Department of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany.
Int J Obes (Lond). 2012 Apr;36(4):614-24. doi: 10.1038/ijo.2011.107. Epub 2011 Jun 14.
To determine the effectiveness of a structured multidisciplinary non-surgical obesity therapy program on the basis of a temporary low-calorie-diet for 12 weeks, and additional intervention modules to enhance nutritional education, to increase physical activity and to modify eating behavior.
Prospective multicenter observational study in obese individuals undergoing a medically supervised outpatient-based 52-week treatment in 37 centers in Germany.
A total of 8296 participants with a body mass index (BMI) of >30 kg m(-2) included within 8.5 years.
Main outcome measures were body weight loss, waist circumference (WC), blood pressure, quality of life and adverse events.
In females, initial body weight was reduced after the 1-year-intervention by 19.6 kg (95% confidence intervals 19.2-19.9 kg) and in males by 26.0 kg (25.2-26.8) according to per protocol analysis of 4850 individuals. Intention-to-treat (ITT) analysis revealed a weight reduction of 15.2 kg (14.9-15.6) in females and 19.4 kg (18.7-20.1) in males. Overall, the intervention resulted in mean reduction in WC of 11 cm; it reduced the prevalence of the metabolic syndrome by 50% and the frequency of hypertension from 47 to 29% of all participants (ITT, all P<0.001). The beneficial effects could be documented for up to 3 years and comprised significant improvement of health-related quality of life. The incidence of adverse effects was low; the only event repeatedly observed and possibly related to either the intervention or the underlying disease was biliary disorders.
The present non-surgical intervention program is a highly effective treatment of obesity grades I-III and obesity-related diseases, and therefore, could be a valuable basis for future weight maintenance strategies required for sustained success.
通过为期 12 周的临时低热量饮食，以及增强营养教育、增加身体活动和改变饮食行为等额外干预模块，确定结构化多学科非手术肥胖治疗方案的有效性。
在德国 37 个中心进行的一项肥胖个体接受医学监督门诊 52 周治疗的前瞻性多中心观察性研究。
8296 名参与者的身体质量指数（BMI）>30 kg/m²，研究时间为 8.5 年。
主要观察指标为体重减轻、腰围（WC）、血压、生活质量和不良事件。
根据 4850 名个体的方案分析，女性在 1 年干预后初始体重减轻 19.6 公斤（95%置信区间 19.2-19.9 公斤），男性减轻 26.0 公斤（25.2-26.8）。意向治疗（ITT）分析显示，女性体重减轻 15.2 公斤（14.9-15.6），男性体重减轻 19.4 公斤（18.7-20.1）。总体而言，干预导致 WC 平均减少 11 厘米；它使代谢综合征的患病率降低了 50%，高血压的频率从所有参与者的 47%降至 29%（ITT，均 P<0.001）。这些有益效果可维持长达 3 年，并显著改善与健康相关的生活质量。不良事件的发生率较低；唯一反复观察到且可能与干预或潜在疾病有关的事件是胆道疾病。
本非手术干预方案是 I-III 级肥胖和肥胖相关疾病的高度有效治疗方法，因此，可能是未来维持成功所需的持续体重维持策略的有价值基础。
