Conference: Annual Scientific Meeting of The Obesity Society, At Atlanta, GA, USA
Shadid et al 2013
ABSTRACT Introduction: Disappointing long-term results from medical treatment have led
to the increasing application of bariatric surgery in class 3 obesity (CL3OB). We report
continuing results from our behavior modification program, which aims to provide an
alternative for surgery.
Methods: 95 adults with CL3OB or CL2OB with major obesity-related complications (Body
Mass Index (BMI) 44.2 ± 0.6 kg/m2), age 48.8 ± 1.3 yr) followed 10 group lessons alternated
with individual consultations with highly trained professionals. Individualized exercise and
diet instructions (1200-2000 kCal/day) were given. 124 controls (BMI 42.9 ± 0.5 kg/m2, age
50.9 ± 1.1 yr) received standard care.
Results: 2-year weight loss of completers (n=62) averaged 18.2 ± 1.2 kg* (14 ± 1% of IBW,
25 ± 2% of excess body weight (EBW)). 41 patients lost ≥ 10% of IBW, 14 of whom ≥ 20%,
and 3 ≥ 30%. Several reached these amounts later. Controls gained 1.0 ± 0.7 kg (0.8 ± 0.6 %
of IBW, 1 ± 1% of EBW), 2 people losing ≥ 10% IBW. Last observation carried forward
analysis (LOCFA) showed mean weight loss of 15.1 ± 1.4 kg* (11 ± 1 % of IBW, 21 ± 2% of
EBW). Preliminary results show weight maintenance of successful subjects up to 3.5 years:
23 (out of the potential 61) patients completing 3 years lost 19 ± 1% of IBW (12 ± 1% in the
LOCFA). 20-35% of our results would have been considered at least satisfactory by various
surgical standards. Metabolic and cardiovascular parameters largely improved despite
lowering of medication.
Conclusion: Non-surgical mid/long term weight loss is achievable in severely obese patients
in outpatient settings; the efficacy/safety trade-off in obesity treatment is an important
consideration in interpreting these results. *p<0.001
