{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T03:02:42Z","timestamp":1789873362914,"version":"4.0.1"},"reference-count":25,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Telemed Telecare"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Although telehealth interventions have produced weight-management outcomes comparable with in-person care in several settings, 12-month randomized evidence from public tertiary services in middle-income countries remains limited. This study compared remote and in-person consultations for obesity treatment in a Brazilian public tertiary-care center, focusing on continuity of care, weight loss, and exploratory metabolic outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This 12-month, matched-pair randomized, prospective, single-center, open-label pilot trial included 32 adults in a multidisciplinary weight-management program. Participants were allocated to telehealth video consultations or standard in-person care. The primary outcomes were appointment attendance and treatment adherence, defined a priori as the proportion of missed appointments that were rescheduled and subsequently attended. Secondary outcomes included percentage change in body weight, the proportion of participants achieving \u22655% weight loss, anthropometric measures, and metabolic parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The overall absence rate did not differ significantly between the telehealth and in-person groups (12.5% vs. 17.1%;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.413). All 10 missed telehealth appointments were rescheduled and attended, compared with 8 of 14 missed in-person appointments (100% vs. 57.1%;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.024). Mean 12-month percentage weight change was \u22124.8%\u2009\u00b1\u20094.7% in the telehealth group and \u22125.5%\u2009\u00b1\u20093.8% in the in-person group, and 56.3% and 62.5% of participants, respectively, achieved \u22655% weight loss. Both groups had significant within-group reductions in waist and hip circumferences. HbA1c decreased within the telehealth group (6.39%\u2009\u00b1\u20091.08% to 5.98%\u2009\u00b1\u20090.46%;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.005), but no between-group difference in HbA1c change was demonstrated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>In this pilot trial, telehealth produced weight and anthropometric outcomes similar to those observed with in-person care and were associated with a higher proportion of missed appointments being rescheduled. The HbA1c finding was exploratory and does not establish metabolic superiority. Larger multicenter trials are needed to confirm these findings and assess long-term effectiveness, implementation, and cost-effectiveness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>Brazilian Registry of Clinical Trials (ReBEC), RBR-7wt6hzm; UTN U1111-1318-5411. Registered on 7 April 2025, retrospectively.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1357633x261488474","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T01:11:09Z","timestamp":1789693869000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of telehealth versus in-person appointments for the treatment of obesity in a Brazilian public tertiary care center: A randomized controlled trial"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-7088-2093","authenticated-orcid":false,"given":"Flavio Roberto Silva","family":"Rocha","sequence":"first","affiliation":[{"name":"Universidade Federal De Sao Paulo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9489-0343","authenticated-orcid":false,"given":"Raphaella Scorsi","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Universidade Federal De Sao Paulo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9383-7907","authenticated-orcid":false,"given":"Carolina Castro Porto Silva","family":"Janovsky","sequence":"additional","affiliation":[{"name":"Universidade Federal De Sao Paulo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1187-0143","authenticated-orcid":false,"given":"Adriana","family":"Sa\u00f1udo","sequence":"additional","affiliation":[{"name":"Universidade Federal De Sao Paulo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8451-8522","authenticated-orcid":false,"given":"Maria Teresa","family":"Zanella","sequence":"additional","affiliation":[{"name":"Universidade Federal De Sao Paulo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4859-7312","authenticated-orcid":false,"given":"Glaucia","family":"Carneiro","sequence":"additional","affiliation":[{"name":"Universidade Federal De Sao Paulo"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.191707"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/obr.12551"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1038\/ijo.2008.247"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1205880"},{"key":"e_1_3_2_6_2","volume-title":"World Obesity Atlas 2025","author":"World Obesity Federation","year":"2025","unstructured":"World Obesity Federation. 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