title: One year weight loss in the TRAMOMTANA study. A randomized controlled trial.
abstract: BACKGROUND
  Morbid obesity is a major health problem and bariatric surgery is currently the most effective therapy available to induce weight loss in these patients. This report describes 1-year changes in weight and metabolic parameters, in a trial designed to examine the effects of a nonsurgical approach, Intensive Life style Intervention (ILI) on the therapy of morbid obesity.
  
  
  METHODS
  The primary outcome was change in body weight. Patients were randomized to ILI (n = 60) or conventional obesity therapy (COT) (n = 46). The ILI group received behavioural therapy and nutritional/physical activity counselling. The COT group received the standard medical treatment available for these patients. A third group consisted of the patients already included in our bariatric surgery waiting list (n = 37).
  
  
  RESULTS
  We present here 1-year data showing that patients who received ILI with no restrictions in calorie intake had a greater percentage of weight loss than patients receiving COT (-11·58% vs -0·4%; P < 0·001). Importantly, 31·4% of patients included in the ILI group were not morbidly obese after 6 months of intervention. This number increased to 42·8% after 12 months of intervention.
  
  
  CONCLUSIONS
  ILI was associated with significant weight loss compared with COT in a group of morbidly obese patients. The weight loss effect was already obtained after 6 months of ILI intervention. These results seriously question the efficacy of the COT approach to morbid obesity. Furthermore, they underscore the use of ILI programmes in the hospital setting to effectively treat morbidly obese patients and might help to reduce the number of candidate patients for bariatric surgery.
authors.affiliation: Grupo de Obesidad y Diabetes - Instituto Universitario de Investigación en Ciencias de la Salud de les Illes Balears- (IUNICS), Hospital Universitario Son Espases, Palma de Mallorca, Spain; Unidad de Investigación-CAIBER, Hospital Universitario Son Espases, Palma de Mallorca, Spain.
authors.forename: Juan Jesús
authors.initials: JJ
authors.lastname: Tur
authors.forename: Antonio Jorge
authors.initials: AJ
authors.lastname: Escudero
authors.forename: María Micaela
authors.initials: MM
authors.lastname: Alos
authors.forename: Ramón
authors.initials: R
authors.lastname: Salinas
authors.forename: Emma
authors.initials: E
authors.lastname: Terés
authors.forename: Joan B
authors.initials: JB
authors.lastname: Soriano
authors.forename: Gabriela
authors.initials: G
authors.lastname: Nicola
authors.forename: Juan Ramón
authors.initials: JR
authors.lastname: Urgelés
authors.forename: Alberto
authors.initials: A
authors.lastname: Pagán
authors.forename: Baltasar
authors.initials: B
authors.lastname: Cortes
authors.forename: Xavier
authors.initials: X
authors.lastname: González
authors.forename: Bartolomé
authors.initials: B
authors.lastname: Burguera
mesh_terms: D000328:Adult; D050110:Bariatric Surgery; D001521:Behavior Therapy; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D003376:Counseling; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D015596:Nutrition Assessment; D009767:Obesity, Morbid / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human