Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA,
Novo Nordisk Inc., Plainsboro, New Jersey, USA.
Obes Facts. 2020;13(6):572-583. doi: 10.1159/000511130. Epub 2020 Nov 16.
Individuals who enroll in intensive behavioral therapy (IBT) programs are asked to make several lifestyle changes simultaneously. However, few studies have examined the relative effects of adherence to different treatment components on weight loss.
This secondary analysis of the SCALE IBT trial assessed adherence to the medication regimen, dietary self-monitoring, and physical activity recommendations and their relative contributions to weight change in individuals with obesity who were provided with IBT combined with either liraglutide 3.0 mg or placebo.
SCALE IBT was a double-blinded, multicenter, randomized controlled trial comparing 56-week weight losses in individuals with obesity who received liraglutide 3.0 mg (n = 142) or placebo (n = 140), as an adjunct to IBT. Adherence to dietary self-monitoring, physical activity, and medication usage (liraglutide or placebo) were measured during the 56-week treatment period. A regression model was used to estimate the relative contribution of adherence to each treatment component to weight loss at week 56.
The proportion of individuals who adhered to each intervention component decreased over time. Compared with non-adherence, complete adherence to dietary self-monitoring and physical activity recommendations were associated with estimated weight changes of -7.2% (95% CI -10.4 to -4.0; p < 0.0001) and -2.0% (95% CI -3.2 to -0.8; p = 0.0009), respectively. Complete adherence to liraglutide predicted an additional weight loss of -6.5% (95% CI -10.2 to -2.9; p = 0.0005) relative to individuals who did not adhere to the medication regimen, while adherence to placebo did not have a statistically significant effect on weight loss (p = 0.33).
High adherence to dietary self-monitoring and use of liraglutide 3.0 mg was associated with clinically relevant weight loss with IBT and adjunctive pharmacotherapy. The effect of adherence to physical activity was significant but smaller.
参加强化行为治疗（IBT）计划的个体被要求同时进行多项生活方式改变。然而，很少有研究检查过不同治疗成分的依从性对减肥的相对影响。
这项 SCALE IBT 试验的二次分析评估了对药物治疗方案、饮食自我监测和体力活动建议的依从性，以及它们对接受 IBT 联合利拉鲁肽 3.0mg 或安慰剂治疗的肥胖个体体重变化的相对贡献。
SCALE IBT 是一项双盲、多中心、随机对照试验，比较了肥胖个体在接受利拉鲁肽 3.0mg（n=142）或安慰剂（n=140）辅助 IBT 治疗 56 周的体重减轻情况。在 56 周的治疗期间，测量了饮食自我监测、体力活动和药物使用（利拉鲁肽或安慰剂）的依从性。使用回归模型估计每个治疗成分对第 56 周体重减轻的相对贡献。
随着时间的推移，遵守每个干预措施的个体比例下降。与不依从相比，完全遵守饮食自我监测和体力活动建议与估计的体重变化分别为-7.2%（95%CI-10.4 至-4.0；p<0.0001）和-2.0%（95%CI-3.2 至-0.8；p=0.0009）相关。与不遵守药物治疗方案的个体相比，完全遵守利拉鲁肽预测体重额外减轻 6.5%（95%CI-10.2 至-2.9；p=0.0005），而遵守安慰剂对体重减轻没有统计学上的显著影响（p=0.33）。
高依从性的饮食自我监测和使用利拉鲁肽 3.0mg 与 IBT 和辅助药物治疗相关的临床相关体重减轻有关。体力活动依从性的效果显著，但较小。
