Weight-Loss Medication in Combination With Lifestyle Modification Shows Better Results
It is recommended that people achieve and maintain a healthy weight through lifestyle modification, including a low-calorie diet and regular exercise. But when that is not enough, weight-loss medications may help. Researchers recommended that people who take weight-loss medications participate in a lifestyle-modification program that includes diet, exercise, and behavioral therapy. In practice, however, medications are often prescribed with minimal or no effort at lifestyle modification.
A new study in the November 17, 2005 issue of the New England Journal of Medicine examined the effectiveness of combining the weight-loss medication, sibutramine (Meridia), with a lifestyle modification program. Researchers found that the combination was about twice as effective as either the medication or the program alone.
About the Study
This study included 224 obese adults who were randomly assigned to receive one of four treatments for one year:
- Sibutramine alone – a sibutramine prescription in combination with eight 10-15 visits with a primary care provider
- Lifestyle modification alone – approximately 30, 90-minute group meetings led by trained psychologists; homework assignments focusing on weight-loss strategies, and instructions to keep daily records of food intake and physical activity
- Combined therapy – a combination of the sibutramine and lifestyle treatments
- Sibutramine plus brief therapy – a combination of the sibutramine treatment and brief lifestyle counseling by the primary care provider, during which homework, including daily food-intake and activity records, was assigned
All participants were on a 1,200-1,500 calorie diet and were encouraged to walk 30 minutes a day on most days of the week.
The participants receiving combined therapy lost an average of 27 pounds, compared with a loss of 11, 15, and 17 pounds in participants taking sibutramine alone, lifestyle modification alone, and sibutramine plus brief therapy, respectively. Thirty-four participants taking sibutramine needed to cut back on their dose because of an increase in blood pressure elevations, a known side effect of sibutramine.
How Does This Affect You?
Weight-loss medications, such as sibutramine, can be effective. In fact, another study in the same issue of the New England Journal of Medicine found that an experimental weight-loss drug, rimonabant, resulted in significant reductions in body weight and waist circumference, as well as improvements in diabetes and other cardiovascular risk factors. The findings of this study, however, underscore the importance of participating in a lifestyle modification program when taking weight-loss medications.
Weight-loss medications—indeed most medications used to treat chronic conditions like ]]>diabetes]]> , ]]>heart disease]]> , and ]]>obesity]]> —should never be regarded as an “easy fix.” It is important to first try a healthful diet and regular exercise when trying to lose weight, and when that is not enough and weight-loss medications are prescribed, it is essential to continue practicing lifestyle modification strategies.
National Center for Chronic Disease and Health Promotion
Weight-Control Information Network
National Institute of Diabetes and Digestive and Kidney Diseases
Despres J-P, Golay A, Sjostrom L. Effects of rimonabant on metabolic risk factors in overweight patients with obesity. NEJM . 2005;353(20):2121-2134.
Wadden TA, Berkowitz RI, Womble LG, et al. Randomized trial of lifestyle modification and pharmacotherapy for obesity. NEJM . 2005;353(20):2111-2120.
Last reviewed Nov 17, 2005 by ]]>Richard Glickman-Simon, MD]]>
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