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Weight loss less than 11 lbs with diet and lifestyle, 11-22 lbs with drugs, and 55-165 lbs w/surgery
Wednesday, July 06, 2005 7:50 am Email this article
When considering only patients who lose at 5 percent of their body weight by the end of weight loss studies, diet and lifestyle changes cause an average weight loss of less than 11 pounds after 2-4 years; weight loss medications cause an average weight loss of 11 to 22 pounds after 1-2 years; and weight loss surgery causes an average weight loss of 55-165 pounds after 2-4 years according to a new review from researchers at McMaster University in Ontario, Canada. Diet and lifestyle changes: 8 lbs after 2-7 years
Diet and lifestyle changes cause an average weight loss of
- 7.7 pounds after 2-3 years, and
- 7.9 pounds after 4-7 years.
Diet drug studies average weight loss: 13 lbs after 1 year, 16 lbs after 2 years
Diet and lifestyle changes cause an average weight loss of
- 13.4 pounds after 1 year, and
- 15.8 pounds after 2 years.
Weight loss surgery: 62-161 lbs after 2 years, 37-161 lbs after 3 years
Weight loss surgery cause an average weight loss of
- 62-161 pounds after 2 year,
- 37-161 pounds after 3 years.
Weight loss surgery: 1-2 people out of every 200 die due to the surgery
The risk of dying after weight loss surgery is 0.5 to 1 percent, or 1 to 2 people out of every 200 that are operated on, although laproscopic surgeries—done with long instruments through small incisions, are associated with fewer complications.
Diet drug studies: 40-60% lost 5%, 3-times more likely than diet alone
In studies using diet drugs, 40-60 percent of patients lost at least 5 percent of their body weight.
This was 2.9 times as many people as in the diet only groups.
Xenical (orlistat) increased odds of 5% loss 2.5-fold after 1 year, 4.6-fold after 2 years
Xenical (orlistat) increased the likelihood of patients losing at least 5 percent of their body weight
- 2.5-fold after 1 year, and
- 4.6-fold after 2 years.
Meridia (sibutramine) increased odds of 5% loss 5-fold after 1 year, 4.4-fold after 2 years
Meridia (sibutramine) increased the likelihood of patients losing at least 5 percent of their body weight
- 5-fold after 1 year, and
- 4.4-fold after 2 years.
Glucophage (metformin) associated with weight loss of less than 7 lbs
Glucophage (metformin) was associated with a weight loss of less than 6.6 pounds.
One study found that patients lost more weight with lifestyle changes (12.3 pounds) than by using Glucophage (metformin) (4.6 pounds).
Diet and lifestyle changes tended to reduce blood pressure
Weight loss studies using diet and lifestyle changes tended to find a decrease in blood pressure, however, the reduction was statistically significant in some studies, but not in others.
Diet and lifestyle changes reduce blood pressure 5-7 points in diabetics
In studies of diabetics or people with impaired glucose tolerance, a weight loss of less than 11 pounds was associated with a reduction in blood pressure of 5-7 / 5-6 mmHg.
Diet and lifestyle changes reduced the risk of diabetes by two-thirds
“In three studies of subjects with impaired glucose tolerance or type 2 diabetes who received dietary/lifestyle and exercise counselling or usual care, counselling conferred a 58-63% lower risk of type 2 diabetes,” they noted.
Weight loss surgery reduced the risk of diabetes by 84%
According to one study which compared weight loss surgery to weight loss with out surgery, those who underwent surgery were 84 percent less likely to get diabetes after 8 years.
Weight loss surgery did not reduce risk of hypertension
However, weight loss surgery did not reduce the risk of hypertension at all.
Diet and lifestyle changes did not consistently reduce blood pressure in those with hypertension
“[However,] in studies of subjects with hypertension, the effects on blood pressure control were inconsistent,” the authors noted.
Diet and drugs may only improve risk factors for cardiovascular disease in patients with risks
Many papers on obesity have written that losing 5-10 percent of body weight or more reduces risk factors for heart disease such as blood pressure, cholesterol, etc.
However, this current paper notes that this much weight loss—or this little weight loss, depending on how you want to look at it—does not necessarily reduce risk factors, except in people with elevated risk factors.
However, this makes perfect sense. Why would we expect risk factors to be reduced if they are not elevated in the first place. This is common in studies on blood pressure; people with normal blood pressure who lose weight tend to not have a decrease in blood pressure.
Intentional weight loss associated with increased lifespan in patients with disease
“ntentional weight loss is associated with increased longevity but only in people with pre-existing disease,” the authors note.
“There are three conclusions from this review:
“(1) in terms of weight loss efficacy, dietary/lifestyle therapy provides [less than an 11 pound] weight loss after 2-4 [years], pharmacologic therapy provides [11-22 pounds] weight loss after 1-2 [years], and surgical therapy provides [55-165 pound] weight loss after 2-4 [years];
“(2) weight loss of [less than] 5% is not consistently associated with improvements in cardiovascular risk factors, and when improvements occur they are mainly in high-risk groups and appear to be intervention specific; and
“(3) weight loss studies have methodologic limitations that restrict their application to everyday clinical practice,” the authors concluded.
Data only from subjects who lost at least 5%
This review paper analyzed data from studies lasting at least 2 years.
They only included data from people who lost at least 5 percent of their body weight at the end of the study.
Diet and lifestyle studies: 16 studies, 5698 people
Their review included 16 diet and lifestyle studies which included 5698 people with an average age of 40-59 years-old, and an average starting weight of 172-255 pounds.
30% of US adults obese, 64% overweight
In 2000, 30 percent of U.S. adults were obese, that is had a body mass index (BMI) of 30 or more, and another 34 percent were overweight with a BMI of 25-29.9 the authors noted.
The prevalence of obesity in the U.S. has increased by 50-60 percent since 1980 they note.
80% of people regain weight slowly, not seen in short-term studies
More than 80 percent of people who lose weight, regain weight slowly, taking more than 6 months to do so, therefore, short-term studies cannot detect this weight regain.
Douketis J, Macie C, Thabane L, Williamson D. Systematic review of long-term weight loss studies in obese adults: clinical significance and applicability to clinical practice. Int J Obes Relat Metab Disord. 2005 Jul 5.
Dr. J. D. Douketis
St Joseph’s Hospital, Room F-541
50 Charlton Ave East
Hamilton, ON, Canada L8N 4A6
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