XENical in the Prevention of Diabetes in Obese Subjects (XENDOS) Study

Torgerson, Jarl; Hauptman, Jonathan; Boldrin, Mark; Sjöström, Lars

doi:10.2337/diacare.27.1.155

Cited by 1,616 publications

(935 citation statements)

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“…Body weight, fat mass and several major metabolic features of IR were improved in the long term and to the extent that the benefit appeared to be comparable to the change seen on drug therapy. 30 Failure to achieve long-term reduction in LDL cholesterol probably reflects insufficient emphasis on the need to reduce saturated fatty acids, and specific dietary advice should reinforce this aspect. There is no evidence for long-term benefit of HF diets such as the Atkins diet.…”

Section: Discussionmentioning

confidence: 99%

Long-term effects of popular dietary approaches on weight loss and features of insulin resistance

et al. 2005

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Objective: High-carbohydrate (HC)-high-fibre diets are recommended for weight loss and for treating and preventing diseases such as diabetes and cardiovascular disease. We report a randomised trial comparing high-fat (HF) and high-protein (HP) diets with the conventional approach. Research design and methods: A total of 93 overweight insulin-resistant women received advice following randomisation to HF, HP or HC dietary regimes, to achieve weight loss followed by weight maintenance over 12 months. Weight, body composition and measures of carbohydrate and lipid metabolism were investigated. Results: Retention rates were 93% for HP and 75% for HC and HF. Features of the metabolic syndrome improved in all groups during the first 6 months, to a greater extent on HF and HP than an HC. During the second 6 months the HF group had increases in waist circumference (mean difference 4.4 cm (95% CI 3.0, 5.8)), fat mass (2.3 kg (1.5, 3.1)), triglycerides (0.28 mmol/l (0.09, 0.46)) and 2 h glucose (0.70 mmol/l (0.22, 1.18)). Overall there was substantial sustained improvement in waist circumference, triglycerides and insulin in the HP group and sustained but more modest changes on HC. Dietary compliance at 12 months was poor in all groups. Conclusions: HP and HC approaches appear to be appropriate options for insulin-resistant individuals. When recommending HP diets appropriate composition of dietary fat must be ensured. HC diet recommendations must include advice regarding appropriate high-fibre, low glycaemic index foods.

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Section: Discussionmentioning

confidence: 99%

Long-term effects of popular dietary approaches on weight loss and features of insulin resistance

et al. 2005

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“…Values are hazard ratios and 95% CI represented by horizontal bars. (26) Orlistat; obesity 0 . 48 0 .…”

Section: Results Of the Prevent Obesity Grrowing Economic Synthesis Smentioning

confidence: 99%

Influences of weight loss on long-term diabetes outcomes

Aucott

2008

Proc. Nutr. Soc.

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Increasing rates of type 2 diabetes (T2DM) follow the obesity 'epidemic', with 86 % of patients with T2DM being overweight and over half being obese. Literature has highlighted that being overweight or obese increases the risk of diabetes. Weight loss for obese patients is associated with clinical improvements, although this evidence is mostly from short-term studies. As part of a Health Technology Assessment systematic review the long-term ( ‡ 2 years) effects of weight loss on change in diabetes-related outcome measures for those with diabetes, or risk of developing diabetes for those without diabetes, was investigated in obese individuals. Eleven studies published between 1966 and 2001 fulfilled the inclusion criteria (Caucasian, BMI > 28 kg/m 2 , adults, no eating disorders, weight loss and changes in diabetes-outcome measures). Results of these studies indicated that intentional weight loss reduces the risk of developing diabetes in the long term and those participants with T2DM often have reduced clinical symptoms and mortality risk. These results have been verified and enhanced by literature published since this review. A similar systematic review was conducted as part of a six-phase project, the PRevent Obesity GRowing Economic Synthesis Study. This review excluded BMI > 34 kg/m 2 and was restricted to lifestyle interventions (or intentional weight loss). Limited information relating to diabetes was gained, with only a non-significant increasing trend for mortality from diabetes for severe weight cycling practices being suggested. Other results indicated a relationship between weight loss and fasting plasma glucose, but because of the heterogeneity of participation groups and lack of definition in relation to diabetes this relationship was not formalised. In summary, weight loss is beneficial for long-term diabetes outcomes for overweight, obese and morbidly-obese participants. There is little research evidence for those individuals who are overweight or just obese, indicating areas of future research in terms of prevention of both obesity and diabetes. Weight loss: Overweight and/or obese: Long-term diabetesThe potential for being overweight or obese has been postulated as a genetic predisposition during the evolution of homo sapiens to protect against leaner times. Unfortunately, in the last 50 years such lean times have not been prevalent (certainly in the developed world and even now in the developing countries energy-rich foods are becoming common place) and labour-saving devices encourage more sedentary behaviour, thus tilting the whole energybalance equation. However, the obesogenic environment is more complex, involving not just genetic and environmental factors but also other interconnecting factors such as biochemical, neurological, physiological, cultural and socio-economic factors (1) . Obesity prevalence has risen alarmingly, especially in the last 20 years (Table 1), and if trends continue it has been forecast that in the UK 33% of men and 28 % of women will be obese by 2010 (2) .Along with...

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“…In a 4-year RCT, orlistat plus lifestyle changes produced slightly greater weight loss and resulted in a greater reduction in the incidence of T2DM (hazard ratio : 0.627, 95% CI 0.455-0.863; P=0.0032) in obese patients, compared with lifestyle changes alone. The preventive effect was essentially explained by the difference in subjects with impaired glucose tolerance 66 .…”

Section: Orlistatmentioning

confidence: 99%

Combating the dual burden: therapeutic targeting of common pathways in obesity and type 2 diabetes

Scheen

Gaal

2014

The Lancet Diabetes & Endocrinology

161

125

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New glucose-lowering therapies, especially glucagon-like peptide-1 receptor agonists and sodium glucose cotransporter-2 inhibitors, offer advantages over traditional antidiabetic agents by promoting weight loss while improving glucose control. . The present review will explore the overlapping pathophysiology and also how the various therapies can, alone or in combination, combat the 'dual burden' of obesity and T2DM. Word count: 249

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XENical in the Prevention of Diabetes in Obese Subjects (XENDOS) Study

Cited by 1,616 publications

References 20 publications

Long-term effects of popular dietary approaches on weight loss and features of insulin resistance

Long-term effects of popular dietary approaches on weight loss and features of insulin resistance

Influences of weight loss on long-term diabetes outcomes

Combating the dual burden: therapeutic targeting of common pathways in obesity and type 2 diabetes

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