Orlistat, an obesity drug, may also be effective when taken at
higher doses, researchers found.
More than one third of U.S. adults are obese, and obesity raises the
risk of heart disease, type 2 diabetes and some types of cancer.
Losing weight - and keeping it off - can reduce those risks.
“Long term weight loss through changes in eating and physical
activity is possible, even in adults who have already acquired
obesity related illness, and effective weight loss programs are now
available,” researchers led by Stephan Dombrowski of Newcastle
University in the UK write.
They pooled data from 45 studies that included a total of 7,788
adults who had lost at least five percent of their body weight. The
studies looked at people’s ability to keep the weight off for a
minimum of one year.
Forty-two of the studies included an initial phase meant to produce
weight loss. The participants in those studies lost an average of
about 24 pounds.
The studies all looked at medication or lifestyle changes such as
diet, physical activity and meal replacements, either alone or in
combination, to help with weight loss maintenance.
The researchers found that people participating in programs that
combined diet and exercise gained back 3.4 fewer pounds after one
year compared to people receiving no extra help with weight
maintenance or standard treatment only.
They also found that combining Orlistat with behavioral changes
resulted in 4 fewer pounds regained after one year compared to
participants who took a drug-free placebo.
Orlistat appeared to be more effective at larger doses, according to
results published in the British medical journal BMJ. But the drug
also came with gastrointestinal side effects.
Lori Rosenthal said the findings echo previous research and that it
was “interesting” that the authors included data from so many
studies.
Rosenthal is a dietician at Montefiore Medical Center in Bronx, New
York. She was not involved in the new review.
“I think it’s great that they covered so many different studies but
there’s also so much variety and the long-term research isn’t there,
you know - going beyond 24 months,” she told Reuters Health.
Still, “We know that interventions like diet and physical activity
are really important in preventing weight regain after losing,” she
said.
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Rosenthal noted that participants who had dropped out of the
programs were not always included in the findings, and that could
affect the review’s results.
“Weight management is hard,” she said. “People have to realize that
it’s not just the losing it - it’s for life, and if you don’t like
what you’re doing, if it doesn’t work for you, you’re not going to
stick with it.”
Support during the weight management phase is important, Rosenthal
added. There are support groups and dietitians who can give people
tricks and tools to help make it easier, she said.
She offered some advice for people who have lost weight and are
moving into a maintenance phase.
“It’s really important to remember that weight management is a mind
and a stomach game,” she said. “You have to feel good about what
you’re having.”
“Really make sure you find foods you like - that you’re choosing
foods not because you’re on a diet but because you like them,”
Rosenthal said. “You have to like them more than the other things
you were eating before.”
Rosenthal said that if people don’t like the new foods they eat or
their new routine, they will be more likely to go right back to old
habits.
She said being mindful and chewing slowly also allows people to
enjoy their food and eat less.
SOURCE: http://bit.ly/REgqxK BMJ,
online May 14, 2014.
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