Psychobehavioral and nutritional predictors of weight loss in obese women treated with sibutramine.
OBJECTIVE
To reveal whether baseline body mass index (BMI), and psychobehavioral and nutritional markers were significant predictors of the change in BMI observed after 4 and 12 months in obese women enrolled in a weight reduction program, including low-energy diet, increased physical activity, cognitive behavior therapy and sibutramine. The impact of changes in psychobehavioral and nutritional markers observed after 4 and 12 months of treatment on BMI changes was also investigated.


METHODS
During a double-blind placebo-controlled 4-month period, subjects received either sibutramine (10 mg/day) or placebo. Then, an open phase with sibutramine administered to all patients continued until month 12.


METHODS
In total, 80 obese women (age: 43.9+/-10.6 y, BMI: 36.7+/-4.8 kg/m(2)).


METHODS
The dependent variable was change in BMI while baseline BMI, mode of treatment, the Beck depression score, the three items (dietary restraint, disinhibition and perceived hunger) of the Eating Inventory (EI), energy and macronutrient intakes were independent variables. At 1-week dietary records were analyzed using a computer software for assessing energy and macronutrient intake.


RESULTS
Multiple regression analysis revealed that the BMI loss at month 4 was significantly influenced by mode of treatment and initial BMI, whereas a borderline negative relationship was observed with the baseline restraint score. Baseline BMI, depression score, restraint score and total energy intake predicted weight loss at month 12. These predictive variables accounted for 43.8% of the variance in BMI loss at 12 months. When relationships between the BMI loss and changes in all included psychobehavioral and nutritional parameters were considered after 12 months of treatment, a drop in the disinhibition score of the EI appeared the only significant factor affecting the BMI decrease.


CONCLUSIONS
Our results suggest that psychobehavioral and nutritional characteristics can be used as predictors of weight loss in response to a comprehensive weight management program including pharmacological treatment with sibutramine.
Hainer
V
V
Institute of Endocrinology, Obesity Management Centre, Prague, Czech Republic. vhainer@endo.cz
Kunesova
M
M
Bellisle
F
F
Hill
M
M
Braunerova
R
R
Wagenknecht
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D001067:Appetite Depressants / Q000627:therapeutic use*; D015992:Body Mass Index; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D003503:Cyclobutanes / Q000627:therapeutic use*; D003863:Depression / Q000150:complications; D004038:Diet, Reducing; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007389:Internal-External Control; D008875:Middle Aged; D009747:Nutritional Physiological Phenomena; D009765:Obesity / Q000188:drug therapy* / Q000523:psychology / Q000628:therapy; D010349:Patient Compliance; D011379:Prognosis; D012044:Regression Analysis; D016896:Treatment Outcome; D015431:Weight Loss
D001067:Appetite Depressants; D003503:Cyclobutanes; C058254:sibutramine