Effects of a 3-Week In-Hospital Body Weight Reduction Program on Cardiovascular Risk Factors, Muscle Performance, and Fatigue: A Retrospective Study in a Population of Obese Adults with or without Metabolic Syndrome

Abstract

Background. In clinical practice, there is the diffuse conviction that obese subjects with metabolic syndrome may be more difficult to treat. Objectives and Methods. The aim of the present study was that to investigate the effectiveness of a 3-week in-hospital body weight reduction program (BWRP) in a large population of obese subjects with and without metabolic syndrome (n = 1922; 222 men and 1700 women, age range 18–83 yr). Outcomes such as body mass index (BMI), total (TOT) and HDL cholesterol, systolic and diastolic blood pressures (SBP and DBP, respectively), coronary heart disease (CHD) score, fatigue severity score (FSS), and stair climbing test (SCT) time were evaluated before and after the intervention (Δ). A sex-, BMI-, and age-related stratification of the obese population with or without metabolic syndrome was applied. Results. When compared to obese subjects without metabolic syndrome, at the basal conditions, obese subjects had a poorer cardiometabolic profile, as demonstrated by higher triglycerides, TOT-cholesterol, DBP, SBP, and CHD score, and a more compromised muscle performance (evaluated by SCT), associated with more perception of fatigue (measured by FSS). Nevertheless, obese subjects with metabolic syndrome obtained more benefits from BWRP than those without metabolic syndrome for some outcomes (i.e., ΔTOT-cholesterol, ΔSBP, and ΔCHD score). Despite these differences, the BWRP-induced weight loss was similar between the two groups (i.e., ΔBMI) as well as the gain of muscle performance (i.e., ΔSCT) and the reduction of fatigue (i.e., ΔFSS). Interestingly, the potentially deleterious fall in HDL-cholesterol levels after BWRP was less evident in obese subjects with metabolic syndrome than those without metabolic syndrome. When pooling all data, the ΔCHD score was associated with age, sex, and metabolic syndrome. The remaining outcomes, such as ΔBMI, ΔFSS, and ΔSCT time, were associated with sex and age but not with metabolic syndrome. Finally, ΔBMI was positively correlated with ΔCHD score, ΔFSS, and ΔSCT time in both obese subjects without metabolic syndrome and obese subjects with metabolic syndrome. Conclusions. When comparing obese subjects undergoing a BWRP, metabolic syndrome is not a negative predictive factor affecting the effectiveness of this intervention in terms of weight loss, muscle performance, and psychological well-being.

Effects of a 3-Week In-Hospital Multidisciplinary Body Weight Reduction Program in Obese Females: Is Measured Resting Energy Expenditure Essential for Tailoring Adequately the Amount of Energy Intake?

“…The treatment of obesity requires lifestyle intervention, behavioral therapy and energy deficit achieved throughout caloric restriction and physical exercise ( 4 ) in order to reduce body weight and correct wrong habits. In this context, residential body weight reduction programs (BWRP) have been demonstrated to be an effective strategy to counteract this condition and its associated comorbidities, due to their multidisciplinary approach ( 5 , 6 ). During BWRP, the prescription of a correct diet plan is essential to ensure a proper and gradual weight loss and to determine improvements of body composition and metabolic parameters ( 5 – 8 ).…”

Frequent Medical Supervision Increases the Effectiveness of a Longitudinal Multidisciplinary Body Weight Reduction Program: A Real-World Experience in a Population of Children and Adolescents with Obesity

“…This remarkable finding was further documented by the more frequent medical supervision in responsive subjects, i.e., children and adolescents with obesity having a weight loss (∆BMI) <−5 kg/m 2 , which represents a very stringent cut-off, when compared to the weight loss induced on average by our in-hospital 3-week BWRP (i.e., about −2 kg/m 2 in terms of ∆BMI) [16][17][18].…”

“…It is noteworthy that, in the present study, weight loss was higher in children and adolescents with metabolic syndrome than those without, although medical supervision was quantitatively the same. Since we have demonstrated that the effectiveness of an (isolate) BWRP is similar in obese subjects with or without metabolic syndrome [17], this would suggest that the "qualitative" features of medical supervision administered to obese adolescents with metabolic syndrome represent a valuable therapeutic component for the success of any intervention in this group of patients who, by contrast with those with simple obesity, need more aggressive clinical management, including more careful medical supervision [28].…”

The Age-Dependent Increase of Metabolic Syndrome Requires More Extensive and Aggressive Non-Pharmacological and Pharmacological Interventions: A Cross-Sectional Study in an Italian Cohort of Obese Women

“…Medical management of metabolic syndrome does not include only pharmacological interventions. In fact, the administration of a BWRP to obese patients has been demonstrated to be extremely effective in improving most of the cardiometabolic conditions underlying the metabolic syndrome, such as dyslipidemia, glucose intolerance, and hypertension [ 7 , 8 ]. In this respect, the early admission of obese patients to a BWRP (third level of health care) might be a valid solution of public health to interrupt the vicious circle referring to the natural history of metabolic syndrome [ 30 ] and the serious issues of underdiagnosis/undertreatment, which have been evidenced in the present study.…”

“…Indeed, body weight reduction programs allow us to reduce visceral obesity, improve glucometabolic homeostasis, and control hypertriglyceridemia and hypertension [6][7][8][9]; moreover, effective pharmacological interventions are available to treat dyslipidaemia, hyperglycaemia, and hypertension in clinical practice [10].…”