LONG-TERM, SUSTAINED, LIFESTYLE-INDUCED WEIGHT LOSS IN SEVERE OBESITY: THE GET-ReAL PROGRAM.
Endocr Pract
; 21(4): 330-8, 2015 Apr.
Article
em En
| MEDLINE
| ID: mdl-25932566
ABSTRACT
OBJECTIVE:
To study the long-term effectiveness of a patient-centered, multidisciplinary lifestyle intervention treatment in patients medically eligible for bariatric surgery.METHODS:
Using a case-control study design, we compared treatment results for 98 adults (mean body mass index [BMI], 44.2 kg/m(2)) with the outcomes of 148 controls (mean BMI, 43.0 kg/m(2)) receiving standard care. The approach included a phased triage for inclusion, followed by 12 lifestyle intervention group sessions alternating with individual visits for behavior, diet, and exercise instructions.RESULTS:
At 2 years, weight loss averaged 15.3 ± 1.4 kg (P<.0010) (12 ± 1% of initial body weight [IBW], P<.001; 21 ± 2% of excess body weight [EBW], P<.001) in an intention-to-treat (ITT) analysis; in completers, weight loss was 18.8 ± 1.5 kg (P<.001) (15 ± 1% IBW, P<.001; 26 ± 3% EBW, P<.001). A total of 42 patients lost ≥10% IBW. Controls remained weight stable (P = .35); 3% lost ≥10% IBW. Patients achieving weight loss that would be considered satisfactory for bariatric surgery included 20% who achieved ≥35% EBW loss, 29% who achieved a BMI <35 kg/m(2) (if starting BMI <50 kg/m(2)) or BMI <40 kg/m(2) (if starting BMI ≥50 kg/m(2)), and 37% who achieved EBW loss ≤50%. These values for completers were 31, 39, and 48%, respectively. In the 55 patients starting the program ≥4 years ago, weight loss maintenance of 12 ± 1% IBW (ITT, 16 ± 1% in completers) was observed.CONCLUSION:
Substantial nonsurgical weight loss, maintained at 2 to 4 years, is achievable in severely obese patients using comprehensive lifestyle approaches; the efficacy/safety trade-off in obesity treatment is an important consideration in interpreting these results.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Redução de Peso
/
Estilo de Vida
/
Obesidade
Tipo de estudo:
Observational_studies
Limite:
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Ano de publicação:
2015
Tipo de documento:
Article