One year weight loss in the TRAMOMTANA study. A randomized controlled trial

Tur, Juan; Escudero, Antonio; Alòs, Maria; Salinas, Ramón; Terés, Emma; Soriano, Joan B.; Nicola, Gabriela; Urgelés, Juan Ramón; Pagán, Alberto; Cortés, Baltasar; González, Xavier; Burguera, Bartolomé

doi:10.1111/cen.12109

Cited by 13 publications

(11 citation statements)

References 19 publications

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“…This report expands our previous trial publication from one year to two years plus a six-month follow-up period [ 24 ]. Individuals with MO (BMI > 40 Kg/m 2 ) were selected from our obesity clinic in Son Espases University Hospital in Mallorca (Spain).…”

Section: Methodssupporting

confidence: 76%

An Intensive Lifestyle Intervention Is an Effective Treatment of Morbid Obesity: The TRAMOMTANA Study—A Two-Year Randomized Controlled Clinical Trial

Burguera

Tur

Escudero

et al. 2015

International Journal of Endocrinology

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Bariatric surgery is currently the most effective therapy to induce weight loss in morbidly obese patients. Objective. This controlled, clinical trial with a two-year intervention was aimed at comparing the efficacy of two nonsurgical approaches versus bariatric surgery, on body weight changes and metabolic parameters in morbidly obese patients. Methods. Patients were randomized to an Intensive Lifestyle Intervention (ILI) (n = 60) or Conventional Obesity Therapy (COT) (n = 46). The ILI group received behavioral therapy and nutritional counseling. The COT group received standard medical treatment. They were compared with a third group, Surgical Obesity Group (SOG) (n = 37). Results. Patients who received ILI had a greater percentage of weight loss than patients receiving COT (−11.3% versus −1.6%; p < 0.0044). Interestingly 31.4% of patients included in the ILI group were no longer morbidly obese after just six months of intervention, increasing to 44.4% after 24 months of intervention. The percentage weight loss in SOG was −29.6% after that same period of time. Conclusions. ILI was associated with significant weight loss when compared to COT, in a group of patients with obesity. An ILI approach could be an alternative therapy to patients with obesity, who are not candidates to undergo bariatric surgery. This trial is registered with EudraCT 2009-013737-24.

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Section: Methodssupporting

confidence: 76%

An Intensive Lifestyle Intervention Is an Effective Treatment of Morbid Obesity: The TRAMOMTANA Study—A Two-Year Randomized Controlled Clinical Trial

Burguera

Tur

Escudero

et al. 2015

International Journal of Endocrinology

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“…The pooled mean difference in weight loss was −8.9 kg and −2.8 kg/m² in BMI. Even though this result can seem modest compared to bariatric surgery (10–15 kg/m 2 , 30–50 kg, 15–30% of weight loss)[ 16 , 17 , 90 ], a weight loss of 5–10%, which represents a reduction of 2–4 kg/m 2 of BMI [ 91 ], is clearly associated with clinically relevant health benefits on glucose and lipids metabolism, blood pressure and psychosocial outcomes (e.g., mood, quality of life, and body image), as well as a reduction in weight-related comorbidities (diabetes, hypertension, hyperlipidemia sleep apnea, osteoarthritis …) in obese individuals [ 12 , 92 – 96 ].…”

Section: Discussionmentioning

confidence: 99%

Effects of Lifestyle Interventions That Include a Physical Activity Component in Class II and III Obese Individuals: A Systematic Review and Meta-Analysis

Romain²,

et al. 2015

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BackgroundIn class II and III obese individuals, lifestyle intervention is the first step to achieve weight loss and treat obesity-related comorbidities before considering bariatric surgery. A systematic review, meta-analysis, and meta-regression were performed to assess the impact of lifestyle interventions incorporating a physical activity (PA) component on health outcomes of class II and III obese individuals.MethodsAn electronic search was conducted in 4 databases (Medline, Scopus, CINAHL and Sportdiscus). Two independent investigators selected original studies assessing the impact of lifestyle interventions with PA components on anthropometric parameters, cardiometabolic risk factors (fat mass, blood pressure, lipid and glucose metabolism), behaviour modification (PA and nutritional changes), and quality of life in adults with body mass index (BMI) ≥ 35 kg/m2. Estimates were pooled using a random-effect model (DerSimonian and Laird method). Heterogeneity between studies was assessed by the Cochran’s chi-square test and quantified through an estimation of the I ².ResultsOf the 3,170 identified articles, 56 met our eligibility criteria, with a large majority of uncontrolled studies (80%). The meta-analysis based on uncontrolled studies showed significant heterogeneity among all included studies. The pooled mean difference in weight loss was 8.9 kg (95% CI, 10.2–7.7; p < 0.01) and 2.8 kg/m² in BMI loss (95% CI, 3.4–2.2; p < 0.01). Long-term interventions produced superior weight loss (11.3 kg) compared to short-term (7.2 kg) and intermediate-term (8.0 kg) interventions. A significant global effect of lifestyle intervention on fat mass, waist circumference, blood pressure, total cholesterol, LDL-C, triglycerides and fasting insulin was found (p<0.01), without significant effect on HDL-C and fasting blood glucose.ConclusionsLifestyle interventions incorporating a PA component can improve weight and various cardiometabolic risk factors in class II and III obese individuals. However, further high quality trials are needed to confirm this evidence, especially beyond weight loss.

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“…Both day and inpatient lifestyle interventions cause clinically meaningful weight loss (≥5–10%) the first year after treatment of patients with SO [25–30]. However, data on changes in BC after an inpatient intervention are sparse [31].…”

Section: Introductionmentioning

confidence: 99%

Changes in Body Composition, Cardiovascular Disease Risk Factors, and Eating Behavior after an Intensive Lifestyle Intervention with High Volume of Physical Activity in Severely Obese Subjects: A Prospective Clinical Controlled Trial

Danielsen

Svendsen

Mæhlum³

et al. 2013

Journal of Obesity

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We examined the effects of a 10–14-weeks inpatient lifestyle modification program, including minimum 90 min of physical activity (PA) five days/week, on body composition, CVD risk factors, and eating behavior in 139 obese subjects (BMI 42.6 ± 5.2 kg/m2). Completion rate was 71% (n = 71) in the intensive lifestyle intervention (ILI) group and 85% (n = 33) among waiting list controls. Compared to controls body weight (−17.0 (95% CI: −18.7, −15.3) kg, P < 0.0001), fat mass (−15.2 (95% CI: −17.4, −13.1) kg, P < 0.0001), fat free mass (−1.2 (95% CI: −2.2, −0.2) kg, P = 0.016) and visceral fat (−86.6(95% CI: −97.4, −75.7) cm2, P < 0.0001) were reduced in the ILI-group after 10–14 weeks. Within the ILI-group weight loss was −23.8 (95% CI: −25.9, −21.7) kg, P < 0.0001 and -20.3 (95% CI: −23.3, −17.3) kg, P < 0.0001, after six and 12 months, respectively. Systolic BP, glucose, triglycerides, and LDL-C were reduced, and HDL-C was increased (all P ≤ 0.006) after 10–14 weeks within the ILI group. The reduction in glucose and increase in HDL-C were sustained after 12 months (all P < 0.0001). After one year, weight loss was related to increased cognitive restraint and decreased uncontrolled eating (all P < 0.05). Thus, ILI including high volume of PA resulted in weight loss with almost maintenance of fat-free mass, favorable changes in CVD risk factors, and eating behavior in subjects with severe obesity.

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One year weight loss in the TRAMOMTANA study. A randomized controlled trial

Cited by 13 publications

References 19 publications

An Intensive Lifestyle Intervention Is an Effective Treatment of Morbid Obesity: The TRAMOMTANA Study—A Two-Year Randomized Controlled Clinical Trial

An Intensive Lifestyle Intervention Is an Effective Treatment of Morbid Obesity: The TRAMOMTANA Study—A Two-Year Randomized Controlled Clinical Trial

Effects of Lifestyle Interventions That Include a Physical Activity Component in Class II and III Obese Individuals: A Systematic Review and Meta-Analysis

Changes in Body Composition, Cardiovascular Disease Risk Factors, and Eating Behavior after an Intensive Lifestyle Intervention with High Volume of Physical Activity in Severely Obese Subjects: A Prospective Clinical Controlled Trial

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