Overview
The OBESIAL (Obesity Structured Intervention in Algeria) study aims to evaluate the clinical, metabolic, and organisational impact of a structured multidisciplinary obesity care pathway implemented under real-world conditions.
Description
OBESIAL is a prospective pragmatic study involving 300 adults with obesity recruited from healthcare facilities in Algeria and followed for 18 months. The primary comparison evaluates outcomes between participants receiving structured multidisciplinary care (G1, n=150) and those receiving non-structured usual care (G2, n=150). The structured pathway includes coordinated medical follow-up, personalised nutritional intervention, adapted physical activity, therapeutic education, and multidisciplinary support.
Within the structured care group, eligible participants will undergo a nested randomised comparison between G1a (lifestyle intervention plus GLP-1 receptor agonist therapy) and G1b (lifestyle intervention alone) to assess the additional effect of GLP-1 receptor agonist treatment.
The primary outcome is the proportion of participants achieving clinically meaningful weight loss (≥5% of initial body weight) at 18 months. Secondary outcomes include changes in body composition, metabolic parameters, treatment response, adherence, and obesity-related outcomes. Longitudinal analyses will be performed using mixed-effects models, while multivariable approaches will explore factors associated with treatment response.
The findings of the OBESIAL study are expected to provide evidence to support the development and optimisation of structured multidisciplinary obesity care pathways in Algeria and may offer relevant insights for other African healthcare systems.
Eligibility
Inclusion Criteria:
- Adults aged 18-65 years
- BMI ≥30 kg/m²
- Written informed consent obtained prior to enrolment
Exclusion Criteria:
- Refusal to participate or inability to adhere to follow-up procedures
- Pregnancy at enrolment
- Severe or unstable comorbidities compromising safety or participation, including:
- Recent acute cardiovascular event (\<60 days)
- Active malignancy
- Severe unstable organic disease
- Previous bariatric surgery
- Obesity pharmacotherapy within the previous 90 days
- Known contraindication to planned therapeutic options
- Severe unstable psychiatric disorders
- Genetic obesity or obesity secondary to uncontrolled endocrine disease
Exclusion Criteria During Follow-up
- Pregnancy occurring during follow-up
- Initiation of chronic treatment associated with weight gain
