Pekkarinen Tuula, Kaukua Jarmo, Mustajoki Pertti
Division of Endocrinology, Department of Medicine, Helsinki University Central Hospital, Peijas Hospital, Sairaalakatu 1, PL 900, 00029 HUS Vantaa, Finland.
Division of Endocrinology, Department of Medicine, Helsinki University Central Hospital, Peijas Hospital, Sairaalakatu 1, PL 900, 00029 HUS Vantaa, Finland ; Sanofi Oy, PL 22, Huopalahdentie 24, 00350 Helsinki, Finland.
J Obes. 2015;2015:651460. doi: 10.1155/2015/651460. Epub 2015 Mar 30.
Weight lost by obese patients is almost always regained over time. Extended treatment may improve maintenance, but solid evidence is lacking.
We determined effectiveness of maintenance therapy after a weight loss program.
Together 201 patients (mean age 47 years and BMI 42 kg/m(2), 71% women) were randomly assigned to either a 17-week weight loss program followed by a one-year maintenance program or to a weight loss program without subsequent maintenance intervention. The weight loss program included behavior modification and a very-low-calorie diet, and maintenance program behavior modification. The primary outcome measure was percentage of patients with 5% or more weight loss at the end of maintenance (week 69) and one year later (week 121). Secondary outcomes were weight related changes in lifestyle and quality of life.
At week 69, 52% of the patients with and 44% of those without maintenance program had lost weight ≥5%, P = 0.40, and, at week 121, 33% and 34%, P = 0.77, respectively. At week 121 secondary outcomes did not differ between the groups among those successfully followed up.
This one-year maintenance program was not effective in preventing weight regain in severely obese patients. Trial Registration. This trial is registered under clinicaltrials.gov Identifier: NCT00590655.
肥胖患者减轻的体重几乎总会随着时间推移而复胖。延长治疗或许能改善体重维持情况,但缺乏确凿证据。
我们确定了减肥计划后维持治疗的有效性。
总共201名患者(平均年龄47岁,体重指数42kg/m²,71%为女性)被随机分为两组,一组接受为期17周的减肥计划,随后是为期一年的维持计划,另一组只接受减肥计划而无后续维持干预。减肥计划包括行为矫正和极低热量饮食,维持计划包括行为矫正。主要结局指标是在维持期结束时(第69周)以及一年后(第121周)体重减轻5%或更多的患者百分比。次要结局是与体重相关的生活方式和生活质量变化。
在第69周时,接受维持计划的患者中有52%体重减轻≥5%,未接受维持计划的患者中有44%体重减轻≥5%,P = 0.40;在第121周时,这两个比例分别为33%和34%,P = 0.77。在第121周时,成功随访的患者中两组的次要结局无差异。
这项为期一年的维持计划对于防止重度肥胖患者体重反弹无效。试验注册。本试验已在clinicaltrials.gov注册,标识符:NCT00590655。