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One-year lifestyle intervention beneficial for severely obese adults

Goodpaster BH. JAMA. 2010;doi:10.1001/jama.2010.1505.
Ryan DH. JAMA. 2010;doi:10.1001/jama.2010.1531.

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Severely obese adults who adhered to an intensive lifestyle intervention using behavior-based diet and physical activity for 1 year experienced significant improvements in weight loss and cardiometabolic risk factors, according to researchers at the University of Pittsburgh School of Medicine.

Bret H. Goodpaster, PhD, and colleagues presented 1-year data on the effects of intensive lifestyle intervention in severely obese adults at the 28th Annual Scientific Meeting of the Obesity Society. The results were simultaneously published in the Journal of the American Medical Association.

The study included 130 adults aged 30 to 55 years with severe obesity who were recruited by local advertisements and mass mailings. The participants were randomly assigned to two groups for a 1-year: diet and physical activity regimen for 1 whole year or diet with a physical activity regimen that began after 6 months. All participants attended group sessions and received individual and telephone contacts.

Both groups lost a significant amount of weight in the first 6 months, but the initial physical activity group lost significantly more weight than the delayed activity group: 10.9 kg vs. 8.2 kg. At 12 months, however, there was no significant difference in the weight loss between the groups: 12.1 kg in the initial physical activity group and 9.9 kg in the delayed activity group.

At 6 months, the initial physical activity group had significantly greater reductions in body fat and waist circumference compared to the delayed activity group, but at 12 months, there was no significant difference in loss between the groups. The initial activity group lost significantly more hepatic fat content. The researchers also noted improvements in blood pressure, serum liver enzyme levels, fasting insulin and insulin resistance in both groups.

“Our data make a strong case that serious consideration should be given by health care systems to incorporating more intensive lifestyle interventions similar to those used in our study,” the researchers concluded. “Additional studies are clearly needed to determine long-term efficacy and cost-effectiveness of such approaches.”

In an accompanying editorial, Donna H. Ryan, MD, of Pennington Biomedical Research Center, Louisiana State University System, and Robert Kushner, MD, MS, of Northwestern University Feinberg School of Medicine, said studies such as this one “are needed to unravel the causes, identify prevention strategies and develop the best treatments for obesity.

“Optimal treatment approaches for class 2 and class 3 obesity are underexplored, while payment approaches for interventions known to work have yet to be adopted,” the editorialists wrote.

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