Companion-Intensive Multi-aspect Weight Management in Chinese Adults with Obesity: A Six-Month Multicenter Randomized Clinical Trial

Abstract

Background Obesity is a globally increasing health epidemic requiring early lifestyle intervention. Our main objective was to examine the effectiveness of companion-intensive multi-aspect weight management (CIMWM) for Chinese adults with obesity. Methods In this 6-month, prospective, open-label, multicenter, randomized controlled clinical trial, we included 272 obese adults aged 18–50 years with a body mass index (BMI) ≥ 28.0 kg/m2 and capable of using smartphones. CIMWM (n = 136) offered both daily online instructions and monthly face-to-face guidance by physicians, dietitians, and health managers along with the provision of meal replacements in the first 3 months. Traditional multi-aspect weight management (TMWM, n = 136) provided monthly face-to-face guidance by the above-mentioned professionals and required daily self-monitoring. Measurements of body composition and metabolic parameters were assessed face-to-face at baseline, 1, 2, 3, and 6 months by physicians. Primary outcomes were the changes in BMI and body composition. Results All participants showed significantly reduced BMI, body fat mass (BFM), visceral fat area (VFA), and HOMA-IR (P < 0.05). CIMWM was shown to be superior to TMWM in the improvement of BMI, alanine aminotransferase (ALT), and the body composition parameters BFM and VFA (P < 0.05). The relationship of baseline non-alcoholic fatty liver disease score (NFS) was positively related to the skeletal muscle mass-to-visceral fat area ratio (S/V). Additionally, the weight management program was beneficial in lowering the NFS among subjects with levels in the highest tertile (P < 0.05). Metabolic memory in terms of the continuous reduction of BMI, VFA, and ALT was retained up to 6 months in spite of participants transferring to self-monitored assessment in the final 3 months. Conclusions The CIMWM strategy in obese Chinese adults proved to be more effective than TMWM, and motivates greater adherence to intervention and lifestyle reprogramming. Trial registration: ChiCTR1800017463, Registered 31 July 2018, retrospectively registry. http://www.chictr.org.cn/showproj.aspx?proj=29649