Lifestyle intervention helps weight loss

Apart from bariatric surgery and pharmacotherapy, few clinical trials have evaluated the treatment of severe obesity. The objective of this study was to determine the efficacy of a weight loss and physical activity intervention on the adverse health risks of severe obesity.

The three year trial included 130 severely obese adult participants without diabetes. A one-year intensive lifestyle intervention consisting of diet and physical activity was implemented. One group (initial physical activity) was randomized to diet and physical activity for the entire 12 months; the other group (delayed physical activity) had the identical dietary intervention but with physical activity delayed for 6 months.

101 subjects completed the 12-month follow-up assessments. Although both intervention groups lost a significant amount of weight at 6 months, the initial-activity group lost significantly more weight in the first 6 months compared with the delayed-activity group. Weight loss at 12 months, however, was similar in the 2 groups. Waist circumference, visceral abdominal fat, hepatic fat content, blood pressure, and insulin resistance were all reduced in both groups. The addition of physical activity promoted greater reductions in waist circumference and hepatic fat content.

As suspected, among patients with severe obesity, a lifestyle intervention involving diet combined with initial or delayed initiation of physical activity resulted in clinically significant weight loss and favorable changes in cardiometabolic risk factors. JAMA 10/27/2010