Short-Term Medical Benefits and Adverse Effects of Weight Loss

Pi-Sunyer, F X

doi:10.7326/0003-4819-119-7_part_2-199310011-00019

Cited by 200 publications

(67 citation statements)

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“…The association of excess weight with dyslipidemia and increased risk of cardiovascular disease (CVD) as well as the importance of diet to reduce the risk of CVD has been well established (Eckel, 1999;Pi-Sunyer, 1993;National Heart, Lung and Blood Institute, NIH, 1998;Van Gaal et al, 1997) In 1993, the second report of the National Cholesterol Education Program (NCEP) re-emphasized the need to reduce the dietary intake of fat, saturated fat and cholesterol to decrease high blood cholesterol (NCEP, 1993). The report also addressed the need for improving weight control and physical activity.…”

Section: Introductionmentioning

confidence: 99%

Lipoprotein responses to weight loss and weight maintenance in high-risk obese subjects

Ditschuneit

Frier²,

Flechtner-Mors

2002

Eur J Clin Nutr

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and 2 Slim-Fast Foods Company, West Palm Beach, Florida, USA Objective: To examine changes in plasma lipids and lipoproteins after 51 months of reduced energy intake and sustained weight loss. Methods: One-hundred patients were randomized to one of two dietary interventions for 3 months (weight loss period). Groups A and B received an energy-restricted diet plan of 5.2 -6.3 MJ=day but group B was further instructed to replace two of three meals with a nutrient-fortified liquid meal replacement (MR). Upon completion of the weight loss period, all patients were given the same instructions regarding energy intake and were advised to use one MR daily. Body weight and 7 day food diaries were measured monthly or bimonthly and blood lipids at baseline, 3, 9 and 51 months. Results: Of the original 100 patients 75 had completed 4 y. Of those 75, 73 had complete lipid records. Baseline body weights of Groups A and B were 90.7 AE 14.0 and 91.6 AE 9.8 kg, respectively. The percentage change in total cholesterol (%DTC) decreased in a linear fashion with increasing weight loss, when all data was combined, but did not approach statistical significance (P 0.26, r ¼ 0.02). Further regression analysis found a significant negative linear relationship (P 0.0001, r ¼ 0.69) between initial total cholesterol (TC) concentrations and %DTC. Hence, data from 27 of the 73 completers who exhibited an elevated serum total cholesterol ( ! 6.2 mmol=l) were isolated and analyzed further. Baseline TC was 6.75 AE 0.64, 5.85 AE 0.63 at 9 months (P < 0.05) and 5.76 AE 0.52 mmol=l at 51 months (P < 0.05). Similar values for VLDL-cholesterol were 1.33 AE 0.80, 0.74 AE 0.24 and 0.66 AE 0.21 mmol=l by 51 months (P < 0.05). Weight decreased by 5.2 AE 5.1, 7.6 AE 4.9 and 6.7 AE 4.6% at 3, 9 and 51 months, respectively. Conclusion: Continuous energy restriction associated with a clinically meaningful weight loss significantly improved the lipid profile of high-risk patients. Similar weight and diet changes occurring in patients with normal plasma cholesterol were either increased or without affect.

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Section: Introductionmentioning

confidence: 99%

Lipoprotein responses to weight loss and weight maintenance in high-risk obese subjects

Ditschuneit

Frier²,

Flechtner-Mors

2002

Eur J Clin Nutr

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“…The minimum clinically significant weight loss after 1 year of therapy (behavioral modification and/or medication) is often regarded as 3-5%, assuming risk factors such as waist circumference, blood pressure, serum lipids and inflammatory markers also improve (2,23,24). In fact, the US FDA has set 5% total bodyweight loss at 1 year as a clinical efficacy hurdle for marketing approval of drugs intended to treat obesity.…”

Section: Obesitymentioning

confidence: 99%

Ascending dose‐controlled trial of beloranib, a novel obesity treatment for safety, tolerability, and weight loss in obese women

Hughes

Kim

Marjason

et al. 2013

Obesity

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Objective: Evaluate the safety and tolerability of beloranib, a fumagillin-class methionine aminopetidase-2 (MetAP2) inhibitor, in obese women over 4 weeks. Design and Methods: Thirty-one obese (mean BMI 38 kg/m 2 ) women were randomized to intravenous 0.1, 0.3, or 0.9 mg/m 2 beloranib or placebo twice weekly for 4 weeks (N ¼ 7, 6, 9, and 9). Results:The most frequent AEs were headache, infusion site injury, nausea, and diarrhea. Nausea and infusion site injury occurred more with beloranib than placebo. The most common reason for discontinuation was loss of venous access. There were no clinically significant abnormal laboratory findings. In subjects completing 4 weeks, median weight loss with 0.9 mg/m 2 beloranib was À3.8 kg (95% CI À5.1, À0.9; N ¼ 8) versus À0.6 kg with placebo (À4.5, À0.1; N ¼ 6). Weight change for 0.1 and 0.3 mg/m 2 beloranib was similar to placebo. Beloranib (0.9 mg/m 2 ) was associated with a significant 42 and 18% reduction in triglycerides and LDL-cholesterol, as well as improvement in C-reactive protein and reduced sense of hunger. Changes in b-hydroxybutyrate, adiponectin, leptin, and fibroblast growth factor-21 were consistent with the putative mechanism of MetAP2 inhibition. Glucose and blood pressure were unchanged. Conclusions: Beloranib treatment was well tolerated and associated with rapid weight loss and improvements in lipids, C-reactive protein, and adiponectin.

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“…The rates of overweight and obesity have been steadily increasing in countries such as the USA, Australia and the UK (3) . A modest weight loss of 5 % in those obese has been shown to be beneficial in improving blood sugar control, CVD-related biomarkers and overall quality of life (4) . Primary-care physicians provide first-line health care in many countries.…”

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confidence: 99%

A systematic review of behavioural weight-loss interventions involving primary-care physicians in overweight and obese primary-care patients (1999–2011)

Yoong

Carey

Sanson‐Fisher

et al. 2012

Public Health Nutr.

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Objective: The present review aimed to examine the effectiveness of behavioural weight-loss interventions involving primary-care physicians in producing weight loss in overweight and obese primary-care patients. Design: A systematic review was conducted by searching online databases (MEDLINE, EMBASE, Cochrane, PsycINFO and SCOPUS) from January 1999 to December 2011. All abstracts were screened and coded for eligibility. The Cochrane Effective Practice and Organisation of Care Group quality criteria were used to assess the methodological adequacy of included studies. Information related to study design, population characteristics and intervention details was extracted. Setting: Primary care. Subjects: Overweight or obese (defined as having a BMI $ 25?0 kg/m 2 ) primarycare patients. Results: Sixteen different studies were included. Of these, six assessed primarycare physicians' delivery of weight-loss counselling; nine assessed weight-loss counselling delivered by non-physician personnel with monitoring by primarycare physicians; and one assessed a multi-component intervention. Overall, highintensity weight-loss counselling by primary-care physicians resulted in moderate but not clinically significant weight loss. High-intensity weight-loss counselling delivered by non-physicians, meal replacements delivered in conjunction with dietitian counselling and referral to commercial weight-loss centre programmes accompanied by regular monitoring by a primary-care physician were effective in producing clinically significant weight loss. Dietitian-delivered care appeared effective in producing weight loss regardless of level of intervention intensity. Conclusions: Overall, there were few studies on this topic and the methodological rigour of some included studies was poor. Additional studies assessing the effectiveness and acceptability of potential interventions are needed to confirm these findings.

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Short-Term Medical Benefits and Adverse Effects of Weight Loss

Cited by 200 publications

References 0 publications

Lipoprotein responses to weight loss and weight maintenance in high-risk obese subjects

Lipoprotein responses to weight loss and weight maintenance in high-risk obese subjects

Ascending dose‐controlled trial of beloranib, a novel obesity treatment for safety, tolerability, and weight loss in obese women

A systematic review of behavioural weight-loss interventions involving primary-care physicians in overweight and obese primary-care patients (1999–2011)

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