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Telephone-based intervention aids weight loss in acetazolamide trial
Adults with obesity randomly assigned acetazolamide or placebo for idiopathic intracranial hypertension lost 6% of their body weight in 6 months when a telephone-based intervention component was included, according to recent findings.
“Neuro-ophthalmologists who treat this condition are aware that weight loss can improve [idiopathic intracranial hypertension], but they are not trained to help patients lose weight, and there are few, if any, resources for them to refer patients to for weight loss, and especially weight-loss programs that can address some of the specific weight-loss challenges for the [idiopathic intracranial hypertension] population,” Richard Weil, MEd, CDE, director of the Obesity Research Center Weight Loss Program at St. Luke's Roosevelt Hospital Center in New York, and colleagues wrote.
Richard Weil
Weil and colleagues designed a telephone-based weight-loss intervention program for 165 adults with obesity participating in the Intracranial Hypertension Treatment Trial, a randomized, double blind, placebo-controlled study of patients with idiopathic intracranial hypertension with mild vision loss (97.6% women; mean age, 29 years; mean BMI, 39.9 kg/m²). Researchers assigned patients acetazolamide (up to 4 mg/day or their maximum tolerated dosage) or matching placebo for 6 months; all participants received a reduced-sodium, weight-reduction diet and telephone-based weight-loss intervention, as participants were recruited from 38 sites across the United States and Canada.
From baseline to 6 months, participants received weekly 30-minute phone counseling sessions after an initial 1-hour session to introduce treatment protocol, nutrition and exercise intervention and a workbook. From months 7 to 12, 30-minute phone sessions were conducted biweekly for 2 months, and then monthly. Four participants without phones received prepaid cell phones. Researchers measured changes from baseline to 6 months in body weight, perimetric mean deviation as assessed by automated perimetry, and quality of life using the National Eye Institute Visual Function Questionnaire and the 36-item Short Form Health Survey.
Mean body weight reduction at 6 months for the acetazolamide group was 7.8% from baseline to 6 months vs. 3.5% for placebo; mean weight loss at 12 months was 8.1% for acetazolamide and 7% for placebo groups. Weight change was not associated with changes in vision or quality-of-life scores.
The researchers noted that the telephone intervention posed challenges, including scheduling times to speak, accommodating cultural food preferences, losing face-to-face interactions and ensuring participants had time to focus on phone sessions (participants were frequently at home with small children).
“Telephone interventions are a low-cost method of delivering effective weight loss interventions to populations spread across large geographic regions, and furthermore, to patients with common and uncommon diseases that are improved by weight loss,” Weil told Endocrine Today. “Weight loss, which can improve vision and prevent blindness in patients with IIH, is possible even if delivered by telephone instead of more conventional, intensive, and expensive face-to-face methods.” – by Regina Schaffer
For more information:
Richard Weil, MEd, CDE, can be reached at Mt Sinai St Luke’s Weight Loss Program, Mt Sinai St Luke’s Hospital, 1111 Amsterdam Avenue WH1020, New York, NY 10025; email: rweil@chpnet.org; website: nyweightloss.org.
Disclosure: The researchers report no relevant financial disclosures.