scholarly journals The effect of rate of weight loss on long-term weight regain in adults with overweight and obesity

Obesity ◽  
2016 ◽  
Vol 24 (2) ◽  
pp. 321-327 ◽  
Author(s):  
Roel G. Vink ◽  
Nadia J. T. Roumans ◽  
Laura A. J. Arkenbosch ◽  
Edwin C. M. Mariman ◽  
Marleen A. van Baak
2018 ◽  
Vol 22 (68) ◽  
pp. 1-246 ◽  
Author(s):  
Alison Avenell ◽  
Clare Robertson ◽  
Zoë Skea ◽  
Elisabet Jacobsen ◽  
Dwayne Boyers ◽  
...  

Background Adults with severe obesity [body mass index (BMI) of ≥ 35 kg/m2] have an increased risk of comorbidities and psychological, social and economic consequences. Objectives Systematically review bariatric surgery, weight-management programmes (WMPs) and orlistat pharmacotherapy for adults with severe obesity, and evaluate the feasibility, acceptability, clinical effectiveness and cost-effectiveness of treatment. Data sources Electronic databases including MEDLINE, EMBASE, PsycINFO, the Cochrane Central Register of Controlled Trials and the NHS Economic Evaluation Database were searched (last searched in May 2017). Review methods Four systematic reviews evaluated clinical effectiveness, cost-effectiveness and qualitative evidence for adults with a BMI of ≥ 35 kg/m2. Data from meta-analyses populated a microsimulation model predicting costs, outcomes and cost-effectiveness of Roux-en-Y gastric bypass (RYGB) surgery and the most effective lifestyle WMPs over a 30-year time horizon from a NHS perspective, compared with current UK population obesity trends. Interventions were cost-effective if the additional cost of achieving a quality-adjusted life-year is < £20,000–30,000. Results A total of 131 randomised controlled trials (RCTs), 26 UK studies, 33 qualitative studies and 46 cost-effectiveness studies were included. From RCTs, RYGB produced the greatest long-term weight change [–20.23 kg, 95% confidence interval (CI) –23.75 to –16.71 kg, at 60 months]. WMPs with very low-calorie diets (VLCDs) produced the greatest weight loss at 12 months compared with no WMPs. Adding a VLCD to a WMP gave an additional mean weight change of –4.41 kg (95% CI –5.93 to –2.88 kg) at 12 months. The intensive Look AHEAD WMP produced mean long-term weight loss of 6% in people with type 2 diabetes mellitus (at a median of 9.6 years). The microsimulation model found that WMPs were generally cost-effective compared with population obesity trends. Long-term WMP weight regain was very uncertain, apart from Look AHEAD. The addition of a VLCD to a WMP was not cost-effective compared with a WMP alone. RYGB was cost-effective compared with no surgery and WMPs, but the model did not replicate long-term cost savings found in previous studies. Qualitative data suggested that participants could be attracted to take part in WMPs through endorsement by their health-care provider or through perceiving innovative activities, with WMPs being delivered to groups. Features improving long-term weight loss included having group support, additional behavioural support, a physical activity programme to attend, a prescribed calorie diet or a calorie deficit. Limitations Reviewed studies often lacked generalisability to UK settings in terms of participants and resources for implementation, and usually lacked long-term follow-up (particularly for complications for surgery), leading to unrealistic weight regain assumptions. The views of potential and actual users of services were rarely reported to contribute to service design. This study may have failed to identify unpublished UK evaluations. Dual, blinded numerical data extraction was not undertaken. Conclusions Roux-en-Y gastric bypass was costly to deliver, but it was the most cost-effective intervention. Adding a VLCD to a WMP was not cost-effective compared with a WMP alone. Most WMPs were cost-effective compared with current population obesity trends. Future work Improved reporting of WMPs is needed to allow replication, translation and further research. Qualitative research is needed with adults who are potential users of, or who fail to engage with or drop out from, WMPs. RCTs and economic evaluations in UK settings (e.g. Tier 3, commercial programmes or primary care) should evaluate VLCDs with long-term follow-up (≥ 5 years). Decision models should incorporate relevant costs, disease states and evidence-based weight regain assumptions. Study registration This study is registered as PROSPERO CRD42016040190. Funding The National Institute for Health Research Health Technology Assessment programme. The Health Services Research Unit and Health Economics Research Unit are core funded by the Chief Scientist Office of the Scottish Government Health and Social Care Directorate.


2015 ◽  
Vol 03 (01) ◽  
pp. 061-063
Author(s):  
Sandra Scrivens

AbstractWith global obesity affecting 475 million people worldwide, the continued popularity of celebrity or fad diets is not surprising. Evidence for their sustainability and long-term positive benefits on weight loss and cardiometabolic risk is, however, limited. Modest weight loss of 5-10% in overweight or obesity is associated with improvements in blood lipids, glycemia, and insulin resistance. As overweight and obesity are the main risk factors for Type 2 diabetes (T2DM), medical nutrition therapy based on a balanced, reduced total energy diet, tailored to the individual, is recommended by the American Diabetes Association, Diabetes UK and transcultural diabetes-specific nutrition algrorithm (tDNA) guidelines.


2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Flavio Cadegiani

Abstract Background: Maintenance of weight loss in patients that undergo weight loss interventions is highly challenging, irrespective of the type of approach to obesity (whether surgical, pharmacological, or non-pharmacological). We proposed a protocol of an aggressive clinical treatment for obesity aiming to prevent the need of bariatric surgery, in patients unwilling to undergo this procedure, by proposing a protocol that included the combination of different anti-obesity medications and non-pharmacological modalities, for longer duration, and with an active approach to prevent weight regain. Our initial 2-year data showed that 93% (40 of 43 patients) with moderate and morbid obesity were able to avoid the need of bariatric surgery, with concomitant improvements of the biochemical profile. However, whether these patients would maintain their successful rates after five years was uncertain. Our objective is to describe the efficacy and safety of a long term (5-year data) pharmacological and multi-modal treatment for moderate and severe obesity. Methods: The 40 patients that were successful in the two-year approach in our obesity center (Corpometria Institute, Brasilia, DF, Brazil) were enrolled. A long-term anti-obesity protocol was employed, with continuous or intermittent use of anti-obesity drugs, trimestral body composition analysis, psychotherapy, visit to a nutritionist every four months, and both resistance and endurance exercises at least four times a week. Body weight (BW), total weight excess (TWE), body fat, markers of lipid and glucose metabolism, liver function, and inflammation were analyzed. Subjects that dropped out were considered as weight regain. Therapeutic success for the 5-year follow-up included as the maintenance of &gt;20% loss of the initial BW loss, and no weight regain (or &lt; 20% of the initial weight loss). Results: A total of 27 patients (67.5%) were able to maintain the body weight, seven dropped out, and six regained more than 20% of the initial weight loss. Of these, 21 (77.8%) had significant further increase of muscle mass and decrease of fat loss, while 17 (63.0%) had further weight loss (p &lt; 0.05), compared to the 2-year data. Improvements on the biochemical profile persisted in all 27 patients, and had significant further improvements in 24 (88.9%) of these patients. Conclusion: The risk of weight regain five years after a weight loss treatment for obesity was significantly lower compared to previous literature, and comparable to the long-term outcomes of bariatric procedures. An aggressive, structured, and long-term clinical weight loss approach has been shown to be feasible, even for morbidly obese patients.


Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 532
Author(s):  
Krzysztof Juchacz ◽  
Patrycja Kłos ◽  
Violetta Dziedziejko ◽  
Rafał W. Wójciak

Overweight and obesity are among the most widespread health problems worldwide. The primary cause of obesity is an inability to control overeating. Therefore, today, obesity needs to be treated more as an eating disorder, i.e., a mental disorder, and thus, it should be approached as such. Taking the above together, this study aimed to assess the impact of supportive psychotherapy on reducing body weight in young overweight and obese women who attempted slimming therapy and, additionally, the possibility of maintaining the weight-loss effect in the long term. Sixty young women aged 20–30 were randomized into three groups that differed in therapeutic management. With the help of an individually selected diet plan, the highest effectiveness in weight loss was demonstrated in people whose weight reduction was supported by goal-oriented psychotherapy. In this group, a sustained effect of slimming and even further weight loss were observed six months following the discontinuation of the therapy. In conclusion, traditional slimming therapies using an individual diet plan and a dietitian’s care are effective; however, supportive psychotherapeutic work provides more beneficial results and maintains the change from a long-term perspective.


Appetite ◽  
2021 ◽  
pp. 105562
Author(s):  
Nuno Casanova ◽  
Kristine Beaulieu ◽  
Pauline Oustric ◽  
Dominic O'Connor ◽  
Catherine Gibbons ◽  
...  

2014 ◽  
Vol 27 (suppl 1) ◽  
pp. 47-50 ◽  
Author(s):  
Simone Dallegrave MARCHESINI ◽  
Giorgio Alfredo Pedroso BARETTA ◽  
Maria Paula Carlini CAMBI ◽  
João Batista MARCHESINI

BACKGROUND: Bariatric surgery, especially Roux-en-Y gastric bypass is an effective treatment for refractory morbid obesity, causing the loss of 75% of initial excess weight. After the surgery, however, weight regain can occur in 10-20% of cases. To help, endoscopic argon plasma coagulation (APC) is used to reduce the anastomotic diameter. Many patients who undergo this treatment, are not always familiar with this procedure and its respective precautions. AIM: The aim of this study was to determine how well the candidate for APC understands the procedure and absorbs the information provided by the multidisciplinary team. METHOD: We prepared a questionnaire with 12 true/false questions to evaluate the knowledge of the patients about the procedure they were to undergo. The questionnaire was administered by the surgeon during consultation in the preoperative period. The patients were invited to fill out the questionnaire. RESULTS: We found out that the majority learned about the procedure through the internet. They knew it was an outpatient treatment, where the anesthesia was similar to that for endoscopy, and that they would have to follow a liquid diet. But none of them knew that the purpose of this diet was to improve local wound healing. CONCLUSION: Bariatric patients who have a second chance to resume weight loss, need continuous guidance. The internet should be used by the multidisciplinary team to promote awareness that APC will not be sufficient for weight loss and weight-loss maintenance in the long term. Furthermore, there is a need to clarify again the harm of drinking alcohol in the process of weight loss, making its curse widely known.


2019 ◽  
Vol 15 (10) ◽  
pp. S118-S119
Author(s):  
Laura Flores ◽  
Priscila Rodrigues-Armijo ◽  
Mark Ringle ◽  
Salim Hosein ◽  
Vishal Kothari

2007 ◽  
Vol 39 (Supplement) ◽  
pp. S160
Author(s):  
Timothy Lohman ◽  
Scott Going ◽  
Ellen Cussler ◽  
Lauve Metcalfe ◽  
Pedro Teixeira

Author(s):  
Deana M Ferreri ◽  
Joel Fuhrman ◽  
Michael D. Singer

Background: Obesity increases risk of diabetes, heart disease and cancer; a healthy weight reduces these risks, however weight loss efforts are prone to failure. Developing methods to promote weight loss maintenance is an important public health goal. We report on weight loss maintenance in individuals who followed a nutrient-dense, plant-rich (NDPR) diet. NDPR guidelines focus on increasing micronutrient density and avoidance of processed, highly palatable foods. Methods: Patients of a private family medical practice and members of a NDPR diet internet community (2273) completed an online survey providing information on length of time following a NDPR diet and body weight at several time points. Results: In respondents with pre-diet BMI ≥ 25 who had been following a NDPR diet for at least 2 years, those who reported adhering to NDPR guidelines in at least 80% of meals lost significantly more weight than those reporting lower adherence. Weight lost during year 1 was maintained at 2 and 3 years, and in respondents with initial BMI in the obese range (≥ 30), those losses were significantly greater in respondents who reported at least 80% adherence compared to 50-79% (56 lb. vs. 34 lb.) at 3 years. Between 1 year and 3 years, a low rate (19%) of weight regain ( ≥ 5 lb.) was reported among respondents 80-100% adherent to NDPR guidelines. Conclusions: Weight loss and maintenance for a period of 3 years was observed in this self-selected group, and respondents who reported 80-100% adherence lost significantly more weight than those who reported 50-79% adherence to NDPR guidelines. Individuals achieved substantially greater weight loss than that commonly observed in weight loss intervention studies. An intervention study, which would provide further insight into the influence of the NDPR guidelines on weight loss and maintenance, is warranted.


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