title: Multicenter evaluation of an interdisciplinary 52-week weight loss program for obesity with regard to body weight, comorbidities and quality of life--a prospective study.
abstract: OBJECTIVE
  To determine the effectiveness of a structured multidisciplinary non-surgical obesity therapy program on the basis of a temporary low-calorie-diet for 12 weeks, and additional intervention modules to enhance nutritional education, to increase physical activity and to modify eating behavior.
  
  
  METHODS
  Prospective multicenter observational study in obese individuals undergoing a medically supervised outpatient-based 52-week treatment in 37 centers in Germany.
  
  
  METHODS
  A total of 8296 participants with a body mass index (BMI) of >30 kg m(-2) included within 8.5 years.
  
  
  METHODS
  Main outcome measures were body weight loss, waist circumference (WC), blood pressure, quality of life and adverse events.
  
  
  RESULTS
  In females, initial body weight was reduced after the 1-year-intervention by 19.6 kg (95% confidence intervals 19.2-19.9 kg) and in males by 26.0 kg (25.2-26.8) according to per protocol analysis of 4850 individuals. Intention-to-treat (ITT) analysis revealed a weight reduction of 15.2 kg (14.9-15.6) in females and 19.4 kg (18.7-20.1) in males. Overall, the intervention resulted in mean reduction in WC of 11 cm; it reduced the prevalence of the metabolic syndrome by 50% and the frequency of hypertension from 47 to 29% of all participants (ITT, all P<0.001). The beneficial effects could be documented for up to 3 years and comprised significant improvement of health-related quality of life. The incidence of adverse effects was low; the only event repeatedly observed and possibly related to either the intervention or the underlying disease was biliary disorders.
  
  
  CONCLUSIONS
  The present non-surgical intervention program is a highly effective treatment of obesity grades I-III and obesity-related diseases, and therefore, could be a valuable basis for future weight maintenance strategies required for sustained success.
authors.affiliation: Department of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany. bischoff.stephan@uni-hohenheim.de
authors.forename: S C
authors.initials: SC
authors.lastname: Bischoff
authors.forename: A
authors.initials: A
authors.lastname: Damms-Machado
authors.forename: C
authors.initials: C
authors.lastname: Betz
authors.forename: S
authors.initials: S
authors.lastname: Herpertz
authors.forename: T
authors.initials: T
authors.lastname: Legenbauer
authors.forename: T
authors.initials: T
authors.lastname: Löw
authors.forename: J G
authors.initials: JG
authors.lastname: Wechsler
authors.forename: G
authors.initials: G
authors.lastname: Bischoff
authors.forename: A
authors.initials: A
authors.lastname: Austel
authors.forename: T
authors.initials: T
authors.lastname: Ellrott
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001835:Body Weight; D031204:Caloric Restriction / Q000379:methods; D015897:Comorbidity; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000178:diet therapy / Q000453:epidemiology*; D033183:Interdisciplinary Communication; D008297:Male; D024821:Metabolic Syndrome / Q000178:diet therapy / Q000453:epidemiology*; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy / Q000453:epidemiology*; D011446:Prospective Studies; D011788:Quality of Life; D055105:Waist Circumference; D061217:Weight Reduction Programs / Q000379:methods*; D055815:Young Adult