Long-term maintenance of weight loss with... : European Journal of Clinical Nutrition (original) (raw)

Long-term maintenance of weight loss with sibutramine in a GP setting following a specialist guided very-low-calorie diet: a double-blind, placebo-controlled, parallel group study

• E MH Mathus-Vliegen

European Journal of Clinical Nutrition

59

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S1

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S31

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S39

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August 2005

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Objective:

Very-low-calorie diets (VLCDs) are used to promote short-term weight loss in obese patients. However, long-term maintenance of weight loss is generally poor. We assessed the efficacy and safety of sibutramine in maintaining weight loss achieved in obese patients by means of a 3-month VLCD.

Design:

A multicenter double-blind, parallel-group trial conducted over 18 months, following a 3-month open label VLCD run-in.

Setting:

Eight hospital centers in The Netherlands, with subsequent follow-up in general practice.

Subjects:

A total of 221 obese subjects, of whom 189 were randomized (mean screening BMI 36.6 kg/m2; mean age 42.6 y).

Measurements:

Patients were given a 3-month VLCD and were required to lose 10% or more of their initial weight. A total of 189 patients completed this phase (mean percentage weight loss 14.5±3.2%) and were randomized to sibutramine 10 mg/day (_n_=94) or matching placebo (_n_=95). All patients received a recommended diet and exercise program. The primary analysis was outcome in terms of achieving 80% weight maintenance of the VLCD period at month 18. Secondary analysis was percentage of initial weight loss maintained at months 6, 12, 18 and end point.

Results:

At month 18, the odds ratio for achieving successful weight maintenance was 1.76 (95% CI 1.06, 2.93) in favor of sibutramine (_P_=0.03). In intention-to-treat analysis, more than 80% of the weight loss achieved during the VLCD phase was maintained by 70, 51 and 30% of sibutramine-treated patients at months 6, 12 and 18, respectively, compared to 48, 31 and 20% of placebo-treated patients. The differences between the treatment groups were significant (_P_≤0.03) at all time points.

Conclusion:

Weight loss achieved with a VLCD is more effectively maintained with sibutramine in combination with a recommended diet and exercise program than with placebo over a follow-up period of 18 months. Sibutramine is well tolerated, with a safety profile consistent with that seen in other previous trials.