Health-related quality of life in WHO Class II–III obese men losing weight with very-low-energy diet and behaviour modification: a randomised clinical trial

Kaukua, Jarmo; Pekkarinen, Tuula; Sane, Timo; Mustajoki, Pertti

doi:10.1038/sj.ijo.0801953

Cited by 51 publications

(75 citation statements)

References 34 publications

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“…One randomised study among obese men losing weight with very-low-energy diet and behaviour modification showed transient improvement in many domains of HRQL during the marked weight loss with the diet, but only improvements in PF, SF, and obesityrelated psychosocial problems were maintained at the end of nearly 6 months into weight maintenance phase. 10 Another study with similar weight loss programme (but a 2-y followup) showed that HRQL benefits were dependent on the success in maintaining the weight loss result. 11 A 10% weight loss at 2 y after treatment was associated with clear improvement in obesity-related psychosocial problems, PF, physical role functioning, bodily pain, GH, mental health, and vitality.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] Weight loss achieved by surgical techniques 1 and lifestyle interventions [4][5][6][7][8][9][10][11] has improved HRQL. Diabetes with its complications has been associated with deteriorated HRQL [12][13][14][15][16] and improvement in glycaemic control with the loss of hyperglycaemic symptoms has improved HRQL in type II diabetes patients.…”

Section: Introductionmentioning

confidence: 99%

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Health-related quality of life in a randomised placebo-controlled trial of sibutramine in obese patients with type II diabetes

2004

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OBJECTIVE:We evaluated the effects of 12-month treatment with sibutramine 15 mg daily compared with placebo on healthrelated quality of life (HRQL) in obese type II diabetes patients. We examined the associations between the changes in HRQL and in weight, glycaemic control, and haemodynamic variables. We also explored the predictive value of HRQL and its changes early during treatment. DESIGN: A randomised clinical trial. The subjects were enrolled in a 2-week single-blind run-in period with a modestly hypocaloric diet (700 kcal daily deficit) and then randomised to receive either sibutramine 15 mg (n ¼ 114, 60% female) or placebo (n ¼ 122, 58% female) once daily with the hypocaloric diet for 12 months. SUBJECTS: Obese (mean BMI 36 kg/m 2 and age 54 y) type II diabetes patients untreated with antidiabetic medications. MEASUREMENTS: The main outcome measures included body weight and HRQL (the RAND 36-Item Health Survey 1.0). RESULTS: The mean weight loss was greater in the sibutramine group (À7.1 kg) than in the placebo group (À2.6 kg, Po0.001). The baseline HRQL was relatively high. There were no significant differences between the treatment groups in glycaemic control or in any of the RAND-36 scales during the study. The scores on physical functioning (PF) and health change (HC) since last year improved in both groups and this improvement was related to weight loss. When HRQL changes were examined in categories of weight loss, the scores on PF and HC increased with Z5% weight loss, but the scores on vitality (V) and general health (GH) increased only after Z15% weight loss. Decrease in HbA1c was associated with increases in the scores of PF, GH, V, mental health, and HC. In the sibutramine group, the increase in diastolic blood pressure was associated with the decrease in the scores of PF, physical role functioning, emotional role functioning (ERF), social functioning (SF), and bodily pain. High baseline scores on ERF and SF, and low scores on V predicted weight loss at 12 months. Also, increasing scores on PF and V during the first 3 months predicted weight loss at 12 months. The sum of four dichotomised HRQL variables (baseline ERF Z75 ¼ 1 and o75 ¼ 0; baseline SFZ80 ¼ 1 and o80 ¼ 0; 3-month change in PF40 ¼ 1 and r0 ¼ 0; 3-month change in V40 ¼ 1 and r0 ¼ 0) predicted weight loss: In the group with sum 0, the mean(s.d.) weight change at 12 months was 0.0(2.6)% and with sum 4 it was -9.0(8.1)% of baseline weight. CONCLUSION: Despite the superior weight loss, sibutramine 15 mg daily did not produce HRQL benefits over placebo when measured with the generic RAND-36 in obese type II diabetes patients. PF and HC since last year improved with Z5% weight loss, but Z15% weight loss was needed to achieve a cluster of HRQL improvements. The decrease in HbA1c was associated with many HRQL benefits. Poor baseline HRQL and the improvement observed in the first months of treatment may prove to be useful in predicting success in long-term weight loss.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Health-related quality of life in a randomised placebo-controlled trial of sibutramine in obese patients with type II diabetes

2004

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“…2 Indeed, adult studies report an inverse relationship between body mass index (BMI) and HRQOL, 2 and indicate that HRQOL improves with weight loss. [2][3][4][5] It also appears that adults seeking treatment for obesity have poorer HRQOL than non-treatment seekers after controlling for weight status. 6,7 Although lagging behind the adult literature, the last 6 years has seen an increase in the number of pediatric studies examining the relationship between obesity and HRQOL, but to our knowledge no earlier published reviews have synthesized this literature.…”

Section: Introductionmentioning

confidence: 99%

Health-related quality of life in obese children and adolescents

et al. 2009

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Objective: This review addresses the effect of overweight and obese weight status on pediatric health-related quality of life (HRQOL). Method: Web of Science, Medline, CINAHL, Cochrane Library, EMBASE, AMED and PubMed were searched for peer-reviewed studies in English reporting HRQOL and weight status in youth (o21 years), published before March 2008. Results: Twenty-eight articles were identified. Regression of HRQOL against body mass index (BMI) using pooled data from 13 studies utilizing the Pediatric Quality of Life Inventory identified an inverse relationship between BMI and pediatric HRQOL (r ¼ À0.7, P ¼ 0.008), with impairments in physical and social functioning consistently reported. HRQOL seemed to improve with weight loss, but randomized controlled trials were few and lacked long-term follow-up. Conclusions: Little is known about the factors associated with reduced HRQOL among overweight or obese youth, although gender, age and obesity-related co-morbidities may play a role. Few studies have examined the differences in HRQOL between community and treatment-seeking samples. Pooled regressions suggest pediatric self-reported HRQOL can be predicted from parent proxy reports, although parents of obese youths tend to perceive worse HRQOL than children do about themselves. Thus, future research should include both pediatric and parent proxy perspectives.

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“…We have previously shown in a randomised clinical trial with obese men that marked weight loss with VLED and behaviour modification led to many HRQL improvements in the short term, but with longer follow-up (nearly 6 months after treatment) only physical functioning, social functioning, and obesity-related psychosocial problems showed maintained improvement. 32 The local guidelines recommend referring obese patients to obesity clinics only if the patient has a BMI Z35 kg/m 2 with obesity-related comorbidity requiring weight loss and if previous attempts to lose weight have failed.…”

Section: Benefits and Limitationsmentioning

confidence: 99%

“…[21][22][23][24][25][26][27] The previous weight loss studies with lifestyle intervention have shown various improvements in HRQL, but the studies have usually been very short in duration. [28][29][30][31] Studies with longer follow-up have shown a more modest improvement in HRQL, 32 and to our knowledge there are no reports of follow-up over 1 y.…”

Section: Introductionmentioning

confidence: 99%

Health-related quality of life in obese outpatients losing weight with very-low-energy diet and behaviour modification—a 2-y follow-up study

et al. 2003

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OBJECTIVE:To study health-related quality of life (HRQL) in a clinically selected sample of obese outpatients. DESIGN: A single-strand before and after study with 2-y follow-up after treatment comprising 10 weeks on very-low-energy diet (VLED) and 4 months of behaviour modification in groups. SUBJECTS: A total of 126 (mean (s.d.) age 48.2 (11.1) y and body mass index 42.8 (6.2) kg/m 2 obese patients (63% women) referred for treatment in an obesity clinic. MEASUREMENTS: Weight and HRQL using questionnaires (RAND 36-Item Health Survey 1.0 and Obesity-related Psychosocial problems scale (OP-scale)). RESULTS: A total of 100 patients (61% women) completed the treatment and 67 (71% women) completed the 2-y follow-up. The mean (s.d.) weight loss was 12.5 (5.6)% at the end of group therapy, 6.0 (7.1)% at 1 y, and 2.6 (7.5)% at 2 y. At baseline, the mean (s.d.) score for the OP-scale was 61.9 (24.6). The mean scores on every RAND-36 scale were markedly lower than in the Finns without chronic conditions. All the scales in HRQL improved markedly during the treatment. During the follow-up, all the scales started to return towards baseline levels, and at 2 y only obesity-related psychosocial problems and physical functioning were still improved relative to baseline. In categories of weight change at 2 y (Z10% weight loss, 0-9.9% weight loss, weight gain), obesity-related psychosocial functioning, physical functioning, and general health showed dose-response improvement with increasing weight loss. A Z10% weight loss at 2 y after treatment was associated with clear improvement in obesity-related psychosocial problems, physical functioning, physical role functioning, bodily pain, general health, mental health, and vitality. A 0-9.9% weight loss was associated with improvement in obesity-related psychosocial problems and physical functioning. Weight gain was associated with improvement in obesity-related psychosocial problems and social functioning. The study population was too small to examine possible gender differences. CONCLUSIONS: Treatment with VLED and behaviour modification produces marked short-term weight loss and clear improvement in all aspects of HRQL. At 2 y after treatment, the average maintained weight loss is modest. However, 1/3 of patients maintained a Z5% weight loss. Improvement in obesity-related psychosocial problems and physical functioning is associated even with less than 10% of maintained weight loss. Since the pattern of HRQL changes only partly followed the pattern of weight change as expected, other factors, such as the therapeutic effect of participating in the weight loss programme or increase in physical activity, may affect HRQL responses.

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Health-related quality of life in WHO Class II–III obese men losing weight with very-low-energy diet and behaviour modification: a randomised clinical trial

Cited by 51 publications

References 34 publications

Health-related quality of life in a randomised placebo-controlled trial of sibutramine in obese patients with type II diabetes

Health-related quality of life in a randomised placebo-controlled trial of sibutramine in obese patients with type II diabetes

Health-related quality of life in obese children and adolescents

Health-related quality of life in obese outpatients losing weight with very-low-energy diet and behaviour modification—a 2-y follow-up study

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