Adaptations of the guidelines for the management of overweight and obesity by the American Heart Association Task Force on Practice Guidelines (AHA), the American College of Cardiology (ACC) and The Obesity Society (TOS)
| Variable | AHA, ACC and TOS guidelines | Intervention adapted to Ouagadougou | Reasons for adaptation |
| Participants | Individuals with adiposity. | Burkinabe adults with either general overweight/obesity or abdominal overweight/obesity and one adult family volunteer. Main cook agrees to cooperate. | Recruit adults in Ouagadougou with high prevalence of adiposity; encourage support from family members, particularly from those who are responsible for the family meals; encourage healthier lifestyle in the entire family. |
| Inclusion criteria | Body mass index (BMI) ≥30.0 kg/m2 or waist circumference ≥88 cm for women and ≥102 cm for men, if BMI 25.0<30.0 kg/m2. | BMI ≥25.0 kg/m2 or waist circumference ≥80 cm for women and ≥94 cm for men. | Potential recruits may have central obesity but have a low BMI; acknowledge the important role of central body fat accumulation. |
| Setting | General practitioner. | Community for recruitment; community, trusted local health centres and home for intervention. | Encourage community and family involvement; increase compliance; reduce attrition. |
| Duration of the intervention | 3 months. | 6-month intensive intervention period with 3 group counsellings, 1 individual home-based contact and weekly sport sessions in groups. | Facilitate motivation, compliance, self-efficacy, family involvement and sustainability. |
| Weight loss goal | ≥5% of initial body weight if BMI 25.0<30.0 kg/m2; ≥10% of initial body weight if BMI ≥30.0 kg/m2. | ≥2.5 kg in the intervention group. | Realistic for adults in Ouagadougou and still relevant to improve the cardiometabolic profile. |
| Physical activity (PA) | >30 min/day (≈1200–1800 kcal/week); mainly endurance sports; for individuals with BMI ≥30.0 kg/m2, increase PA in daily routine (eg, walking, taking stairs); PA counselling: health-beneficial effects of physical activity beyond weight loss and PA goal setting. | >30 min/day (≈1200–1800 kcal/week); increase PA in daily routine (eg, brisk walking); group counselling: health-beneficial effects of physical activity beyond weight loss; PA goal setting: GPAQ; PA groups sessions. | Most relevant; achievable recommendations, accounting for workload and family time; encouragement of self-chosen activity in a group or alone; incorporates goal setting, behavioural contracting and tailored health communication. |
| Dietary intervention and targets | Dietary advice by general practitioner: daily energy deficit of 500 kcal; reduction of total fat and/or reduction of carbohydrates. | 3 group counsellings with a dietician in the language of choice (French, Morré); 1 home-based cooking session focusing on cooking methods, portion sizes, food choices and fat amount for cooking; diet goal setting: 24-hour dietary recall protocols. | Bilingual dietary counselling available; achievable and comprehensible approach, given the low level of formal education and health literacy in the study population; engage the available family in a domestic setting especially those who prepare the family meals; incorporates goal setting, behavioural contracting and tailored health communication. |
GPAQ, Global Physical Activity Questionnaire.