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There is a wide acknowledgement of obesity as a relevant clinical entity. Such relevance can be inferred by the huge worldwide amount of research and related health promotion and clinical efforts. Though the evidence sustains some cues for the therapeutic success, the overall long-term effectiveness of obesity treatment tends to be not so satisfactory. Scientific literature is not unequivocal in key areas of nutritional intervention, such as the magnitude of caloric restriction, proportion of macronutrients, meal frequency, among others. The same applies to the area of physical activity recommendation for weight control. As a correlate of this scenario of incertitude, there is a proliferation of interventions and there is a clear need to integrate the scientific and clinical evidence. This paper presents a narrative literature review of key issues of clinical practice in obesity, regarding a set of actions that, in the overall, have as main purpose the promotion of reduction and/or control of body weight. The role of the health professional is highlighted as a facilitator of acquisition of habits that favor weight control, by integrating the professional's scientific knowledge with the patient's readiness for and capacity to change.

Background: Intragastric balloon is a temporary treatment for weight loss with proven safety and efficacy when associated with lifestyle intervention. It is indicated in the super--obese who are candidates for bariatric surgery to lose weight and to reduce their high surgical risk. Our aim was to retrospectively evaluate the results of the patients in whom this device was inserted during a three-year period from the beginning of this practice in the Hospital de Santa Maria., Methods: Data from the medical records in what concerns bioanthropometric characteristics in the beginning and following balloon removal were reviewed and submitted to descriptive analysis., Results: Fifty-seven patients underwent intragastric balloon placement, of whom 46 female and 11 male, with median age 44,2 ± 11,77 years. Median body mass index (BMI) 51,6 ± 9,45 kg/m(2). Five patients were lost to follow-up. The balloon was inserted for a median time of 206 ± 62,62 days, during which there was a median weight loss of 17,2 ± 9,46 kg, a reduction of 6,7 ± 3,73 kg/m(2) in BMI and a mean excessive weight loss of 26,7 ± 16,99%. There were 5 patients in whom serious complications occurred, one of which died. One half of the patients went on to bariatric surgery. The median time between balloon removal and surgery was 241,6 ± 243,66 days in which there was a median weight variation of + 3,5 ± 11,69 kg. The remaining patients: 15 dropped out further treatment, 5 patients are under medical therapy and have no invasive procedure scheduled, 4 patients are to be submitted to another balloon insertion and 2 patients were submitted to the insertion of a second balloon during the time this article refers to., Conclusions: Our findings are similar to some previously described. Intragastric balloon is a temporary and efficacious option in the treatment of morbid obesity. However, it is very important to strictly select the patients and to have a good coordination with the Surgical department so that results can be optimized.

Nutritional deficiences are common in patients who have undergone bariatric surgery for morbid obesity. There are limited data on nutritional status before surgery. We now begin to realize the importance and the high frequency of that situation in the morbidly obese who have never undergone any invasive procedure. It is very important to acknowlegde this fact, so that specific therapy is begun before surgery. It is our conviction that in doing so we minimize the risk of having serious deficiencies after surgery. We report a case of a morbidly obese woman with nutritional deficiencies before bariatric surgery.