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A recent study examined how intensive behavioural therapy may be a useful weight loss therapy resulting in real change among participants.
Obesity is a rising cause for concern the world over and it is linked to a number of medical conditions that pose a significant burden on healthcare resources. The Centers for Medicare & Medicaid Services in the United States has been working on a specific approach for weight loss therapy, called Intensive Behavioural Therapy (IBT), for obesity.
A recent study examined if this approach does result in a significant change through a randomized trial. This trial, conducted by the University of Pennsylvania, used an open-label design to test IBT and its delivery in clinical practice without placebo. The study also examined the efficacy of liraglutide, which is a medication to control weight gain. They published their results in the journal Obesity.
Eligible participants for this study were between the age of 21 and 70 years with a BMI measurement between kg/m2, who had 30 to 55 prior attempts at weight loss before considering anti-obesity medication. The clients agreed to participate for a year. All interventionists prior to initiating treatment underwent four to six hours of instruction to deliver IBT and are certified after conducting two role-play visits satisfactory. Individual supervision was also provided once a month for 30-60 minutes.
The primary outcome they measured in the study was a reduction in body weight at week 52 compared to the beginning of the study. The measurements are done by certified staff at random and also at weeks 24 and 52 and during IBT visits to provide feedback to the participants. Blood pressure, lipids, triglycerides, glucose, insulin, C-reactive protein, and blood pressure were examined using standardized methods. Symptoms of depression and quality of life are two other variables they also studied.
Following 21 brief sessions of IBT, meaningful weight loss occurred over a period of a year. They also found that adding liraglutide to IBT resulted in double the weight loss over the same time period. As far as researchers are aware, this is the first-of-its-kind study to use a randomized controlled trial to test the efficacy of IBT for obesity.
It is seen that participants in the IBT-alone group lost 6.1 % of their weight during the one-year period. About 44% of the participants did lose either 5% or more of their weight during the same one-year period which is one of the defining criteria for clinically significant weight loss. Participants who attended all the counselling visits lost 9.7% of baseline weight compared to those with lower attendance losing 3.5%.
The strengths of the study include a high level of participation, retention, and engagement of the participants in weight loss therapy. The limitations include that the study did not include older adults over the age of 65 years. Another limitation is that the study was not conducted in a primary care setting.
The implications of the study are important indicating that physicians can certainly provide the right kind of IBT treatment for obesity through weight loss therapy. This necessitates a need for specialized instructions for other non-speciality practitioners to provide the same kind of care. This shows that an increase in access to IBT could significantly reduce the cost of this service and yield promising results in weight loss management practices.
Written by Sonia Leslie Fernandez, Medical News Writer
Reference: Wadden, T., Walsh, O., Berkowitz, R., Chao, A., Alamuddin, N., Gruber, K., Leonard, S., Mugler, K., Bakizada, Z. and Tronieri, J. (2018). Intensive Behavioral Therapy for Obesity Combined with Liraglutide 3.0 mg: A Randomized Controlled Trial. Obesity.