# Effects of lifestyle modification counselling on weight and body composition among adults with overweight or obesity on antiretroviral therapy: a randomized controlled trial

## TL;DR

Lifestyle counselling helped HIV patients on ART lose weight and improve body composition over six months.

## Contribution

Demonstrated that structured lifestyle modification counselling improves weight and body composition in HIV patients on ART.

## Key findings

- Participants receiving counselling lost significantly more weight, fat mass, and visceral fat than the control group.
- The intervention group showed increased fat-free mass and skeletal muscle, indicating better body composition.
- 21.6% of participants achieved at least a 3% weight loss, and counselling significantly correlated with this outcome.

## Abstract

we aimed to evaluate the impact of lifestyle modification counselling on weight and body composition among adults with overweight or obesity receiving antiretroviral treatment (ART).

This randomized, open-label, controlled trial enrolled 126 adults aged 18–65 years, living with human immunodeficiency virus (HIV) and classified as overweight or obese. Of these, 116 participants (63 in the control group and 53 in the intervention group) completed the six-month follow-up. Weight and body composition outcomes were analyzed among those who completed the study, with comparisons made between baseline and post-intervention measurements. The effect of lifestyle modification counselling on weight and body composition was evaluated through linear mixed effects model and multiple linear regression analysis.

Over the six-month trial, participants who received lifestyle modification counselling showed significantly greater reductions in body weight (Δ = −1.4 kg, p = 0.002), visceral fat (Δ = −0.53, p = 0.006), fat mass (Δ = −2.16 kg, p ​< ​0.001), and body fat percentage (Δ ​= ​−2.02 ​%, p ​< ​0.001) compared to the control group. The intervention group experienced greater increases in fat-free mass (Δ ​= ​+0.673 kg, p ​= ​0.068) and percentage skeletal muscle (Δ ​= ​+1.27 ​%, p ​< ​0.001) compared to the control group. Additionally, lifestyle modification counselling significantly contributed to achieving at least a 3 ​% weight loss from baseline (β ​= ​0.158, p ​= ​0.048).

Lifestyle modification counselling resulted in promising and favorable changes in weight and body composition. Therefore, offering routine structured counselling interventions within ART clinics for individuals with overweight or obesity may help reduce obesity-related health risks and improve clinical outcomes (Thai Clinical Trials Registry TCTR20240905007).

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•Lifestyle counselling resulted in significant reductions in weight, fat mass, visceral fat and body fat percentage.•The intervention group showed an increase in fat-free mass and skeletal muscle, reflecting improved body composition.•Overall, 21.6 % of participants had at least a 3 % weight loss from their baseline.•Counselling significantly correlated with ≥3 % weight loss.•The findings indicate that lifestyle counselling leads to favorable changes in weight and body composition.

Lifestyle counselling resulted in significant reductions in weight, fat mass, visceral fat and body fat percentage.

The intervention group showed an increase in fat-free mass and skeletal muscle, reflecting improved body composition.

Overall, 21.6 % of participants had at least a 3 % weight loss from their baseline.

Counselling significantly correlated with ≥3 % weight loss.

The findings indicate that lifestyle counselling leads to favorable changes in weight and body composition.