LONG-TERM, SUSTAINED, LIFESTYLE-INDUCED WEIGHT LOSS IN SEVERE OBESITY: THE GET-ReAL PROGRAM

Samyah Shadid, Rolf C. Jakob, Michael Dennis Jensen

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

OBJECTIVE: To study the long-term effectiveness of a patient-centered, multidisciplinary lifestyle intervention treatment in patients medically eligible for bariatric surgery.

METHODS: Using a case-control study design, we compared treatment results for 98 adults (mean body mass index [BMI], 44.2 kg/m(2)) with the outcomes of 148 controls (mean BMI, 43.0 kg/m(2)) receiving standard care. The approach included a phased triage for inclusion, followed by 12 lifestyle intervention group sessions alternating with individual visits for behavior, diet, and exercise instructions.

RESULTS: At 2 years, weight loss averaged 15.3 ± 1.4 kg (P<.0010) (12 ± 1% of initial body weight [IBW], P<.001; 21 ± 2% of excess body weight [EBW], P<.001) in an intention-to-treat (ITT) analysis; in completers, weight loss was 18.8 ± 1.5 kg (P<.001) (15 ± 1% IBW, P<.001; 26 ± 3% EBW, P<.001). A total of 42 patients lost ≥10% IBW. Controls remained weight stable (P = .35); 3% lost ≥10% IBW. Patients achieving weight loss that would be considered satisfactory for bariatric surgery included 20% who achieved ≥35% EBW loss, 29% who achieved a BMI <35 kg/m(2) (if starting BMI <50 kg/m(2)) or BMI <40 kg/m(2) (if starting BMI ≥50 kg/m(2)), and 37% who achieved EBW loss ≤50%. These values for completers were 31, 39, and 48%, respectively. In the 55 patients starting the program ≥4 years ago, weight loss maintenance of 12 ± 1% IBW (ITT, 16 ± 1% in completers) was observed.

CONCLUSION: Substantial nonsurgical weight loss, maintained at 2 to 4 years, is achievable in severely obese patients using comprehensive lifestyle approaches; the efficacy/safety trade-off in obesity treatment is an important consideration in interpreting these results.

Original languageEnglish (US)
Pages (from-to)330-338
Number of pages9
JournalEndocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
Volume21
Issue number4
DOIs
StatePublished - Apr 1 2015

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Morbid Obesity
Life Style
Weight Loss
Body Weight
Body Mass Index
Bariatric Surgery
Intention to Treat Analysis
Triage
Case-Control Studies
Therapeutics
Obesity
Maintenance
Exercise
Diet
Safety
Weights and Measures

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

@article{1e5e33c19d8949cdb5ffe2a372dff5af,
title = "LONG-TERM, SUSTAINED, LIFESTYLE-INDUCED WEIGHT LOSS IN SEVERE OBESITY: THE GET-ReAL PROGRAM",
abstract = "OBJECTIVE: To study the long-term effectiveness of a patient-centered, multidisciplinary lifestyle intervention treatment in patients medically eligible for bariatric surgery.METHODS: Using a case-control study design, we compared treatment results for 98 adults (mean body mass index [BMI], 44.2 kg/m(2)) with the outcomes of 148 controls (mean BMI, 43.0 kg/m(2)) receiving standard care. The approach included a phased triage for inclusion, followed by 12 lifestyle intervention group sessions alternating with individual visits for behavior, diet, and exercise instructions.RESULTS: At 2 years, weight loss averaged 15.3 ± 1.4 kg (P<.0010) (12 ± 1{\%} of initial body weight [IBW], P<.001; 21 ± 2{\%} of excess body weight [EBW], P<.001) in an intention-to-treat (ITT) analysis; in completers, weight loss was 18.8 ± 1.5 kg (P<.001) (15 ± 1{\%} IBW, P<.001; 26 ± 3{\%} EBW, P<.001). A total of 42 patients lost ≥10{\%} IBW. Controls remained weight stable (P = .35); 3{\%} lost ≥10{\%} IBW. Patients achieving weight loss that would be considered satisfactory for bariatric surgery included 20{\%} who achieved ≥35{\%} EBW loss, 29{\%} who achieved a BMI <35 kg/m(2) (if starting BMI <50 kg/m(2)) or BMI <40 kg/m(2) (if starting BMI ≥50 kg/m(2)), and 37{\%} who achieved EBW loss ≤50{\%}. These values for completers were 31, 39, and 48{\%}, respectively. In the 55 patients starting the program ≥4 years ago, weight loss maintenance of 12 ± 1{\%} IBW (ITT, 16 ± 1{\%} in completers) was observed.CONCLUSION: Substantial nonsurgical weight loss, maintained at 2 to 4 years, is achievable in severely obese patients using comprehensive lifestyle approaches; the efficacy/safety trade-off in obesity treatment is an important consideration in interpreting these results.",
author = "Samyah Shadid and Jakob, {Rolf C.} and Jensen, {Michael Dennis}",
year = "2015",
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doi = "10.4158/EP14381.OR",
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T1 - LONG-TERM, SUSTAINED, LIFESTYLE-INDUCED WEIGHT LOSS IN SEVERE OBESITY

T2 - THE GET-ReAL PROGRAM

AU - Shadid, Samyah

AU - Jakob, Rolf C.

AU - Jensen, Michael Dennis

PY - 2015/4/1

Y1 - 2015/4/1

N2 - OBJECTIVE: To study the long-term effectiveness of a patient-centered, multidisciplinary lifestyle intervention treatment in patients medically eligible for bariatric surgery.METHODS: Using a case-control study design, we compared treatment results for 98 adults (mean body mass index [BMI], 44.2 kg/m(2)) with the outcomes of 148 controls (mean BMI, 43.0 kg/m(2)) receiving standard care. The approach included a phased triage for inclusion, followed by 12 lifestyle intervention group sessions alternating with individual visits for behavior, diet, and exercise instructions.RESULTS: At 2 years, weight loss averaged 15.3 ± 1.4 kg (P<.0010) (12 ± 1% of initial body weight [IBW], P<.001; 21 ± 2% of excess body weight [EBW], P<.001) in an intention-to-treat (ITT) analysis; in completers, weight loss was 18.8 ± 1.5 kg (P<.001) (15 ± 1% IBW, P<.001; 26 ± 3% EBW, P<.001). A total of 42 patients lost ≥10% IBW. Controls remained weight stable (P = .35); 3% lost ≥10% IBW. Patients achieving weight loss that would be considered satisfactory for bariatric surgery included 20% who achieved ≥35% EBW loss, 29% who achieved a BMI <35 kg/m(2) (if starting BMI <50 kg/m(2)) or BMI <40 kg/m(2) (if starting BMI ≥50 kg/m(2)), and 37% who achieved EBW loss ≤50%. These values for completers were 31, 39, and 48%, respectively. In the 55 patients starting the program ≥4 years ago, weight loss maintenance of 12 ± 1% IBW (ITT, 16 ± 1% in completers) was observed.CONCLUSION: Substantial nonsurgical weight loss, maintained at 2 to 4 years, is achievable in severely obese patients using comprehensive lifestyle approaches; the efficacy/safety trade-off in obesity treatment is an important consideration in interpreting these results.

AB - OBJECTIVE: To study the long-term effectiveness of a patient-centered, multidisciplinary lifestyle intervention treatment in patients medically eligible for bariatric surgery.METHODS: Using a case-control study design, we compared treatment results for 98 adults (mean body mass index [BMI], 44.2 kg/m(2)) with the outcomes of 148 controls (mean BMI, 43.0 kg/m(2)) receiving standard care. The approach included a phased triage for inclusion, followed by 12 lifestyle intervention group sessions alternating with individual visits for behavior, diet, and exercise instructions.RESULTS: At 2 years, weight loss averaged 15.3 ± 1.4 kg (P<.0010) (12 ± 1% of initial body weight [IBW], P<.001; 21 ± 2% of excess body weight [EBW], P<.001) in an intention-to-treat (ITT) analysis; in completers, weight loss was 18.8 ± 1.5 kg (P<.001) (15 ± 1% IBW, P<.001; 26 ± 3% EBW, P<.001). A total of 42 patients lost ≥10% IBW. Controls remained weight stable (P = .35); 3% lost ≥10% IBW. Patients achieving weight loss that would be considered satisfactory for bariatric surgery included 20% who achieved ≥35% EBW loss, 29% who achieved a BMI <35 kg/m(2) (if starting BMI <50 kg/m(2)) or BMI <40 kg/m(2) (if starting BMI ≥50 kg/m(2)), and 37% who achieved EBW loss ≤50%. These values for completers were 31, 39, and 48%, respectively. In the 55 patients starting the program ≥4 years ago, weight loss maintenance of 12 ± 1% IBW (ITT, 16 ± 1% in completers) was observed.CONCLUSION: Substantial nonsurgical weight loss, maintained at 2 to 4 years, is achievable in severely obese patients using comprehensive lifestyle approaches; the efficacy/safety trade-off in obesity treatment is an important consideration in interpreting these results.

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