Orientador: Wilma de Grava kempinas / Banca: José de Anchieta de Castro / Banca: Horta Junior / Banca: Luis Alberto Domingo francia-Farie / Banca: Maria de Fátima Magalhães Lazari / Banca: Rafael Henrique Nóbrega / Resumo: A sibutramina é um inibidor seletivo da recaptação neuronal de noradrenalina e serotonina amplamente utilizada para o tratamento da obesidade. Investigações anteriores demonstraram o impacto da sibutramina nas reservas espermáticas e na contratilidade de órgãos relacionados a ejaculação. Portanto, o objetivo do presente trabalho foi avaliar os parâmetros espermáticos e a contratilidade da próstata ventral e do ducto epididimário distal isolado de ratos expostos in vivo e in vitro a sibutramina. No experimento 1, ratos machos Wistar (12-16 semanas /350-450 g) foram divididos em dois grupos: tratado oralmente com sibutramina (10 mg/kg/dia) e grupo controle, que recebeu apenas o veículo (dimetilsulfóxido e solução salina). Após 30 dias de tratamento, os animais foram pesados e eutanasiados por decapitação. Os testículos direitos, epidídimos, ductos deferentes, próstatas ventrais e glândulas seminais (sem a glândula coaguladora) foram removidos e os seus pesos foram determinados. Os testículos e epidídimos direitos foram utilizados para a determinação do número de espermatozoides e os esquerdos para análise histopatológica. Além disso, os espermatozoides da cauda do epididimo direito foram usados para inseminação artificial in utero e para análise da motilidade e morfologia espermática. Os níveis séricos de testosterona, hormônio folículo estimulante (FSH) e hormônio luteinizante (LH) também foram mensurados. No experimento 2, um outro lote de ratos, seguindo o mesmo desenho experimental, foi utilizado para a realização dos ensaios in vitro de reatividade farmacológica do ducto epididimário distal isolado. No experimento 3 ratos machos adultos foram utilizados para os ensaios in vitro de reatividade farmacológica do ducto epididimário distal isolado, com e sem a presença de sibutramina, e para ensaios in vivo da reatividade farmacológica da próstata ventral, com e ... / Abstract: Sibutrmine is a neuronal noradrenaline and serotonin reuptake inhibitor laegely used for the treatment of obesity. Previous investigations have shown the impact of sibutraimine on ejaculation contractility related organs and sperm reserves. Therefore, the aim of the present work was to evaluate sperm parameters and the contractility of isolated distal cauda epididymidis duct and ventral prostate of rats exposed in vivo and in vitro to sibutramine. In experiment 1, Wistar male rats (12-16 weeks/350-450 g) were divided into two groups: treated orally with sibutramine (10 mg/kg/day) and control, which received only the vehicle (dimethyl sulfoxide and saline). After 30 days of treatment the animals were weighed and euthanized by decapitation. The right testis, .... / Doutor

Abstract Introduction: Obesity amongst children is a major health problem. At the outpatient paediatric clinic at Södertälje hospital in Region Stockholm, there is a large and well-established treatment model against childhood obesity. During spring 2020 all elective care in Region Stockholm, including visits to the obesity team, was cancelled for 3 months due to relocation of health care professionals because of the Covid-19 pandemic. Aim: To investigate whether the first wave of the Covid-19 pandemic affected the outcome of childhood obesity treatment at one outpatient paediatric clinic in Region Stockholm. Methods: A retrospective controlled cohort study comparing two groups regarding results of first year of obesity treatment for children. One group had their first year of treatment during the first wave of the Covid-19 pandemic and the control group before the pandemic. Data was retrieved from BORIS and complemented by a review of medical records. Results: Mean change in BMI SDS after one year of treatment in the Covid group was -0.10 units and in the control group -0.11 (ns). In the Covid group more patients quit the treatment programme and had a smaller number of visits to a nurse compared to controls. Conclusion: This study showed no difference in outcome regarding change in BMI SDS. However, it seems that the cancellation of visits might have affected the number of children lost to follow-up. Therefore, clinics should consider “digi-physical” care (e.g., via telephone, videocalls or other media) to secure the child and parents motivation and participation in the obesity treatment programme.

Bakgrund: Obesitas är en kronisk och komplex sjukdom som har en negativ effekt på både fysisk och psykisk livskvalitet jämfört med normalbefolkningen. Tidigare och nuvarande studier om obesitas och dess behandlingar har främst utvärderat viktminskning och förbättringar av obesitasrelaterade sjukdomar och ofta saknat patientperspektivet på hälsan. Därtill har forskning visat att personal inom hälso- och sjukvården är bristfälligt rustade för att stödja personer med obesitas vilket ökar patientgruppens lidande och försämrar dess livskvalitet. Syfte: Syftet var att undersöka om det finns vetenskapligt stöd för att kirurgisk obesitasbehandling är effektivare avseende fysisk och psykisk hälsorelaterad livskvalitet jämfört med medicinsk obesitasbehandling hos vuxna personer med obesitas. Metod: Studien genomfördes som en systematisk litteraturstudie baserad på SBU:s metod och utmynnade i totalt tre RCT-studier. Resultat: Litteraturöversiktens sammanvägda resultat visar på mycket låg vetenskapligt stöd. Därmed kan resultatet inte med säkerhet uttala sig om huruvida kirurgisk obesitasbehandling är mer effektiv jämfört med medicinsk obesitasbehandling avseende fysisk och psykisk hälsorelaterad livskvalitet. Resultatet indikerar att obesitaskirurgi kan förbättra fysisk livskvalitet i högre grad jämfört med medicinsk obesitasbehandling. Den psykiska livskvaliteten förbättras däremot inte i högre utsträckning efter obesitaskirurgi jämfört med kontrollbehandlingen. Konklusion: Där behövs fler RCT-studier som är större, baserade på samma livskvalitetsinstrument och vars mått är redovisade på ett enhetligt sätt. / Background: Obesity is a chronical and complex disease which has a negative impact on physical and mental health-related quality of life compared to the normal population. Previous and current studies on obesity and its treatments have mainly evaluated weight loss and improvements in obesity-related diseases and often lacked the patient perspective on health. In addition, research has shown that healthcare personnel are inadequately equipped to support people with obesity, which increases the patient  group´s suffering and impairs its quality of life. Aim: The aim was to investigate whether there is scientific support that surgical obesity treatment is more effective in terms of physical and mental health-related quality of life compared to medical obesity treatment in obese adults. Method: The study was conducted as a systematic review based on  SBU´s method and resulted in a total of three RCT studies. Results: The combined results of the literature review show very little scientific support. Thus, the result cannot state with certainty whether bariatric surgery is more effective compared to medical obesity treatment regarding physical and mental health-related quality of life. The result indicates that bariatric surgery can improve physical quality of life to a greater degree compared to medical obesity treatment. In contrast, the mental quality of life does not improve to a greater extent after bariatric surgery compared to the control treatment. Conclusion: There is a need for more RCT studies that are lager, based on the same quality of life instrument and whose measurements are reported in a uniform manner.

Thesis (MScMedSc)--Stellenbosch University, 2012. / Includes bibliography / ENGLISH ABSTRACT: Obesity is a major source of morbidity and mortality worldwide. More than 1.5 billion individuals over the age of 20 years are overweight, with more than 500 million of these individuals being obese. Obesity increases the risk of developing cardiovascular disease, type 2 diabetes and certain types of cancer. Recently, a number of plant extracts have been shown to possess anti-obesity properties in vitro and in various animal models of obesity. The aim of this study was to investigate the effect of a hot water fermented extract of Cyclopia maculata, a South African herbal tea more commonly referred to as honeybush, on lipogenesis and lipolysis in 3T3-L1 pre-adipocytes and adipocytes. To investigate the effect of C. maculata extract on adipogenesis, 3T3-L1 preadipocytes were differentiated in adipogenesis inducing media containing various concentrations. The optimal concentration was determined by screening concentrations ranging from 0 to 1,600 μg/ml. 3T3-L1 pre-adipocytes were differentiated with TNFα or unsupplemented adipogenesis inducing media as positive and negative controls, respectively. Intracellular lipid accumulation was measured by using the Oil O Red stain and a commercial triglyceride assay kit. Cell viability was measured using the 3-(4,5-Dimethylthiazol-2-yl)-2,5- diphenyltetrazolium bromide (MTT) and adenosine tri-phosphate (ATP) assays. The expression of PPARγ, C/EBPα, SREBP-1 and PPARα was assessed by Western blot analysis, while the expression of the secreted proteins leptin and adiponectin was assessed by ELISA. The effect of C. maculata extract on lipolysis was investigated by differentiating 3T3-L1 pre-adipocytes in adipogenesis inducing and adipogenesis maintenance media for 8 days until they were mature adipocytes, and thereafter treating with C. maculata extract for 24 hours. The optimal concentration was determined by screening concentrations ranging from 0 to 1,600 μg/ml. Isoproteronol or unsupplemented adipogenesis maintenance media was used as positive and negative controls, respectively. Intracellular lipid break down was measured by using the Oil O Red stain, while glycerol release, a marker of lipolysis, was measured using a commercial kit. Cell viability was measured using the MTT and ATP assays. The expression of HSL and perilipin was assessed by Western blot analysis, while the expression of secreted proteins leptin and adiponectin was assessed by ELISA. Treatment with the C. maculata extract, at most of the concentrations tested, decreased intracellular lipid accumulation in pre-adipocytes. The Oil O Red and the intracellular triglyceride assay, in combination with the cell viability assays, showed that 80 μg/ml optimally reduced intracellular lipid without affecting cell viability. Western blot analysis showed that differentiation of 3T3-L1 adipocytes in the presence of 80 μg/ml of the C. maculata extract decreased the expression of PPARγ2, a key adipogenenic transcription factor, 1.8-fold (p=0.006). PPARγ2 was observed at a smaller size than expected and further studies are needed. The results of the C/EBPα, SREBP-1 and PPARα Western blots were not included in this study and are recommended to be further optimized to reduce non-specific binding. ELISA results showed a significant increase in the secretion of the adipokines, adiponectin (>10-fold, p<0.001) and leptin (1.5-fold, p=0.002). The C. maculata extract was better than the positive control, TNFα, at inhibiting adipogenesis. A concentration of 80 μg/ml of the C. maculata extract maximally induced lipolysis, without affecting cell viability. Western blot analysis showed non-specific binding, and are recommended to be further optimized to reduce non-specific binding. Western blot analysis also showed that acute treatment (24 hours) of mature 3T3-L1 adipocytes with 80 μg/ml increased the expression of the lipolytic protein, HSL (1.6-fold, p=0.025). Perilipin Western blot was not included due to non-specific binding. ELISA results showed an increase in adiponectin (1.5-fold, p=0.015) and leptin (1.2-fold, p=0.067) secretion. Similar results were obtained after treatment with the C. maculata extract or the positive control, isoproteronol. This study shows that treatment of 3T3-L1 pre-adipocytes and adipocytes with 80 μg/ml of C. maculata plant extract inhibits adipogenesis and induces adipolysis, without causing cytotoxicity. A major limitation of the current study is that it was conducted in an in vitro model and does not represent the complexity of obesity as it occurs in humans. However, despite this, we believe that these results are promising and provide support for future in vivo studies to substantiate these preliminary findings. The results of this study is aligned with the Department of Science and Technology’s Ten Year Innovation Plan and the “Farmer to Pharma” value chain that aims to improve our bio-economy by developing our indigenous resources. Moreover, this type of initiative will be able to stimulate job creation, while being able to utilize the very rich South African indigenous knowledge. / AFRIKAANSE OPSOMMING: Vetsug is 'n groot oorsaak van morbiditeit en mortaliteit wêreldwyd. Tans is meer as 1,5 miljard mense oor die ouderdom van 20 jaar oorgewig, met meer as 500 miljoen van hierdie individue wat vetsugtig is. Vetsug verhoog die risiko vir die ontwikkeling van kardiovaskulêre siekte, tipe 2 diabetes en sekere soorte kanker. Onlangs het 'n aantal plantekstrakte anti-vetsug eienskappe in vitro en in verskeie dier modelle van vetsug getoon. Die doel van hierdie studie was om die effek van die Cyclopia maculata, 'n Suid-Afrikaanse kruie-tee, meer algemeen bekend as heuningbos, op lipogenese en lipolise in 3T3-L1 pre-adiposiete en adiposiete te ondersoek. Vir die ondersoek, is 3T3-L1 pre-adiposiete gedifferensieer in ‘n adipogeneseinduserende media met verskillende konsentrasies van ‘n warm water ekstrak van gefermenteerde C. maculata. Die optimale konsentrasie van C. maculata ekstrak is bepaal deur die selle met verskeie konsentrasies te behandel wat gewissel het van 0 tot 1600 mg / mL. 3T3-L1 pre-adiposiete is met adipogenese-induserende media gedifferensieer met of sonder TNFα supplementasie wat as positiewe en negatiewe kontrole, onderskeidelik gedien het. Intrasellulêre lipied-versameling is gemeet deur middel van Oil O Red kleuring en trigliseried-inhoud is bepaal deur 'n kommersiële kit. Sel-lewensvatbaarheid is bepaal deur 3-(4,5-Dimetielthiazol-2- yl)-2,5-difenieltetrazolium bromied (MTT) en adenosien tri-fosfaat (ATP) assays. Die PPARγ, C/EBPα, SREBP-1 and PPARα proteïen uitdrukking is deur middel van Western-blot analise bepaal, terwyl die gesekreteerde proteïene, leptien en adiponektien, deur ELISA bepaal is. Die effek van C. maculata ekstrak op lipolise is ondersoek deur 3T3-L1 preadiposiete in adipogenese-induserende media te differensieer waarna die selle vir ‘n verdere 8 dae in adipogenese-onderhoud media gekultuur is totdat hulle volwasse adiposiete bereik het, voordat die adiposiete behandel is met C. maculata ekstrak vir 24 uur. Die optimale konsentrasie C. maculata ekstrak is bepaal deur die selle met verskeie konsentrasies te behandel wat gewissel het van 0 tot 1600 mg/ml. Adipogenese-onderhoud media met of sonder isoproterenol is onderskeidelik gebruik as die positiewe en negatiewe kontroles. Intrasellulêre lipied afbraak is deur middel van Oil O Red gemeet, terwyl vry gliserol, 'n merker van lipolise, deur ‘n kommersiële kit bepaal is. Sel-lewensvatbaarheid is bepaal deur MTT en ATP assays. Die uitdrukking van HSL is deur middel van Western-blot analise bepaal, terwyl die uitdrukking van die gesekreteerde proteïene, leptien en adiponektien, deur ELISA gemeet is. Ek stel voor dat die perilipin Western blots verder geoptimaliseer word om sodoende nie-spesifieke binding te verminder. Behandeling met C. maculata ekstrak het intrasellulêre lipied-akkumulasie in die pre-adiposiete verminder, by die meeste van die konsentrasies wat getoets is. Die Oil O Red en die intrasellulêre trigliseried toetse, in kombinasie met die sellewensvatbaarheid assays, het getoon dat 80 mg/ml C. maculata ekstrak intrasellulêre lipied optimaal verminder sonder om die sel-lewensvatbaarheid te affekteer. Western blot analise het getoon dat die differensiasie van 3T3-L1 adiposiete in die teenwoordigheid van 80 mg/ml C. maculata ekstrak die uitdrukking van PPARγ2, 'n sleutel adipogenetiese transkripsie faktor, 1.8-voudig (p=0.006) verlaag. PPARy2 is waargeneem by a kleiner grootte as verwag en verdere ondersoek word benodig. Ek stel voor dat die C/EBPα, PPARα en SREBP- 1 Western blots verder geoptimaliseer word om sodoende nie-spesifieke binding te verminder. ELISA resultate het 'n beduidende toename in die sekresie van die adipokines, adiponektien (>10-voudig, p <0.001) en leptien (1.5-voudig, p= 0.002) getoon. Cyclopia maculata ekstrak was beter as die positiewe kontrole, TNFα, om adipogenese te inhibeer. Teen ‘n konsentrasie van 80 mg/ml het C. Maculata ekstrak lipolise maksimaal geïnduseer, sonder om sel-lewensvatbaarheid te beinvloed. ELISA resultate het 'n toename in adiponektien (1.5-voudig, p = 0.015) en leptien (1.2-voudig, p = 0,067) sekresie getoon. Soortgelyke resultate is verkry met die positiewe kontrole, isoproteronol, as met C. maculata ekstrak behandeling. Hierdie studie het getoon dat die behandeling van 3T3-L1 pre-adiposiete en adiposiete met 80 mg/ml C. maculata ekstrak adipogenese inhibeer en adipolise induseer, sonder enige sitotoksisiteit. 'n Beperking van die huidige studie is dat dit in 'n in vitro model gedoen is wat nie die kompleksiteit van vetsug in die mens weerspieël nie. Ten spyte daarvan is resultate belowend en ondersteun dit toekomstige in vivo studies om hierdie voorlopige bevindinge te staaf. Bewys dat ‘n water ekstrak van gefermenteerde C. maculata anti-vetsug eienskappe het kan groot ekonomiese gevolge vir die heuningbos industrie inhou. Die resultate van hierdie studie is in lyn met die Departement van Wetenskap en Tegnologie se tien jaar Innovasie Plan en die "Farm Pharma" waardeketting wat daarop gemik is om ons bio-ekonomie te verbeter deur die ontwikkeling van ons inheemse hulpbronne. Daarbenewens sal hierdie tipe inisiatief potensieel werkskepping stimuleer, terwyl dit die ryk Suid-Afrikaans inheemse kennis aanwend.

University of Macau / Faculty of Education

(in English): A total of 62% of the Czech adult population currently suffer from overweight or obesity (BMI over 25). Overweight problems are mostly caused by bad eating and exercising habits. The web application Self-Coaching with cognitive behavioral therapy elements helps overweight or obese users to gradually change their bad habits. The objective of the research part of the thesis is to evaluate the effect of a 5-week use of the web application Self-Coaching and to find out whether or not this effect changes if the users are provided with a virtual intervention of an instructor trained in a cognitive behavioral approach to obesity treatment. I evaluated the percentage of weight loss as compared to the initial body weight, the energy and nutritional balance of the diet, vegetable intake, physical activity, the number of days of using the application and the use of the psychological section of the application (psycho-coaching). Weight loss was the identified main effect of the web application Self-Coaching. After five weeks, the users lost on average 2.5% of their initial weight. The intervention of the instructor helped to increase the number of days, for which the users used Self-Coaching.

No description available.

Pediatric obesity is skyrocketing nowadays worldwide. Therefore, helping and supporting clinicians in curing children is needed. As Health IT is soaring thanks to the emergence of a cutting-edge technology, treatments can now be followed closely and daily to give a personalized therapy. Thus, this thesis investigates how to build a clinical decision support tool to address this issue. The study was carried with the company Evira by following the user-centered design thinking method. The user research, carried out with semi-structured interviews at Martina Barnsjukhuset and Capio Vårdcentral Zinkensdamm, provided the users needs. A prototype was developed with considering this user research and requirements. Next, it was tested by experts during task-based and semi-structured interviews. This evaluation phase concluded that the prototype was intuitive and effective. By using different metrics, it allowed clinicians to see the activity of the patients, the irregularities and variation of their weight, their weighting habits, and the gender distribution of the patients. The final tool corrected some of the requests obtained during the evaluation. Thus, the proposed interface could support the decision of clinicians to improve treatment effectiveness and enable better resource planning. Further research can still be carried out in order to fine-tune this tool. / Fetma hos barn ökar kraftigt i dag över hela världen. Därför behövs det hjälp och stöd till kliniker för att behandla barn. Eftersom hälso- och sjukvårdsinformatik är på frammarsch tack vare framväxten av en banbrytande teknik kan behandlingar nu följas noga och dagligen för att ge en personlig behandling. I denna avhandling undersöks värdet av ett kliniskt beslutsstöd för att lösa detta problem. Studien genomfördes tillsammans med företaget Evira genom att följa metoden för användarcentrerat designtänkande. Användar- forskningen, som genomfördes med semistrukturerade intervjuer på Martina Barnsjukhuset och Capio Vårdcentral Zinkensdamm, gav användarnas behov. En prototyp utvecklades med hänsyn till denna användarundersökning och dessa krav. Därefter testades den av experter under uppgiftsbaserade och semistrukturerade intervjuer. I denna utvärderingsfas konstaterades att prototypen var intuitiv och effektiv. Den gjorde det möjligt för kliniker att se patienternas aktivitet och effektiviteten i behandlingen. Det slutliga verktyget korrigerade några av de önskemål som framkom under utvärderingen. Det föreslagna gränssnittet ökade således behandlingseffektiviteten och möjliggjorde bättre resursplanering. Ytterligare forskning kan fortfarande utföras för att finslipa detta verktyg.

Devido ao constante aumento na prevalência de obesidade e doenças relacionadas é sugerido que indivíduos obesos sejam submetidos a programas educativos para redução da massa corporal. Objetivos: avaliar os efeitos de um programa de Educação em Saúde (Educação nutricional e Educação física) voltado a um grupo de mulheres obesas. Métodos: 50 mulheres obesas foram submetidas a um programa de quatro meses envolvendo educação nutricional (1 vez/semana) e exercício físico (aeróbio e contra-resistência - 3 vezes/semana). Foram avaliadas variáveis antropométricas, metabólicas e alimentares: peso, estatura, circunferência da cintura e do quadril, composição corporal por raios X de dupla energia (DEXA), teste ergoespirométrico e gasto energético de repouso (VO2000-Imbrasport&#174;), hemograma, leucograma, perfil lipídico, glicemia, leptina, IGF-1 (Fator de crescimento semelhante à insulina-1, TSH (Hormônio estimulante da tireóide), albumina e pré albumina, 3 diários alimentares e de atividade física. Para análise dos resultados, as participantes foram distribuídas em G1 (IMC inicial < IMC final) e G2 (IMC inicial &#8805; IMC final). Resultados: No G1 houve redução de: massa corporal, IMC, CC, CQ, RCQ, gordura corporal (kg), massa corporal magra (kg) e glicemia. No G2 não foram encontradas alterações significativas nestas variáveis. Não foram encontradas diferenças significativas no GER e ambos os grupos apresentaram aumento do VO2 pico, redução da leptina plasmática e da albumina sérica. Conclusões: O programa de perda de peso realizado neste estudo foi eficiente para resultar em redução da massa corporal em 50% das participantes, apresentando também melhoras em fatores de risco para doenças cardiovasculares. Independentemente da redução da massa corporal e na massa corporal magra, programas de exercício físico sem o controle individualizado da ingestão alimentar, principalmente de proteínas, pode resultar em prejuízos para o estado nutricional de mulheres obesas. / Because of the high prevalence of obesity and its associated comorbities all over the world, it is suggested to submmit obese people to edicational weight reduction programs. Objectives: to evaluate the effects of an educational program (nutrition and physical education) in obese women. Methods: 50 obese women were submitted to a four months program of nutritional education (once a week) and exercise training (aerobic and resistance -3 times/week). They were evaluated variables related to anthropometry, metabolic and eating behavior: weight, height, waist and hip circumferences, body composition by dual X-ray energy (DEXA), aerobic power and resting energy expenditure (VO2000-lmbrasport&#174;); hemogram, leucogram, lipid profile, glucose level, leptin, IGF-1 (Insulin like growth factor-1), TSH (Tireoid stimulating hormone), albumin and pré-albumin, 3 days of food and physical activity records. The participants were distributed into the follow groups for the analysis: G1 (initial BMI < final BMI) and G2 (initial BMI &#8805; final BMI). Results: In G1 they were reduced: body mass, body mass index (BMI), waist circumference, hip circumference, waist/hip relation, fat mass (kg), lean body mass (kg) and glucose. No statistical differences were found in these parameters in G2. No statistical differences were found in resting energy expenditure in both groups and there was an increase in VO2peak, decrease in leptin and albumin concentration in both groups. Conclusions: The weight reduction program realized in this study was efficient to result weight loss in 50% of the participants, with improvements in cardiovascular risk factors. Independent of reductions on body mass and lean body mass, exercise training programs without individualized control of protein intake, especially of proteins, can jeopardize nutritional status of obese women.

Devido ao constante aumento na prevalência de obesidade e doenças relacionadas é sugerido que indivíduos obesos sejam submetidos a programas educativos para redução da massa corporal. Objetivos: avaliar os efeitos de um programa de Educação em Saúde (Educação nutricional e Educação física) voltado a um grupo de mulheres obesas. Métodos: 50 mulheres obesas foram submetidas a um programa de quatro meses envolvendo educação nutricional (1 vez/semana) e exercício físico (aeróbio e contra-resistência - 3 vezes/semana). Foram avaliadas variáveis antropométricas, metabólicas e alimentares: peso, estatura, circunferência da cintura e do quadril, composição corporal por raios X de dupla energia (DEXA), teste ergoespirométrico e gasto energético de repouso (VO2000-Imbrasport&#174;), hemograma, leucograma, perfil lipídico, glicemia, leptina, IGF-1 (Fator de crescimento semelhante à insulina-1, TSH (Hormônio estimulante da tireóide), albumina e pré albumina, 3 diários alimentares e de atividade física. Para análise dos resultados, as participantes foram distribuídas em G1 (IMC inicial < IMC final) e G2 (IMC inicial &#8805; IMC final). Resultados: No G1 houve redução de: massa corporal, IMC, CC, CQ, RCQ, gordura corporal (kg), massa corporal magra (kg) e glicemia. No G2 não foram encontradas alterações significativas nestas variáveis. Não foram encontradas diferenças significativas no GER e ambos os grupos apresentaram aumento do VO2 pico, redução da leptina plasmática e da albumina sérica. Conclusões: O programa de perda de peso realizado neste estudo foi eficiente para resultar em redução da massa corporal em 50% das participantes, apresentando também melhoras em fatores de risco para doenças cardiovasculares. Independentemente da redução da massa corporal e na massa corporal magra, programas de exercício físico sem o controle individualizado da ingestão alimentar, principalmente de proteínas, pode resultar em prejuízos para o estado nutricional de mulheres obesas. / Because of the high prevalence of obesity and its associated comorbities all over the world, it is suggested to submmit obese people to edicational weight reduction programs. Objectives: to evaluate the effects of an educational program (nutrition and physical education) in obese women. Methods: 50 obese women were submitted to a four months program of nutritional education (once a week) and exercise training (aerobic and resistance -3 times/week). They were evaluated variables related to anthropometry, metabolic and eating behavior: weight, height, waist and hip circumferences, body composition by dual X-ray energy (DEXA), aerobic power and resting energy expenditure (VO2000-lmbrasport&#174;); hemogram, leucogram, lipid profile, glucose level, leptin, IGF-1 (Insulin like growth factor-1), TSH (Tireoid stimulating hormone), albumin and pré-albumin, 3 days of food and physical activity records. The participants were distributed into the follow groups for the analysis: G1 (initial BMI < final BMI) and G2 (initial BMI &#8805; final BMI). Results: In G1 they were reduced: body mass, body mass index (BMI), waist circumference, hip circumference, waist/hip relation, fat mass (kg), lean body mass (kg) and glucose. No statistical differences were found in these parameters in G2. No statistical differences were found in resting energy expenditure in both groups and there was an increase in VO2peak, decrease in leptin and albumin concentration in both groups. Conclusions: The weight reduction program realized in this study was efficient to result weight loss in 50% of the participants, with improvements in cardiovascular risk factors. Independent of reductions on body mass and lean body mass, exercise training programs without individualized control of protein intake, especially of proteins, can jeopardize nutritional status of obese women.