| January 21,
2001
Combining Weight
Loss Medication with Strong Diet and Exercise Program
Triples Weight Loss Over Use of Medication Alone
Penn Study Finds Combination also Increases Patient
SatisfactionPenn Study
Philadelphia, PA -- Researchers
at the University of Pennsylvania Medical Center report
today in the Archives of Internal Medicine ( January
22, 2001) that obese women lost an average 24.4 pounds
(10.8 percent of their body weight) in one year, when
they used the weight loss medication MERIDIA in combination
with a comprehensive lifestyle modification program
that included diet and exercise -- compared to a loss
of only 8.4 pounds (4.1%) for women treated by medication
alone.
Participants in both groups were prescribed 10-to-15
milligrams per day of MERIDIA, a weight loss medication
manufactured by the Knoll Pharmaceutical Co. They were
also told to limit their daily food intake to 1,200-to-1,500
calories, and to exercise four to five times a week.
For the first five months, those in the lifestyle modification
program also attended weekly group sessions in which
they learned to keep food and activity records, to plan
their meals and snacks, and to control situations associated
with problem eating.
Women in the group that received only medication had
10 brief physician visits over the year, during which
a doctor monitored their health but did not provide
detailed instruction in lifestyle modification. These
participants received general advice and support, comparable
to treatment that would be provided by most primary
care doctors.
"The results clearly demonstrate the benefits of combining
medication with lifestyle modification," said Thomas
A. Wadden, Ph.D., director of the Weight and Eating
Disorders Program at the University of Pennsylvania
and the study's lead author.
"These medications may decrease the desire to eat by
reducing hunger and cravings or by increasing feelings
of fullness; they modify internal (physiological) factors
that control eating," Wadden said. "Lifestyle modification,
by contrast, helps people control their external environment
by teaching them to reduce portion sizes, avoid fast-food
restaurants, store foods out of sight, and plan meals
and snacks in advance. Weight loss medications are not
a substitute for an individual's own efforts to improve
eating and activity habits.
" A third group of women was also provided medication
combined with lifestyle modification. But during the
first 4 months, members of this group limited their
food intake to 1000 calories a day, consisting of four
servings daily of a nutritional supplement (OPTIFAST
800, manufactured by the Novartis Nutrition Co.) and
a frozen food entrée for dinner.
At the end of the year, these women had lost an average
35.5 pounds (16.5% of their initial weight) -- representing
"outstanding weight loss," according to Robert I. Berkowitz,
M.D., Medical Director of the Weight and Eating Disorders
Program and co-author of the study. "The next step is
to determine whether continuing the medication long-term
will help patients maintain these large weight losses,"
he said.
The study also found that participants had highly unrealistic
weight loss expectations. Before treatment, women in
all three groups reported that they expected to lose
the equivalent of 25% of their initial body weight,
even after investigators had told them to expect a loss
of only 5%-15%. The participants treated by medication
alone achieved by far the smallest percentage of their
expected weight loss and were the least satisfied with
changes in their weight, health, and appearance. Those
who received the combination approach were significantly
more satisfied with their outcomes, but were only moderately
satisfied over all.
"We have to help people realize that a loss of five
to 10 percent of their initial body weight is a real
therapeutic success," Wadden said. "Most overweight
women won't look like Cindy Crawford after treatment,
but they can improve their health and vitality by losing
those first 10-to-20 pounds."
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