Effectiveness of a lifestyle modification programme in weight maintenance in obese subjects after cessation of treatment with Orlistat.
OBJECTIVE
To examine the efficacy of a lifestyle modification programme in weight maintenance for obese subjects after cessation of treatment with Orlistat.


METHODS
Fifty-five subjects with and without diabetes mellitus were randomized to a lifestyle modification programme or to usual care at the end of 6 months' treatment with Orlistat. The intervention programme was nutritionist led, consisting of components of dietary management, physical activity, peer group support and discussion using techniques of self-monitoring, stimulus control and cognitive restructuring. Anthropometric indices, body composition, basal metabolic rate, blood pressure, fasting glucose, glycosylated haemoglobin, lipid profile, 24-hour urinary albumin excretion, dietary intake, physical activity level, and quality of life were assessed before and after the intervention period. Results Subjects in the intervention group maintained their weight loss and favourable anthropometric, metabolic, dietary intake, physical activity and quality of life profiles, while most parameters deteriorated in the usual care group, being more marked in subjects with diabetes. The magnitude of weight gain was comparable to that lost during Orlistat treatment.


CONCLUSIONS
A specially designed nutritionist-led lifestyle modification programme for obese subjects is effective in weight maintenance after treatment with Orlistat, in the absence of which the benefits of drug treatment were lost. The magnitude of the effect of lifestyle modification is comparable to that observed with Orlistat.
Woo
Jean
J
Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China. jeanwoowong@cuhk.edu.hk
Sea
Mandy M M
MM
Tong
Peter
P
Ko
Gary T C
GT
Lee
Zoe
Z
Chan
Juliana
J
Chow
Francis C C
FC
D000293:Adolescent; D000328:Adult; D000419:Albuminuria / Q000652:urine; D019440:Anti-Obesity Agents / Q000627:therapeutic use*; D001481:Basal Metabolism / Q000502:physiology; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure / Q000502:physiology; D001823:Body Composition / Q000502:physiology; D001835:Body Weight / Q000502:physiology*; D015928:Cognitive Behavioral Therapy; D048909:Diabetes Complications; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D015444:Exercise / Q000502:physiology; D005215:Fasting / Q000097:blood; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007783:Lactones / Q000627:therapeutic use*; D008049:Lipase / Q000037:antagonists & inhibitors*; D008055:Lipids / Q000097:blood; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy / Q000188:drug therapy*; D000077403:Orlistat; D011788:Quality of Life; D040242:Risk Reduction Behavior; D012648:Self Care; D012944:Social Support; D015431:Weight Loss / Q000502:physiology
D019440:Anti-Obesity Agents; D001786:Blood Glucose; D004791:Enzyme Inhibitors; D006442:Glycated Hemoglobin; D007783:Lactones; D008049:Lipase; D008055:Lipids; D000077403:Orlistat