Lifestyle Modification Plus Medication More Effective Than Medication Alone for Weight Loss

A new study shows that treatment with a lifestyle modification program of diet, exercise and behavioral therapy when used in combination with the weight loss medication sibutramine (Meridia ) resulted in significantly greater weight loss among obese adults than treatment with the medication alone. The study, conducted by researchers from the University of Pennsylvania, appears in the November 17, 2005 issue of The New England Journal of Medicine and was supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), one of the National Institutes of Health (NIH).

"NIH is fighting the increasing problem of obesity in America by supporting research that will result in better treatments and therapies for weight loss and the prevention of obesity's associated diseases, such as type 2 diabetes, heart disease, and some forms of cancer," says NIH Director Elias A. Zerhouni, M.D.

"Lifestyle modification should be the first line of treatment for obesity," says Susan Yanovski, M.D., director of the Obesity and Eating Disorders Program for NIDDK, and author of an accompanying editorial in the journal. "But for obese adults who can t lose enough weight to improve their health, medication used as an adjunct can help."

"The take home message is that weight loss medications will be most effective when they are combined with a reduced calorie diet and increased physical activity," says Thomas A. Wadden, Ph.D., Professor of Psychology in the Department of Psychiatry at the University of Pennsylvania School of Medicine, and lead author of the study. "Weight loss medication used alone can produce some weight loss, but lifestyle modification treatment can help patients acquire skills to successfully make changes in their diet and physical activity."

A total of 224 obese adults aged 18 to 65 years participated in the one-year study. Participants were randomly assigned to one of four groups: 1. weight loss medication alone; 2. lifestyle modification alone; 3. weight loss medication plus lifestyle modification; and 4. weight-loss medication plus brief physician-mediated therapy. The researchers included the fourth treatment group to measure the effectiveness of weight-loss medication combined with brief lifestyle modification counseling delivered by primary care providers. The researchers looked at this type of therapy as a possible model for delivering lifestyle modification therapy in the setting of primary care practice.

Participants in the lifestyle modification therapy group attended a total of 30, 90-minute group meetings. During the meetings participants were instructed to complete and share weekly assignments, which included keeping detailed daily food and physical activity records. Participants in the brief lifestyle modification counseling group met with primary care physicians eight times for 10 to 15 minute visits, where they were given homework assignments, which also included keeping daily food and activity records. Participants in the weight-loss medication therapy alone group also met with primary care physicians eight times for 10 to 15 minute visits, but were not instructed to keep food or activity records and were provided only general information on diet and exercise. Those participants in the combined therapy group received both the lifestyle modification therapy and the weight-loss medication. All groups were prescribed a 1200 to 1500 calorie diet and the same exercise plan.

1. Prev:Top 10 Weight Loss Lies to Eliminate for Steady Weight Loss
2. Next:Daily Weighing Helps People Lose Weight, Prevents Gain