Retrospective cohort study. A database from the Department of Nutrition was used from June to December 2018. Anthropometric measurements such as weight, BMI and waist circumference were collected at the beginning and end of the follow-up. The analysis was done with descriptive statistics using measures of central tendency, dispersion and percentages. In the bivariate analysis, Student T test and Chi square test were used. A p <0.05 was considered significant.

Results: Out of the 196 patients, 79% were women. Weight loss of at least 5% compared to the initial weight was reported in 22% of the participants and it was observed that 33% of the patients gained weight at the end of their followup.

Conclusion: The treatment of patients with obesity requires a comprehensive approach that includes cognitive behavioral intervention, in order to maintain the motivation to preserve the new lifestyle.

Keywords: Obesity; Educational Intervention; Nutrition


Obesity is a chronic disease of multifactorial etiology in which genetic, environmental and lifestyle aspects are involved. It is a positive energy balance, which occurs when the calorie intake exceeds the energy expenditure [1]. It is classified primarily based on the Body Mass Index (BMI) [2]. The waist circumference (WC) is useful to assess the risk associated with obesity, to estimate visceral obesity and cardiometabolic risk [3], a WC >90 centimeters (cm) in men and >80 cm in women is considered to be high [2]. Comprehensive treatment should include medical, nutritional, psychological treatment, physical activity and, if necessary, surgical interventions [4]. The objective of the dietary treatment of obesity is to achieve a significant loss (10% of the initial weight) of weight in the medium term, to maintain this loss at long term, to prevent weight gain, to reduce the cardiovascular and metabolic risk associated with overweight, improve cardiovascular risk factors associated with obesity that is usually achieved with the loss of 5 to 10% of overweight and improve comorbidities related to overweight [1].

Due to the accelerated increase in obesity in the Mexican population, one of the fastest in the world, Mexico has one of the highest prevalence’s in the world. This situation is an important Public Health problem, because it secondarily increases the risk of developing chronic diseases, which generates an increase in expenses at the family and institutional level. The intervention in nutrition education, "NutrIMSS", aims to control and maintain the following indicators within the recommended ranges: BMI, WC, blood glucose, cholesterol, triglycerides and blood pressure [5]. According to the World Health Organization (WHO) [6], obesity has tripled worldwide since 1975. In 2016, 39% of adults aged 18 and over were overweight, and 13% were obese, which has been associated with a higher number of deaths compared underweight patients. In Mexico, in 2018 the prevalence of obesity was 36.1% [7] and 24% in Baja California (2012) [8].

The general objective of the research was to evaluate the effectiveness of the educational intervention of "NutrIMSS" for weight loss in Family Medicine Unit #27 (FMU 27). As secondary objectives, the following were proposed: to quantify weight loss before and after the educational intervention and to know the clinical factors (weight, height, BMI, WC).

Material and Methods

Study Design and Population

An analytical cross-sectional study was conducted in Tijuana, Baja California, Mexico, between September and October 2019. The research was carried out at FMU 27, of the Instituto Mexicano del Seguro Social (IMSS); primary care unit and main health care center in the region. Patients who attended the “NutrIMSS” educational strategy between June and December 2018, aged 18 years or over, were included. Patients who did not attend 3 or more monthly appointments were excluded. Those patients with incomplete data were eliminated.


Information was collected in a data collection form in the SPSS version 25 program in Spanish, of the following variables: age, sex, weight, height, BMI, waist circumference; the data was obtained from the database of the nutrition department at the beginning and at the end of the educational strategy.

Statistical Analysis

The data was analyzed using descriptive statistics with measures of central tendency and dispersion for quantitative variables; frequencies and percentages for qualitative. In the bivariate analysis, the Student T test was used to compare the measures observed at the beginning and at end of the follow-ups of the quantitative variables and the Chisquare test for the analysis of the qualitative dichotomous variables. A p <0.05 was considered statistically significant.


The study was approved by the Local Committee for Ethics and Health Research number 204; with registration number R-2019-204- 029. The research was carried out under the General Health Law on Health Research, the Declaration of Helsinki and the Bioethical Principles. Due to the type of study, no informed consent was required from the participants.


The sample was 196 patients. 79.1% were women, 58.2% identified themselves as workers (Table 1). The median age for the patients was 48.98 (±8) years old (Table 2). At the end of the followups, a weight loss in kilos (kg) of at least 5% compared to the initial weight was reported in 21.9% of the patients. It was identified that 32.7% had gained weight. The mean weight lost by the end was 1.8 kg. A significant association was found between sex and waist circumference (p <0.001), in this category all women and 85.4% of men presented abnormal waist circumference. When measuring BMI ordinally, we found that 23.9% of women and 41.5% of men were overweight; grade I obesity in 34.2% of women and 36.6% of men; grade II obesity in 21.9% of women and 12.2% of men; grade III obesity in 19.4% of women and 4.9% of men; and normal weight in 0.6% of women and 4.9% of men, this association was significant (p = 0.01).