Randomized Trial of Lifestyle Modification and Pharmacotherapy for Obesity

Wadden, Thomas A.; Berkowitz, Robert I.; Womble, Leslie G.; Sarwer, David B.; Phelan, Suzanne; Cato, Robert K.; Hesson, Louise A.; Osei, Suzette Y.; Kaplan, Rosalind; Stunkard, Albert J.

doi:10.1056/nejmoa050156

Cited by 706 publications

(530 citation statements)

References 25 publications

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“…Numerous studies have shown that attention to lifestyle modification can dramatically reduce progression to type 2 diabetes (52)(53)(54). Weight loss of as little as 7% of body weight during the 1st year of intervention, with lesser amounts to follow, is extremely effective and well within the capability of most patients.…”

Section: Risk Factor Managementmentioning

confidence: 99%

Preventing Cardiovascular Disease and Diabetes

et al. 2006

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Section: Risk Factor Managementmentioning

confidence: 99%

Preventing Cardiovascular Disease and Diabetes

et al. 2006

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“…This conservative approach was developed by Wadden et al 21 and has been used on other large-scale studies. 22,23 Consistent with IOM recommendations, 3 we classified successful maintainers as those who maintained a weight loss of 5% or more of initial body weight. For items assessing behaviors and barriers, response categories 1-3 were collapsed and classified as 'infrequent' and response categories 4 and 5 were classified as 'frequent.'…”

Section: Statistical Analysesmentioning

confidence: 99%

Weight maintenance, behaviors and barriers among previous participants of a university-based weight control program

et al. 2007

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Objective: To examine weight loss maintenance among previous participants of a university-based behavioral weight management program and to compare behavioral strategies and perceived barriers between successful and unsuccessful maintainers. Method: Previous program participants (n ¼ 179) completed mailed surveys assessing current weight, weight control behaviors and perceived barriers to weight loss maintenance. Results: At 14.1 ± 10.8 months following completion of treatment, survey respondents were on average 12.6 ± 12.6 kg, or 11.3±10.7%, below baseline weight; 76.5% of respondents had successfully maintained weight, defined as maintaining a weight loss of at least 5% below baseline. Compared to unsuccessful maintainers, successful maintainers reported practicing four dietary and three physical activity weight control strategies more often and experiencing five barriers to healthy eating and exercise less often. After accounting for time since treatment and maximum weight loss while in treatment, the strongest correlates of successful weight loss maintenance were frequent exercise and perceived difficulty of weight management. Conclusions: Clinically meaningful weight loss maintenance was achieved by the majority of participants. Findings support the literature indicating that physical activity is one of the strongest predictors of successful weight loss maintenance. Findings also suggest that strategies to reduce the level of perceived effort required for long-term weight control may improve maintenance outcomes.

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“…24 In a large 12-month multicenter trial with 498 adolescents aged 12-16 years, the mean absolute change in BMI was 2.9 kg/m 2 (8.2%) in the sibutramine group compared with 0.3 kg/m 2 (0.8%) in the placebo group (P < 0.001). 25 Sibutramine has also been studied as part of a behavioral weight-loss program. With sibutramine alone and minimal behavioral intervention, the weight loss over 12 months was approximately 5.0 ± 7.4 kg.…”

Section: Sibutraminementioning

confidence: 99%

Medical Therapy for Obesity

Bray

2010

Mount Sinai J Medicine

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Obesity results from a prolonged small positive energy imbalance, and treatment needs to reverse this imbalance. Many different diets have been tried to treat obesity, and weight loss occurs with all of them. There is currently no evidence that supports the superiority of one macronutrient composition for diets over any other. The principal effect seems to be the degree of adherence to the prescribed calorie reduction. Obesity drugs have been developed that tap brain mechanisms for controlling feeding and the gastrointestinal tract The prevalence of obesity now exceeds 30% of US adults, 1 but may be leveling off at an unacceptably high level. More than two-thirds of Americans are overweight, 1 and excessive weight is a problem for children and adolescents too. 2 The fundamental More than two-thirds of Americans, including children and adolescents, are overweight.problem is the result of a small, but prolonged, positive energy balance, where energy from food exceeds energy needed for everyday living. 3,4 REALITIES IN TREATING AN OBESE PATIENT One of the key messages for obese patients is that when caloric intake is reduced below that needed for daily energy expenditure, there is a predictable rate of weight loss. 4 Men generally lose weight faster than women of similar height and weight on any given diet, because men have more lean body mass and therefore higher energy expenditure. Similarly, older patients have a lower metabolic expenditure and as a rule lose weight more slowly than do younger subjects with similar adherence to weight-loss programs. Thus, adherence to any program is an essential component of success.

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Randomized Trial of Lifestyle Modification and Pharmacotherapy for Obesity

Cited by 706 publications

References 25 publications

Preventing Cardiovascular Disease and Diabetes

Preventing Cardiovascular Disease and Diabetes

Weight maintenance, behaviors and barriers among previous participants of a university-based weight control program

Medical Therapy for Obesity

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