This document provides an overview of clinical studies on Medifast's weight loss programs. Key findings include:
- A randomized controlled trial found greater weight loss and improvements in health markers with Medifast vs a food-based diet over 40 weeks.
- Another randomized trial found twice as much weight loss and less regain with Medifast vs a standard diet in people with type 2 diabetes.
- A program evaluation found significant weight loss maintained at 52 weeks using Medifast supplements and medication.
- A study found Medifast beverages increased resting energy expenditure and decreased appetite.
- An open label trial found significant reductions in weight, body fat, and BMI in completers of a Medifast program over
Abstract
Background and purpose: Diet and muscle fiber type are all major factors in predicting intramuscular carnosine concentration [1]. Constituent substrate availability, including the amino acids L-histidine and more specifically beta alanine, play the greatest role in determining the concentration of intramuscular carnosine, a potent intracellular Hydrogen ion buffer. The purpose of this review is to analyze the efficacy of beta alanine supplementation on exercise performance, specifically activities relying on anaerobic glycolysis.
Method: The review included articles from peer-reviewed journals with sufficient data related to the purpose and focus of the study. Inclusion criteria included randomized control trials, systematic reviews and meta-analysis published since 2007.
Results: Twenty relevant studies were identified; various experimental protocols were employed, including both acute and chronic effects of beta alanine supplementation on physical performance. All studies were published 2007 through 2017, providing a robust overview of experimentation over the last 10 years.
Discussion and conclusion: Among studies analyzed in this mini-review, the consensus reached regarding the efficacy of beta alanine supplementation for performance enhancement was relatively positive. Most studies followed similar supplementary strategies, consuming anywhere from 1.6 to 6.4g/day for 2 to 10 weeks. The majority of these studies demonstrated statistically significant increases in intramuscular carnosine content, a physiological parameter that is positively correlated with sprinting and power performance. Many studies presented results in support of enhanced muscular endurance performance subsequent to supplementation relative to the placebo group. Researchers also noted a decline in peak aerobic capacity concurrent to a delay in the onset of blood lactate accumulation, supporting the notion of enhanced glycolytic capacity. More research is necessary to identify optimal dosing strategies for performance optimization across the spectrum of physical activities.
Dietary Strategies for Weight Loss MaintenanceMARKETDIGITALBN
Weight regain after a successful weight loss intervention is very common. Most studies
show that, on average, the weight loss attained during a weight loss intervention period is not
or is not fully maintained during follow-up. We review what is currently known about dietary
strategies for weight loss maintenance, focusing on nutrient composition by means of a systematic
review and meta-analysis of studies and discuss other potential strategies that have not been studied
so far. Twenty-one studies with 2875 participants who were overweight or obese are included in
this systematic review and meta-analysis
Semaglutide brings breakthroughs in weight management for type 2 diabetes bio...DoriaFang
On March 2, "The Lancet" published an important study of semaglutide in patients with type 2 diabetes. In the STEP-2 trial, medication once a week can help overweight or obese type 2 diabetic patients lose an average of nearly 10 kg in weight, and more than a quarter of the patients lose more than 15%, which is much higher than the existing drugs in diabetic patients. At the same time, this also significantly improves overall health conditions including blood sugar, blood pressure, and blood lipids.
This randomized, double-blinded, placebo-controlled study assessed the effects of Oxytocin FactorTM for weight loss over 45 days. 45 participants were randomized to receive either a placebo or Oxytocin FactorTM twice daily. Results showed that the Oxytocin FactorTM group lost more weight (14.89 lbs), body fat (4.72%), and waist circumference (4.31 inches) on average compared to the placebo group, though statistical significance was not achieved due to the small sample size. Larger studies are needed to determine the statistical significance of Oxytocin FactorTM as a safe and effective weight loss tool.
Case study for rugby athlete in rehabilitationDaniel Kapsis
This case study examined an 8-week nutritional intervention for a rugby player undergoing rehabilitation for a shoulder injury. The intervention consisted of a 3,400 kcal per day diet with high protein and carbohydrates, as well as creatine and whey protein supplements. The athlete gained 5.2 kg total, of which 4.9 kg was lean muscle mass while maintaining his body fat percentage. Arm measurements increased significantly, indicating muscle hypertrophy. The intervention successfully helped the athlete rapidly gain muscle mass during rehabilitation without increasing body fat.
This document provides an overview of clinical studies on Medifast's weight loss programs. Key findings include:
- A randomized controlled trial found greater weight loss and improvements in health markers with Medifast vs a food-based diet over 40 weeks.
- Another randomized trial found twice as much weight loss and less regain with Medifast vs a standard diet in people with type 2 diabetes.
- A program evaluation found significant weight loss maintained at 52 weeks using Medifast supplements and medication.
- A study found Medifast beverages increased resting energy expenditure and decreased appetite.
- An open label trial found significant reductions in weight, body fat, and BMI in completers of a Medifast program over
Abstract
Background and purpose: Diet and muscle fiber type are all major factors in predicting intramuscular carnosine concentration [1]. Constituent substrate availability, including the amino acids L-histidine and more specifically beta alanine, play the greatest role in determining the concentration of intramuscular carnosine, a potent intracellular Hydrogen ion buffer. The purpose of this review is to analyze the efficacy of beta alanine supplementation on exercise performance, specifically activities relying on anaerobic glycolysis.
Method: The review included articles from peer-reviewed journals with sufficient data related to the purpose and focus of the study. Inclusion criteria included randomized control trials, systematic reviews and meta-analysis published since 2007.
Results: Twenty relevant studies were identified; various experimental protocols were employed, including both acute and chronic effects of beta alanine supplementation on physical performance. All studies were published 2007 through 2017, providing a robust overview of experimentation over the last 10 years.
Discussion and conclusion: Among studies analyzed in this mini-review, the consensus reached regarding the efficacy of beta alanine supplementation for performance enhancement was relatively positive. Most studies followed similar supplementary strategies, consuming anywhere from 1.6 to 6.4g/day for 2 to 10 weeks. The majority of these studies demonstrated statistically significant increases in intramuscular carnosine content, a physiological parameter that is positively correlated with sprinting and power performance. Many studies presented results in support of enhanced muscular endurance performance subsequent to supplementation relative to the placebo group. Researchers also noted a decline in peak aerobic capacity concurrent to a delay in the onset of blood lactate accumulation, supporting the notion of enhanced glycolytic capacity. More research is necessary to identify optimal dosing strategies for performance optimization across the spectrum of physical activities.
Dietary Strategies for Weight Loss MaintenanceMARKETDIGITALBN
Weight regain after a successful weight loss intervention is very common. Most studies
show that, on average, the weight loss attained during a weight loss intervention period is not
or is not fully maintained during follow-up. We review what is currently known about dietary
strategies for weight loss maintenance, focusing on nutrient composition by means of a systematic
review and meta-analysis of studies and discuss other potential strategies that have not been studied
so far. Twenty-one studies with 2875 participants who were overweight or obese are included in
this systematic review and meta-analysis
Semaglutide brings breakthroughs in weight management for type 2 diabetes bio...DoriaFang
On March 2, "The Lancet" published an important study of semaglutide in patients with type 2 diabetes. In the STEP-2 trial, medication once a week can help overweight or obese type 2 diabetic patients lose an average of nearly 10 kg in weight, and more than a quarter of the patients lose more than 15%, which is much higher than the existing drugs in diabetic patients. At the same time, this also significantly improves overall health conditions including blood sugar, blood pressure, and blood lipids.
This randomized, double-blinded, placebo-controlled study assessed the effects of Oxytocin FactorTM for weight loss over 45 days. 45 participants were randomized to receive either a placebo or Oxytocin FactorTM twice daily. Results showed that the Oxytocin FactorTM group lost more weight (14.89 lbs), body fat (4.72%), and waist circumference (4.31 inches) on average compared to the placebo group, though statistical significance was not achieved due to the small sample size. Larger studies are needed to determine the statistical significance of Oxytocin FactorTM as a safe and effective weight loss tool.
Case study for rugby athlete in rehabilitationDaniel Kapsis
This case study examined an 8-week nutritional intervention for a rugby player undergoing rehabilitation for a shoulder injury. The intervention consisted of a 3,400 kcal per day diet with high protein and carbohydrates, as well as creatine and whey protein supplements. The athlete gained 5.2 kg total, of which 4.9 kg was lean muscle mass while maintaining his body fat percentage. Arm measurements increased significantly, indicating muscle hypertrophy. The intervention successfully helped the athlete rapidly gain muscle mass during rehabilitation without increasing body fat.
This study examined how weight loss affects resting metabolic rate and its relationship to lean muscle mass and fitness levels in obese adults. Obese men and women were placed on a very low calorie diet and exercise program to lose 15% of their body weight over 3 months. Their resting metabolic rate, body composition via DXA scan, and fitness via VO2 max test were measured at baseline and after weight loss. The results found that resting metabolic rate, lean mass, and fitness all decreased with weight loss. While resting metabolic rate was positively correlated with lean mass at both timepoints, the changes in each were not correlated, suggesting other factors also influence changes in resting metabolic rate with weight loss.
The effect of high-fat versus high-carb diet on body composition in strength-...RefoRefaat
Low-fat, high-carb (LFHC) and low-carb, high-fat (LCHF) diets change body composition as a consequence of the reduction of body fat of overweight persons. The
aim of this study is the assessment of the impact of LFHC and LCHF diets on body
composition of men of a healthy body mass who do strength sports while maintaining the appropriate calorific value in a diet and protein intake. The research involved
55 men aged 19–35, with an average BMI of 24.01 ± 1.17 (min. 20.1, max. 26.1). The
participants were divided into two groups following two interventional diets: highfat diet or high-carb diet, for 12 weeks. The body composition of the participants
Antioxidant and protective effect of latex of Calotropis proceraRaman Sehgal
The document summarizes a study that evaluated the antioxidant and anti-diabetic effects of latex from the Calotropis procera plant against alloxan-induced diabetes in rats. The study found that daily oral administration of the latex at 100 and 400 mg/kg doses produced a dose-dependent decrease in blood glucose levels and increase in hepatic glycogen content in diabetic rats. It also prevented loss of body weight and reduced water consumption compared to diabetic controls. The latex treatment increased hepatic antioxidant levels like superoxide dismutase, catalase and glutathione, while decreasing lipid peroxidation levels. The antioxidant and anti-diabetic effects of the latex were comparable to the standard drug glibenclamide.
Impact of Yogic Exercise on Body Fat Percentage on Middle Aged Obese PeopleSports Journal
Purpose: The Purpose of the study was to find out the effect of yogic exercises on body fat percentage of middle aged obese people.
Selection of Subjects: For the present study 20 male obese people from locality of Bilaspur were selected randomly as the subjects for the study. The age of the subjects ranged between 40-50 years.
Selection of Variables: The variables selected for the present study were yogic training (independent variable), body fat percentage (dependent variable).
Methodology: For the study pretest – post-test randomized group design, which consists of control group (10 subjects) and experimental group (10 subjects) were used. The data were collected through the pretest, before training and post-test, after six weeks of yogic exercises training.
Statistical Technique: For comparing pre and post-test means of experimental and control groups, descriptive analysis and Analysis of Co-Variance (ANCOVA) were used and the level of significance was set at 0.05 level of confidence.
Result: The result of the study showed that there was insignificant difference between pre and post-test (experimental group) of body fat percentage.
1) A study investigated the metabolic phenotypes that determine an individual's response to dietary fat interventions in relation to biomarkers of insulin resistance.
2) The study analyzed data from 417 subjects with metabolic syndrome who were randomly assigned to one of four diet groups that varied fat and carbohydrate composition.
3) Based on changes in insulin resistance (HOMA-IR) levels, subjects were classified into three response groups: non-responders, responders whose insulin resistance improved, and responders whose insulin resistance worsened. Fasting insulin and C-peptide levels before the intervention predicted an individual's response to the dietary changes.
This document summarizes a study that compared lipid oxidation and perceived exertion levels during different types of exercise in obese individuals. Ten obese men performed three 45-minute exercises: continuous exercise at the fat max intensity, and two intermittent exercises that alternated between intensities above and below the fat max. While total energy expenditure was highest with continuous exercise, the amount of fat oxidized was equivalent across all exercises. Perceived exertion as measured by the Borg scale was lower for the intermittent exercises compared to continuous exercise. The study concludes that intermittent exercise is less strenuous but similarly effective for fat oxidation in obese individuals compared to continuous exercise.
This summary provides the key points from the document in 3 sentences:
The document discusses 3 studies that examined the effects of creatine monohydrate supplementation combined with resistance training on muscular strength and endurance. The studies found that subjects who took creatine monohydrate supplements showed significant increases in measures of muscular strength like 1 rep max for bench press and leg press compared to placebo groups. The studies support the hypothesis that creatine supplementation increases phosphocreatine levels and ATP production, leading to greater muscular strength and endurance gains with resistance training.
The study examined the differences in muscle hypertrophy between experienced (EXP) and inexperienced (INEXP) strength trainers over 12 weeks. 70 college students were divided into EXP and INEXP groups. Participants performed exercises 3 days/week and maximum weight lifted was measured at weeks 0, 6, and 12.
For the bench press, leg extension, and leg curl exercises, some groups saw significant differences between EXP and INEXP participants. For the bench press, Group 1-1 saw EXP lift 9.2 lbs more than INEXP from weeks 0-6. For the leg extension, Group 1-1 saw INEXP lift 14.8 lbs more than EXP from weeks 0-6, and Group 3
This study examined the effects of ezetimibe treatment for 3 months on glucose metabolism in 96 Japanese patients with type 2 diabetes and hypercholesterolemia. Ezetimibe treatment significantly lowered LDL-cholesterol levels. HbA1c levels decreased in approximately 50% of patients after treatment. Univariate analysis found that changes in HbA1c were associated with serum alanine aminotransferase levels, aspartate aminotransferase to alanine aminotransferase ratio, and age. Higher baseline ALT levels and an AST/ALT ratio below 1.0 were significantly associated with decreases in HbA1c following ezetimibe administration, suggesting ezetimibe may improve glucose control through effects on
This document summarizes the findings from the Food Choice at Work study, which assessed the effectiveness and cost-effectiveness of complex workplace dietary interventions focused on environmental modification alone or in combination with nutrition education. The study recruited employees from 4 manufacturing workplaces in Cork, Ireland and found that combining nutrition education and environmental strategies led to significant reductions in intakes of saturated fat, salt, and increases in nutrition knowledge compared to the control workplace. A small but significant decrease in BMI was also observed. An economic evaluation found that the combined intervention was cost-effective. The document concludes that combining multi-level intervention approaches shows promise for promoting healthy diets and weight loss in workplace settings.
Clinical Study done on GlucAffect. A product from Reliv International, a food science company - Mission: Nourish Our World. Better control and reversal of type 2 diabetes was noted. Best noted for blood sugar management.
2010 carbohydrate for weight and metabolic control- where do we standAgrin Life
This document reviews the evidence on carbohydrate intake for weight and metabolic control. It discusses how recommendations have generally advocated high carbohydrate intake but the prevalence of obesity and diabetes has still increased. Recent evidence suggests diets lower in carbohydrates and higher in unsaturated fats or protein may facilitate weight loss and improve health markers independent of weight loss. The document concludes that future studies are still needed to determine if diets with a more balanced macronutrient composition than currently recommended could better support weight and metabolic health.
This study investigated factors associated with weight loss and changes in body composition in a commercial weight reduction program. The study found that factors like food habits, skipping breakfast, marital status, stress levels, changes in physical activity and cardiovascular fitness had an impact on weight loss, body composition changes and fitness levels. A model combining macronutrient intake, stress levels and physical activity was found to have a strong association with weight loss and explained 42.13% of the variability in weight loss. Vegetarian diets, not skipping meals, and higher physical activity levels were associated with greater weight loss success.
This document summarizes a randomized controlled trial that compared weight loss and metabolic outcomes after 2 years on a low-carbohydrate versus low-fat diet. 307 participants were assigned to either a low-carbohydrate diet with limited carbohydrate intake (20g/day for 3 months, then increasing) or a low-fat diet with limited calorie intake (1200-1800 kcal/day). Both diets were combined with behavioral treatment. At 2 years, weight loss was similar (around 7kg) between groups. The low-carbohydrate diet resulted in greater improvements in blood lipids but also more initial side effects. Long-term weight loss requires ongoing behavioral support regardless of diet.
This document provides information on weight management and obesity, including classifications of nutritional status based on BMI and waist circumference, components of weight management interventions, weight management guidelines and constructing a nutritional care process for weight management. It defines classifications of weight status, discusses goals for obesity therapy including weight loss and maintenance. It also describes various dietary approaches for weight loss such as low-calorie, low-fat, high-protein low-carb diets and meal replacement programs. The document stresses the importance of a multicomponent approach including diet, physical activity and behavior therapy for successful long-term weight management.
1. Dietary interventions, exercise, and drug therapies can help with weight loss but maintaining long-term weight loss remains a challenge.
2. Studies show modest weight loss of 3-5kg on average from dietary and exercise changes alone but adherence is often low.
3. Combining dietary changes, increased physical activity, and drug therapies like Orlistat can result in greater initial weight loss of 5-10% but significant weight regain occurs over time.
This randomized controlled trial examined the effects of diet-induced weight loss, exercise-induced weight loss, exercise without weight loss, and a control group on obesity and related health factors in obese men over 3 months. It found that both diet-induced and exercise-induced weight loss groups lost approximately 7.5 kg (8%) of body weight, with greater total fat loss in the exercise group. Abdominal fat and insulin resistance decreased similarly in both weight loss groups. Exercise without weight loss reduced abdominal fat and prevented further weight gain, but did not change weight or insulin resistance.
The MedPass pilot project was implemented at a long-term care facility over 12 weeks to address malnutrition among elderly residents. Nineteen residents received a high-energy, high-protein nutritional supplement with their medications four times per day. Fifteen residents completed the study. The majority experienced positive weight gain and improved nutritional status based on screening scores. Administering supplements with medications increased consumption and appeared to benefit malnutrition.
This document discusses principles of weight management and obesity treatment. It outlines that the goal of obesity therapy is no longer an "ideal" weight, but a healthier weight loss of 5-15% of initial weight. Long-term behavioral and pharmacological studies show maximum weight losses of 10-15% can be achieved and maintained. Challenges include facilitating acceptance of modest goals and developing long-term treatment models.
This document outlines guidelines and recommendations for treating obesity in primary care. It discusses:
- Evaluating patients using BMI and waist circumference measurements annually and discussing obesity-related health risks.
- Recommending lifestyle interventions including calorie reduction, exercise over 200-300 minutes per week, and behavioral support over 6-12 months.
- Considering prescription of weight loss medications for patients with a BMI over 27-30 or referral for bariatric surgery for patients over 35-40.
- Managing obesity as a chronic disease by prescribing long-term interventions to support weight loss maintenance through behavior and habit changes.
This document discusses the evaluation and management of obesity by gastroenterologists. It covers assessing a patient's readiness to change, obtaining a medical history and physical exam, evaluating lifestyle factors, screening for psychological issues, and the potential role of endoscopy in initial and postoperative evaluation of bariatric surgery patients. Key aspects include using the stages of change model, motivational interviewing techniques, evaluating diet and exercise habits, screening for eating disorders, and being familiar with normal and abnormal postoperative anatomy after different bariatric procedures.
1) The study evaluated the Ideal Protein Weight Loss Method (IPWLM), a 4-stage ketogenic diet, on 272 patients over 12 weeks.
2) 233 patients completed the program, losing on average 3.5 pounds per week for males and 2.5 pounds for females, with significant reductions in weight, waist size, BMI, blood pressure, cholesterol, triglycerides, and glucose.
3) The results demonstrate that IPWLM produces rapid and significant weight loss as well as improved metabolic markers in a short period of time.
This study examined how weight loss affects resting metabolic rate and its relationship to lean muscle mass and fitness levels in obese adults. Obese men and women were placed on a very low calorie diet and exercise program to lose 15% of their body weight over 3 months. Their resting metabolic rate, body composition via DXA scan, and fitness via VO2 max test were measured at baseline and after weight loss. The results found that resting metabolic rate, lean mass, and fitness all decreased with weight loss. While resting metabolic rate was positively correlated with lean mass at both timepoints, the changes in each were not correlated, suggesting other factors also influence changes in resting metabolic rate with weight loss.
The effect of high-fat versus high-carb diet on body composition in strength-...RefoRefaat
Low-fat, high-carb (LFHC) and low-carb, high-fat (LCHF) diets change body composition as a consequence of the reduction of body fat of overweight persons. The
aim of this study is the assessment of the impact of LFHC and LCHF diets on body
composition of men of a healthy body mass who do strength sports while maintaining the appropriate calorific value in a diet and protein intake. The research involved
55 men aged 19–35, with an average BMI of 24.01 ± 1.17 (min. 20.1, max. 26.1). The
participants were divided into two groups following two interventional diets: highfat diet or high-carb diet, for 12 weeks. The body composition of the participants
Antioxidant and protective effect of latex of Calotropis proceraRaman Sehgal
The document summarizes a study that evaluated the antioxidant and anti-diabetic effects of latex from the Calotropis procera plant against alloxan-induced diabetes in rats. The study found that daily oral administration of the latex at 100 and 400 mg/kg doses produced a dose-dependent decrease in blood glucose levels and increase in hepatic glycogen content in diabetic rats. It also prevented loss of body weight and reduced water consumption compared to diabetic controls. The latex treatment increased hepatic antioxidant levels like superoxide dismutase, catalase and glutathione, while decreasing lipid peroxidation levels. The antioxidant and anti-diabetic effects of the latex were comparable to the standard drug glibenclamide.
Impact of Yogic Exercise on Body Fat Percentage on Middle Aged Obese PeopleSports Journal
Purpose: The Purpose of the study was to find out the effect of yogic exercises on body fat percentage of middle aged obese people.
Selection of Subjects: For the present study 20 male obese people from locality of Bilaspur were selected randomly as the subjects for the study. The age of the subjects ranged between 40-50 years.
Selection of Variables: The variables selected for the present study were yogic training (independent variable), body fat percentage (dependent variable).
Methodology: For the study pretest – post-test randomized group design, which consists of control group (10 subjects) and experimental group (10 subjects) were used. The data were collected through the pretest, before training and post-test, after six weeks of yogic exercises training.
Statistical Technique: For comparing pre and post-test means of experimental and control groups, descriptive analysis and Analysis of Co-Variance (ANCOVA) were used and the level of significance was set at 0.05 level of confidence.
Result: The result of the study showed that there was insignificant difference between pre and post-test (experimental group) of body fat percentage.
1) A study investigated the metabolic phenotypes that determine an individual's response to dietary fat interventions in relation to biomarkers of insulin resistance.
2) The study analyzed data from 417 subjects with metabolic syndrome who were randomly assigned to one of four diet groups that varied fat and carbohydrate composition.
3) Based on changes in insulin resistance (HOMA-IR) levels, subjects were classified into three response groups: non-responders, responders whose insulin resistance improved, and responders whose insulin resistance worsened. Fasting insulin and C-peptide levels before the intervention predicted an individual's response to the dietary changes.
This document summarizes a study that compared lipid oxidation and perceived exertion levels during different types of exercise in obese individuals. Ten obese men performed three 45-minute exercises: continuous exercise at the fat max intensity, and two intermittent exercises that alternated between intensities above and below the fat max. While total energy expenditure was highest with continuous exercise, the amount of fat oxidized was equivalent across all exercises. Perceived exertion as measured by the Borg scale was lower for the intermittent exercises compared to continuous exercise. The study concludes that intermittent exercise is less strenuous but similarly effective for fat oxidation in obese individuals compared to continuous exercise.
This summary provides the key points from the document in 3 sentences:
The document discusses 3 studies that examined the effects of creatine monohydrate supplementation combined with resistance training on muscular strength and endurance. The studies found that subjects who took creatine monohydrate supplements showed significant increases in measures of muscular strength like 1 rep max for bench press and leg press compared to placebo groups. The studies support the hypothesis that creatine supplementation increases phosphocreatine levels and ATP production, leading to greater muscular strength and endurance gains with resistance training.
The study examined the differences in muscle hypertrophy between experienced (EXP) and inexperienced (INEXP) strength trainers over 12 weeks. 70 college students were divided into EXP and INEXP groups. Participants performed exercises 3 days/week and maximum weight lifted was measured at weeks 0, 6, and 12.
For the bench press, leg extension, and leg curl exercises, some groups saw significant differences between EXP and INEXP participants. For the bench press, Group 1-1 saw EXP lift 9.2 lbs more than INEXP from weeks 0-6. For the leg extension, Group 1-1 saw INEXP lift 14.8 lbs more than EXP from weeks 0-6, and Group 3
This study examined the effects of ezetimibe treatment for 3 months on glucose metabolism in 96 Japanese patients with type 2 diabetes and hypercholesterolemia. Ezetimibe treatment significantly lowered LDL-cholesterol levels. HbA1c levels decreased in approximately 50% of patients after treatment. Univariate analysis found that changes in HbA1c were associated with serum alanine aminotransferase levels, aspartate aminotransferase to alanine aminotransferase ratio, and age. Higher baseline ALT levels and an AST/ALT ratio below 1.0 were significantly associated with decreases in HbA1c following ezetimibe administration, suggesting ezetimibe may improve glucose control through effects on
This document summarizes the findings from the Food Choice at Work study, which assessed the effectiveness and cost-effectiveness of complex workplace dietary interventions focused on environmental modification alone or in combination with nutrition education. The study recruited employees from 4 manufacturing workplaces in Cork, Ireland and found that combining nutrition education and environmental strategies led to significant reductions in intakes of saturated fat, salt, and increases in nutrition knowledge compared to the control workplace. A small but significant decrease in BMI was also observed. An economic evaluation found that the combined intervention was cost-effective. The document concludes that combining multi-level intervention approaches shows promise for promoting healthy diets and weight loss in workplace settings.
Clinical Study done on GlucAffect. A product from Reliv International, a food science company - Mission: Nourish Our World. Better control and reversal of type 2 diabetes was noted. Best noted for blood sugar management.
2010 carbohydrate for weight and metabolic control- where do we standAgrin Life
This document reviews the evidence on carbohydrate intake for weight and metabolic control. It discusses how recommendations have generally advocated high carbohydrate intake but the prevalence of obesity and diabetes has still increased. Recent evidence suggests diets lower in carbohydrates and higher in unsaturated fats or protein may facilitate weight loss and improve health markers independent of weight loss. The document concludes that future studies are still needed to determine if diets with a more balanced macronutrient composition than currently recommended could better support weight and metabolic health.
This study investigated factors associated with weight loss and changes in body composition in a commercial weight reduction program. The study found that factors like food habits, skipping breakfast, marital status, stress levels, changes in physical activity and cardiovascular fitness had an impact on weight loss, body composition changes and fitness levels. A model combining macronutrient intake, stress levels and physical activity was found to have a strong association with weight loss and explained 42.13% of the variability in weight loss. Vegetarian diets, not skipping meals, and higher physical activity levels were associated with greater weight loss success.
This document summarizes a randomized controlled trial that compared weight loss and metabolic outcomes after 2 years on a low-carbohydrate versus low-fat diet. 307 participants were assigned to either a low-carbohydrate diet with limited carbohydrate intake (20g/day for 3 months, then increasing) or a low-fat diet with limited calorie intake (1200-1800 kcal/day). Both diets were combined with behavioral treatment. At 2 years, weight loss was similar (around 7kg) between groups. The low-carbohydrate diet resulted in greater improvements in blood lipids but also more initial side effects. Long-term weight loss requires ongoing behavioral support regardless of diet.
This document provides information on weight management and obesity, including classifications of nutritional status based on BMI and waist circumference, components of weight management interventions, weight management guidelines and constructing a nutritional care process for weight management. It defines classifications of weight status, discusses goals for obesity therapy including weight loss and maintenance. It also describes various dietary approaches for weight loss such as low-calorie, low-fat, high-protein low-carb diets and meal replacement programs. The document stresses the importance of a multicomponent approach including diet, physical activity and behavior therapy for successful long-term weight management.
1. Dietary interventions, exercise, and drug therapies can help with weight loss but maintaining long-term weight loss remains a challenge.
2. Studies show modest weight loss of 3-5kg on average from dietary and exercise changes alone but adherence is often low.
3. Combining dietary changes, increased physical activity, and drug therapies like Orlistat can result in greater initial weight loss of 5-10% but significant weight regain occurs over time.
This randomized controlled trial examined the effects of diet-induced weight loss, exercise-induced weight loss, exercise without weight loss, and a control group on obesity and related health factors in obese men over 3 months. It found that both diet-induced and exercise-induced weight loss groups lost approximately 7.5 kg (8%) of body weight, with greater total fat loss in the exercise group. Abdominal fat and insulin resistance decreased similarly in both weight loss groups. Exercise without weight loss reduced abdominal fat and prevented further weight gain, but did not change weight or insulin resistance.
The MedPass pilot project was implemented at a long-term care facility over 12 weeks to address malnutrition among elderly residents. Nineteen residents received a high-energy, high-protein nutritional supplement with their medications four times per day. Fifteen residents completed the study. The majority experienced positive weight gain and improved nutritional status based on screening scores. Administering supplements with medications increased consumption and appeared to benefit malnutrition.
This document discusses principles of weight management and obesity treatment. It outlines that the goal of obesity therapy is no longer an "ideal" weight, but a healthier weight loss of 5-15% of initial weight. Long-term behavioral and pharmacological studies show maximum weight losses of 10-15% can be achieved and maintained. Challenges include facilitating acceptance of modest goals and developing long-term treatment models.
This document outlines guidelines and recommendations for treating obesity in primary care. It discusses:
- Evaluating patients using BMI and waist circumference measurements annually and discussing obesity-related health risks.
- Recommending lifestyle interventions including calorie reduction, exercise over 200-300 minutes per week, and behavioral support over 6-12 months.
- Considering prescription of weight loss medications for patients with a BMI over 27-30 or referral for bariatric surgery for patients over 35-40.
- Managing obesity as a chronic disease by prescribing long-term interventions to support weight loss maintenance through behavior and habit changes.
This document discusses the evaluation and management of obesity by gastroenterologists. It covers assessing a patient's readiness to change, obtaining a medical history and physical exam, evaluating lifestyle factors, screening for psychological issues, and the potential role of endoscopy in initial and postoperative evaluation of bariatric surgery patients. Key aspects include using the stages of change model, motivational interviewing techniques, evaluating diet and exercise habits, screening for eating disorders, and being familiar with normal and abnormal postoperative anatomy after different bariatric procedures.
1) The study evaluated the Ideal Protein Weight Loss Method (IPWLM), a 4-stage ketogenic diet, on 272 patients over 12 weeks.
2) 233 patients completed the program, losing on average 3.5 pounds per week for males and 2.5 pounds for females, with significant reductions in weight, waist size, BMI, blood pressure, cholesterol, triglycerides, and glucose.
3) The results demonstrate that IPWLM produces rapid and significant weight loss as well as improved metabolic markers in a short period of time.
The Eating Behavior Questionnaire of Hendricks & Obesity Treatment FoundationEd J. Hendricks, M.D.
The EBQ is a novel behavioral psychometric scale for clinical evaluation of treatment effectiveness in treating overweight and obese patients with diet, lifestyle modification and pharmacotherapy.
Delivered for the 25th Annual Convention of the Philippine Association for the Study of Overweight and Obese (PASOO) at the EDSA Shangri-la Hotel in Manila.
Dr. Pramod Tripathi, Founder, Freedom From Diabetes Pvt Ltd on the topic of 'Reversing Diabetes and Lifestyle Disorders' at IFAH held at Le Meridien, Dubai on 16th - 18th December, 2019.
The document discusses various bariatric surgeries and their effectiveness, complications, and long-term outcomes. It finds that while restrictive procedures like bands and sleeves can initially cause weight loss, they often fail long-term as patients develop increased hunger and turn to unhealthy high-calorie foods and drinks. The mini-gastric bypass is presented as a more effective alternative, blocking the neuro-hormonal hunger system, inducing more durable weight loss and diabetes remission over 10-15 years with low complication rates according to studies of over 1000 and 1322 patients. A controlled trial also found the mini-gastric bypass was twice as effective at controlling diabetes as sleeve gastrectomy.
Lovidia Appetite Suppressant and Natural Hunger Control Supplement Martin Brown
Ambra BioScience – Lovidia was formed to develop and commercialize products that deliver measurable improvement in health and wellness. Lovidia Hunger Control Formula, the first GSM-based commercial product has been shown to reduce hunger in a randomized, double-blind, placebo-controlled clinical study with 220 subjects. The Company’s flagship product, Lovidia hunger control and weight loss, is based on the Company’s patented science known as Gut Sensory Modulation or GSM. GSM involves delivering GRAS (General Recognized As Safe) dietary ingredients orally past the stomach to the lining of the gut. Lovidia’s proprietary blend of GRAS ingredients is non-stimulating, vegan, non-GMO, gluten-free and dairy-free. There are two forms of Lovidia: (1) Lovidia, which is a natural Hunger Control blend that releases over 1-3 hours in your gut and (2) Lovidia XR (Extended Release) which releases the natural blend over 3-6 hours in your gut.
Calories, Carbs, or Quality? What Matters Most for Body WeightInsideScientific
The document summarizes a presentation by Kevin Hall on factors influencing body weight regulation. Hall discusses how dietary factors like amount of carbohydrates, fat, and ultra-processed foods affect human body weight based on studies using mathematical models of metabolism. A key finding is that consumption of ultra-processed foods leads to increased calorie intake and subsequent weight gain compared to unprocessed or minimally processed diets, even when calories are controlled.
This document discusses nutrition in surgical patients. It begins by outlining the goals of nutritional support, which include identifying patients at risk of malnutrition, preventing or reversing catabolism, and meeting energy requirements. It then covers topics like malnutrition, nutritional assessment tools, estimating energy needs, and administration of enteral and parenteral nutrition. The key points are that nutritional support should begin preoperatively for high-risk patients or if oral intake won't resume within 7 days post-op, and the enteral route is preferred over parenteral nutrition when possible.
Some stimuli, including specific foods, seem to have enough particularities to make a difference even if their potential to exert an influence a priori appears to be limited. This is the case of yogurt whose consumption is low relative to the amount of daily food consumed but that has been shown to be independently related to reduced body weight and fat. Numerous factors may explain a beneficial effect of yogurt on body weight stability and metabolic fitness. Cohort studies show that the consumption of dairy including yogurt is related to a reduced intake of high fat-high sugar foods, suggesting that the benefits of dairy food may be due to a decrease in the potential negative effects of unhealthy eating. The ability of yogurt to promote a negative energy balance is also likely explained by the satiating and thermogenic effects of some of its nutrients, e.g. calcium and proteins, via mechanisms involving gut hormones. Yogurt has a matrix that can accommodate structural changes affecting energy intake independently of its nutrient content. For instance, we recently demonstrated that the increase in the whey/casein ratio in a yogurt matched for volume and energy and protein content as a control yogurt significantly decreased subsequent energy intake to a much greater extent than the energy content of the yogurt preload. The presence of bacteria in yogurt represents another factor that may explain the effects of yogurt consumption on energy balance and its components. In this regard, recent data suggest that the supplementation of some probiotics facilitates appetite control and accentuates body weight loss in the context of a weight-reducing program. Finally, our recent analyses of relevant data in the Quebec Family Study reveal that yogurt consumption may be the signature of a global healthy lifestyle and food-related personal profile. Female yogurt consumers are more physically active, report a reduced percent energy intake as fat and display a lower disinhibition score than non-yogurt consumers. Taken together, yogurt has numerous features that may globally explain the decreased proneness of yogurt consumers towards excess body fat.
Slides Lezing Dr. Ir. Ben van Ommen TNO leefstijlcongresWim Tilburgs
Slides van de lezing van Dr. Ir. Ben van Ommen tijdens het eerste jaarlijkse leefstijlcongres georganiseerd door TNO en het Leids Universitair Medisch Centrum LUMC
This document discusses assessing a patient's diet and using low-calorie diets (LCD) and very low-calorie diets (VLCD) for weight loss and management. It provides information on factors that influence food choices, differences between plant-based and Western diets, strategies for changing diet and lifestyle, and using meal replacements and customizing protein intake as part of a weight loss plan.
Das ist ein Vortrag, den Dr. Clarence P. Davis im Jahre 2007 im Rahmen eines Anti-Aging Kongresses in Paris gehalten hat. Er beinhaltet theoretisches Basis- und Hintergrundswissen zu den verschiedenen Diaettypen, sowie einige praktische Beispiele aus dem aerztlichen Alltag. Der Vortrag ist auf einem hohen Niveau und richtet sich ausschliesslich an professionelle Leser mit fundierten Vorkenntnissen.
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1. Diet and/or behavior modification:
Long-term results
-5
-5
0
0
WEight change (kg)
WEight change (kg)
-5
-5
-10
-10 VLCD
VLCD
Modified diet + behavior
Modified diet + behavior
modification
modification
-15
-15
VLCD + behavior modification
VLCD + behavior modification
-20
-20
1
1 2
2 3
3 4
4 5
5
Intervention
Intervention Years after intervention
Years after intervention
(adapdet from Wadden TA. Ann Intern Med 1993; 119:688-93)
(adapdet from Wadden TA. Ann Intern Med 1993; 119:688-93)
Ann Intern Med. 1993 Oct 1;119(7 Pt 2):688-93. Links
Treatment of obesity by moderate and severe caloric restriction. Results of clinical
research trials.
Wadden TA.
Syracuse University, New York.
Recent studies of the treatment of obesity by moderate and severe caloric restriction show that
patients treated in randomized trials using a conventional 1200 kcal/d reducing diet, combined
with behavior modification, lose approximately 8.5 kg in 20 weeks. They maintain
approximately two thirds of this weight loss 1 year later. Patients treated under medical
supervision using a very-low-calorie diet (400 to 800 kcal/d) lose approximately 20 kg in 12
to 16 weeks and maintain one half to two thirds of this loss in the following year. Both dietary
interventions are associated with increasing weight regain over time, although regain can be
minimized with the recognition that obesity, in many cases, is a chronic condition that
requires continuing care. Patients who participate in a formal weight-loss maintenance
program, exercise regularly, or both are likely to achieve the best long-term results.
PMID: 8363198 [PubMed - indexed for MEDLINE]
2. Comparison of Energy Densities
Prentice AM et al Obes Rev. 2003 Nov;4(4):187-94
Obes Rev. 2003 Nov;4(4):187-94. Links
Fast foods, energy density and obesity: a possible mechanistic link.
Prentice AM,
Jebb SA.
MRC International Nutrition Group, London School of Hygiene and Tropical Medicine, UK.
andrew.prentice@ishtm.ac.uk
Fast foods are frequently linked to the epidemic of obesity, but there has been very little
scientific appraisal of a possible causal role. Here we review a series of studies demonstrating
that the energy density of foods is a key determinant of energy intake. These studies show that
humans have a weak innate ability to recognise foods with a high energy density and to
appropriately down-regulate the bulk of food eaten in order to maintain energy balance. This
induces so called 'passive over-consumption'. Composition data from leading fast food
company websites are then used to illustrate that most fast foods have an extremely high
energy density. At some typical outlets the average energy density of the entire menus is
approximately 1100 kJ 100 g(-1). This is 65% higher than the average British diet
(approximately 670 kJ 100 g(-1)) and more than twice the energy density of recommended
healthy diets (approximately 525 kJ 100 g(-1)). It is 145% higher than traditional African
diets (approximately 450 kJ 100 g(-1)) that probably represent the levels against which human
weight regulatory mechanisms have evolved. We conclude that the high energy densities of
many fast foods challenge human appetite control systems with conditions for which they
were never designed. Among regular consumers they are likely to result in the accidental
consumption of excess energy and hence to promote weight gain and obesity.
PMID: 14649369 [PubMed - indexed for MEDLINE]
3. Consistent weight loss in clinical trials
Weight loss (%) Placebo + Xenical +
diet diet
12 p<0.001 p<0.001
10.2% p<0.001
10 9.7%
8.8%
8
6.1% 6.6%
6 5.8%
4
2
0
Sjöström Rössner Davidson
Sjöström L et al Lancet. 1998 Jul 18;352(9123):167-72
Rössner S et al Obes Res. 2000 Jan;8(1):49-61
Davidson MH et al JAMA. 1999 Jan 20;281(3):235-42
Lancet. 1998 Jul 18;352(9123):167-72.Related Articles, Links
Comment in:
Lancet. 1998 Jul 18;352(9123):160-1.
Lancet. 1998 Oct 31;352(9138):1473-4.
Lancet. 1998 Oct 31;352(9138):1473; author reply 1474.
Randomised placebo-controlled trial of orlistat for weight loss and prevention of weight
regain in obese patients. European Multicentre Orlistat Study Group.
Sjostrom L, Rissanen A, Andersen T, Boldrin M, Golay A, Koppeschaar HP, Krempf M.
Sahlgrenska University Hospital, Goteborg, Sweden.
BACKGROUND: We undertook a randomised controlled trial to assess the efficacy and
tolerability of orlistat, a gastrointestinal lipase inhibitor, in promoting weight loss and
preventing weight regain in obese patients over a 2-year period. METHODS: 743 patients
(body-mass index 28-47 kg/m2), recruited at 15 European centres, entered a 4-week, single-
blind, placebo lead-in period on a slightly hypocaloric diet (600 kcal/day deficit). 688 patients
who completed the lead-in were assigned double-blind treatment with orlistat 120 mg (three
times a day) or placebo for 1 year in conjunction with the hypocaloric diet. In a second 52-
week double-blind period patients were reassigned orlistat or placebo with a weight
maintenance (eucaloric) diet. FINDINGS: From the start of lead-in to the end of year 1, the
orlistat group lost, on average, more bodyweight than the placebo group (10.2% [10.3 kg] vs
6.1% [6.1 kg]; LSM difference 3.9 kg [p<0.001] from randomisation to the end of year 1).
During year 2, patients who continued with orlistat regained, on average, half as much weight
as those patients switched to placebo (p<0.001). Patients switched from placebo to orlistat lost
an additional 0.9 kg during year 2, compared with a mean regain of 2.5 kg in patients who
continued on placebo (p<0.001). Total cholesterol, low-density lipoprotein (LDL) cholesterol,
LDL/high-density lipoprotein ratio, and concentrations of glucose and insulin decreased more
in the orlistat group than in the placebo group. Gastrointestinal adverse events were more
4. common in the orlistat group. Other adverse symptoms occurred at a similar frequency during
both treatments. INTERPRETATION: Orlistat taken with an appropriate diet promotes
clinically significant weight loss and reduces weight regain in obese patients over a 2-year
period. The use of orlistat beyond 2 years needs careful monitoring with respect to efficacy
and adverse events.
Publication Types:
Clinical Trial
Multicenter Study
Randomized Controlled Trial
PMID: 9683204 [PubMed - indexed for MEDLINE]
Obes Res. 2000 Jan;8(1):49-61.Related Articles, Links
Weight loss, weight maintenance, and improved cardiovascular risk factors after 2 years
treatment with orlistat for obesity. European Orlistat Obesity Study Group.
Rossner S, Sjostrom L, Noack R, Meinders AE, Noseda G.
Obesity Unit, Huddinge Hospital, Stockholm, Sweden. stephan.rossner@medhs.ki.se
OBJECTIVE: To determine the effect of orlistat, a new lipase inhibitor, on long-term weight
loss, to determine the extent to which orlistat treatment minimizes weight regain in a second
year of treatment, and to assess the effects of orlistat on obesity-related risk factors.
RESEARCH METHODS AND PROCEDURES: This was a 2-year, multicenter, randomized,
double-blind, placebo-controlled study. Obese patients (body mass index 28 to 43 kg/m2)
were randomized to placebo or orlistat (60 or 120 mg) three times a day, combined with a
hypocaloric diet during the first year and a weight maintenance diet in the second year of
treatment to prevent weight regain. Changes in body weight, lipid profile, glycemic control,
blood pressure, quality of life, safety, and tolerability were measured. RESULTS: Orlistat-
treated patients lost significantly more weight (p<0.001) than placebo-treated patients after
Year 1 (6.6%, 8.6%, and 9.7% for the placebo, and orlistat 60 mg and 120 mg groups,
respectively). During the second year, orlistat therapy produced less weight regain than
placebo (p = 0.005 for orlistat 60 mg; p<0.001 for orlistat 120 mg). Several obesity-related
risk factors improved significantly more with orlistat treatment than with placebo. Orlistat
was generally well tolerated and only 6% of orlistat-treated patients withdrew because of
adverse events. Orlistat leads to predictable gastrointestinal effects related to its mode of
action, which were generally mild, transient, and self-limiting and usually occurred early
during treatment. DISCUSSION: Orlistat administered for 2 years promotes weight loss and
minimizes weight regain. Additionally, orlistat therapy improves lipid profile, blood pressure,
and quality of life.
Publication Types:
Clinical Trial
Multicenter Study
Randomized Controlled Trial
PMID: 10678259 [PubMed - indexed for MEDLINE]
5. JAMA. 1999 Jan 20;281(3):235-42.Related Articles, Links
Erratum in:
JAMA 1999 Apr 7;281(13):1174.
Comment in:
JAMA. 1999 Jan 20;281(3):278-80.
Weight control and risk factor reduction in obese subjects treated for 2 years with
orlistat: a randomized controlled trial.
Davidson MH, Hauptman J, DiGirolamo M, Foreyt JP, Halsted CH, Heber D,
Heimburger DC, Lucas CP, Robbins DC, Chung J, Heymsfield SB.
Chicago Center for Clinical Research, Ill, USA.
CONTEXT: Orlistat, a gastrointestinal lipase inhibitor that reduces dietary fat absorption by
approximately 30%, may promote weight loss and reduce cardiovascular risk factors.
OBJECTIVE: To test the hypothesis that orlistat combined with dietary intervention is more
effective than placebo plus diet for weight loss and maintenance over 2 years. DESIGN:
Randomized, double-blind, placebo-controlled study conducted from October 1992 to
October 1995. SETTING AND PARTICIPANTS: Obese adults (body mass index [weight in
kilograms divided by the square of height in meters], 30-43 kg/m2) evaluated at 18 US
research centers. INTERVENTION: Subjects received placebo plus a controlled-energy diet
during a 4-week lead-in. On study day 1, the diet was continued and subjects were
randomized to receive placebo 3 times a day or orlistat, 120 mg 3 times a day, for 52 weeks.
After 52 weeks, subjects began a weight-maintenance diet, and the placebo group (n = 133)
continued to receive placebo and orlistat-treated subjects were rerandomized to receive
placebo 3 times a day (n = 138), orlistat, 60 mg (n = 152) or 120 mg (n = 153) 3 times a day,
for an additional 52 weeks. MAIN OUTCOME MEASURES: Body weight change and
changes in blood pressure and serum lipid, glucose, and insulin levels. RESULTS: A total of
1187 subjects entered the protocol, and 892 were randomly assigned on day 1 to double-blind
treatment. For intent-to-treat analysis, 223 placebo-treated subjects and 657 orlistat-treated
subjects were evaluated. During the first year orlistat-treated subjects lost more weight (mean
+/- SEM, 8.76+/-0.37 kg) than placebo-treated subjects (5.81+/-0.67 kg) (P<.001). Subjects
treated with orlistat, 120 mg 3 times a day, during year 1 and year 2 regained less weight
during year 2 (3.2+/-0.45 kg; 35.2% regain) than those who received orlistat, 60 mg (4.26+/-
0.57 kg; 51.3% regain), or placebo (5.63+/-0.42 kg; 63.4% regain) in year 2 (P<.001).
Treatment with orlistat, 120 mg 3 times a day, was associated with improvements in fasting
low-density lipoprotein cholesterol and insulin levels. CONCLUSIONS: Two-year treatment
with orlistat plus diet significantly promotes weight loss, lessens weight regain, and improves
some obesity-related disease risk factors.
Publication Types:
Clinical Trial
Multicenter Study
Randomized Controlled Trial
PMID: 9918478 [PubMed - indexed for MEDLINE]
6. Xenical: Long-term weight reduction
Veränderung Körpergewicht (%)
0 Placebo
Xenical® 60mg
-2 Xenical® 120mg
*p<0.01
-4
-6
-8
-10
-4 0 10 20 30 40 52 60 70 80 90 104
Sjöström L et al Lancet. 1998 Jul 18;352(9123):167-72
Lancet. 1998 Jul 18;352(9123):167-72.Related Articles, Links
Comment in:
Lancet. 1998 Jul 18;352(9123):160-1.
Lancet. 1998 Oct 31;352(9138):1473-4.
Lancet. 1998 Oct 31;352(9138):1473; author reply 1474.
Randomised placebo-controlled trial of orlistat for weight loss and prevention of weight
regain in obese patients. European Multicentre Orlistat Study Group.
Sjostrom L, Rissanen A, Andersen T, Boldrin M, Golay A, Koppeschaar HP, Krempf M.
Sahlgrenska University Hospital, Goteborg, Sweden.
BACKGROUND: We undertook a randomised controlled trial to assess the efficacy and
tolerability of orlistat, a gastrointestinal lipase inhibitor, in promoting weight loss and
preventing weight regain in obese patients over a 2-year period. METHODS: 743 patients
(body-mass index 28-47 kg/m2), recruited at 15 European centres, entered a 4-week, single-
blind, placebo lead-in period on a slightly hypocaloric diet (600 kcal/day deficit). 688 patients
who completed the lead-in were assigned double-blind treatment with orlistat 120 mg (three
times a day) or placebo for 1 year in conjunction with the hypocaloric diet. In a second 52-
week double-blind period patients were reassigned orlistat or placebo with a weight
maintenance (eucaloric) diet. FINDINGS: From the start of lead-in to the end of year 1, the
orlistat group lost, on average, more bodyweight than the placebo group (10.2% [10.3 kg] vs
6.1% [6.1 kg]; LSM difference 3.9 kg [p<0.001] from randomisation to the end of year 1).
During year 2, patients who continued with orlistat regained, on average, half as much weight
as those patients switched to placebo (p<0.001). Patients switched from placebo to orlistat lost
an additional 0.9 kg during year 2, compared with a mean regain of 2.5 kg in patients who
continued on placebo (p<0.001). Total cholesterol, low-density lipoprotein (LDL) cholesterol,
LDL/high-density lipoprotein ratio, and concentrations of glucose and insulin decreased more
7. in the orlistat group than in the placebo group. Gastrointestinal adverse events were more
common in the orlistat group. Other adverse symptoms occurred at a similar frequency during
both treatments. INTERPRETATION: Orlistat taken with an appropriate diet promotes
clinically significant weight loss and reduces weight regain in obese patients over a 2-year
period. The use of orlistat beyond 2 years needs careful monitoring with respect to efficacy
and adverse events.
Publication Types:
Clinical Trial
Multicenter Study
Randomized Controlled Trial
PMID: 9683204 [PubMed - indexed for MEDLINE]
Xenical: XENDOS-results
Placebo + Xenical +
(kg) 0 lifestyle modification lifestyle modification
–3
–4,1 kg
–6
–6,9 kg
–9
p<0.001 vs. Placebo
–12
0 52 104 156 208
Woche
Torgerson JS et al Diabetes Care. 2004 Jan;27(1):155-61
Diabetes Care. 2004 Jan;27(1):155-61.Related Articles, Links
Erratum in:
Diabetes Care. 2004 Mar;27(3):856.
XENical in the prevention of diabetes in obese subjects (XENDOS) study: a randomized
study of orlistat as an adjunct to lifestyle changes for the prevention of type 2 diabetes in
obese patients.
Torgerson JS, Hauptman J, Boldrin MN, Sjostrom L.
Department of Body Composition and Metabolism, Sahlgrenska University Hospital,
Goteborg, Sweden.
OBJECTIVE: It is well established that the risk of developing type 2 diabetes is closely linked
to the presence and duration of overweight and obesity. A reduction in the incidence of type 2
diabetes with lifestyle changes has previously been demonstrated. We hypothesized that
8. adding a weight-reducing agent to lifestyle changes may lead to an even greater decrease in
body weight, and thus the incidence of type 2 diabetes, in obese patients. RESEARCH
DESIGN AND METHODS: In a 4-year, double-blind, prospective study, we randomized
3,305 patients to lifestyle changes plus either orlistat 120 mg or placebo, three times daily.
Participants had a BMI >/=30 kg/m2 and normal (79%) or impaired (21%) glucose tolerance
(IGT). Primary endpoints were time to onset of type 2 diabetes and change in body weight.
Analyses were by intention to treat. RESULTS: Of orlistat-treated patients, 52% completed
treatment compared with 34% of placebo recipients (P < 0.0001). After 4 years' treatment, the
cumulative incidence of diabetes was 9.0% with placebo and 6.2% with orlistat,
corresponding to a risk reduction of 37.3% (P = 0.0032). Exploratory analyses indicated that
the preventive effect was explained by the difference in subjects with IGT. Mean weight loss
after 4 years was significantly greater with orlistat (5.8 vs. 3.0 kg with placebo; P < 0.001)
and similar between orlistat recipients with impaired (5.7 kg) or normal glucose tolerance
(NGT) (5.8 kg) at baseline. A second analysis in which the baseline weights of subjects who
dropped out of the study was carried forward also demonstrated greater weight loss in the
orlistat group (3.6 vs. 1.4 kg; P < 0.001). CONCLUSIONS: Compared with lifestyle changes
alone, orlistat plus lifestyle changes resulted in a greater reduction in the incidence of type 2
diabetes over 4 years and produced greater weight loss in a clinically representative obese
population. Difference in diabetes incidence was detectable only in the IGT subgroup; weight
loss was similar in subjects with IGT or NGT [correction].
Publication Types:
Clinical Trial
Randomized Controlled Trial
PMID: 14693982 [PubMed - indexed for MEDLINE]