Clinically Meaningful Weight Loss From Behavioral Therapy

Compared to controls, 3 kg more weight loss with behavioral treatment, with or without orlistat

TUESDAY, Oct. 4 (HealthDay News) -- Although health-outcome data are sparse, behavioral interventions are effective in yielding clinically meaningful weight loss in overweight and obese individuals, according to a study published in the Oct. 4 issue of the Annals of Internal Medicine.

Erin S. LeBlanc, M.D., M.P.H., from the Kaiser Permanente Northwest in Portland, Ore., and colleagues reviewed available literature to summarize the effectiveness and shortcomings of primary care-relevant weight-loss interventions in overweight and obese individuals. A total of 6,498 abstracts and 648 articles were reviewed from 2005 to 2010, and 58 trials comparing the benefits of weight-loss interventions with control groups were included.

The investigators found that, after 12 to 18 months, behavioral treatments resulted in 3 kg greater weight loss in the intervention versus control group, with more treatment sessions correlating with greater weight loss. There were limited data to suggest maintenance of weight-loss for one year or more. After 12 months, orlistat plus behavioral intervention correlated with 3 kg greater weight loss versus placebo. There was less weight loss seen with metformin. There were insufficient data on the effects of weight-loss treatments on long-term health outcomes (including death and cardiovascular disease). Data on the effects of weight-loss treatments on intermediate outcomes (including lipids and blood pressure) were mixed and small. For patients with prediabetes, diabetes incidence was reduced with weight-loss treatment. Gastrointestinal symptoms were the main reason for withdrawal of medications, and there were insufficient data on serious medication harms.

"Behavioral weight-loss interventions with or without orlistat or metformin yielded clinically meaningful weight loss; however, health-outcome data were sparse," the authors write.

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