Join a Program – Part 3

Two articles in the recent New England Journal of Medicine show the benefits of enrolling in a weight loss program.

In the first study, 415 obese patients were divided into 3 groups:

  1. One intervention provided patients with weight-loss support remotely — through the telephone, a study-specific Web site, and e-mail.
  2. The other intervention provided in-person support during group and individual sessions, along with the three remote means of support.
  3. There was also a control group in which weight loss was self-directed.

As you can see, the people in the program, even with only remote support, lost about 13 lbs in the first 6 months, and kept most of it off up to 2 years after starting out.

Figure 1. Mean Weight Change According to Randomized Group.

The second study of 390 people divided them into three groups, using primary care physicians (PCP) “in collaboration with auxiliary health professionals (lifestyle coaches) in their practices.”

  1. Usual care, consisting of quarterly PCP visits that included education about weight management;
  2. Brief lifestyle counseling, consisting of quarterly PCP visits combined with brief monthly sessions with lifestyle coaches who instructed participants about behavioral weight control; or
  3. Enhanced brief lifestyle counseling, which provided the same care as described for the previous intervention but included meal replacements or weight-loss medication (orlistat or sibutramine).

Again, an enhanced program produced better outcomes.

Estimated Percent Reduction in Baseline Weight over a 24-Month Period

An accompanying editorial contains some caveats:

Finally, although more than one third of patients may respond to lifestyle counseling with weight loss of at least 5% of their baseline weight, many obese persons do not successfully achieve or maintain weight losses sufficient to improve their health by means of lifestyle changes alone.

Some patients will require additional treatments (e.g., medications or bariatric surgery) as an adjunct to, but not a replacement for, lifestyle interventions. Continued research on ways to enhance patients’ adherence to long-term lifestyle changes should improve the reach and effectiveness of behavioral treatments for obesity in primary care settings.

I got my start on sustainable weight loss (125 lbs, stable for 2 years now) at the Structure House Weight Loss Program in Durham NC.

 

Dr John Ellis MD

Board-certified anesthesiologist, with expertise in cardiovascular anesthesia and the implications of obesity and sleep apnea in anesthesia. See vascularanesthesia.com for professional information. Dr. Ellis has used the strategies in here to: (1) lose 120 lbs over 18 months, (2) stop all antihypertensive medicines, and (3) no longer need CPAP treatment for sleep apnea.

One Comment:

  1. Mitigating preventable chronic disease: Progress report of the Cleveland Clinic’s Lifestyle 180 program. http://www.ncbi.nlm.nih.gov/pubmed/22112436
    Average person lost about 16 lbs, 2.4″ waist, cholestrol, etc.

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