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Contrave plus diet, exercise and behavior mod causes weight loss of 9.3% vs 5.1%
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Thursday, August 19, 2010 10:18 am Email this article
People given Contrave (bupropion SR (Wellbutrin) plus naltrexone SR) combined with an intensive program of diet, exercise, and behavior modification therapy lost an average of 9.3% of body weight compared to 5.1% for those given a placebo according to a new one-year (56-week) study.
The average weight loss in the drug group was 21 lbs, reducing their body weight from 224 lbs to 203 lbs, a 9.3% weight loss, compared to an average weight loss in the placebo group was 11 lbs, reducing their body weight from 220 lbs to 209 lbs, a 5.1% weight loss.
Note: This weight loss is the average for patients who either completed the entire one-year study, and the last weight measured if the patient dropped out later in the study. For example, if a patient had lost 8% after 8 months, and then dropped out of the study, a weight loss of 8% would be recorded as the amount of weight lost even though the patient did not complete the entire study. Drug Doses
Wellbutrin SR (bupropion sustained-release): 360 mg per day; naltrexone SR: 32 mg per day
The dose of Wellbutrin SR (bupropion sustained-release) was 360 mg per day, plus 32 mg of naltrexone SR per day.
Subjects
Subjects: 584 in the drug group; 200 in the placebo group
The study involved 584 people in the drug group versus 200 in the placebo group.
Weight Loss
Weight Loss: 21 lbs vs 11 lbs
The average weight loss in the drug group was 21 lbs, reducing their body weight from 224 lbs to 203 lbs, a loss of 9.3% of body weight.
The average weight loss in the placebo group was 11 lbs, reducing their body weight from 220 lbs to 209 lbs, a loss of 5.1% of body weight.
Dropouts
Forty-two percent (42%) of both the drug group and the placebo group did not complete the study.
This means that 58% completed the one year (56 week) study.
Dropouts Due To Adverse Effects
One-fourth (25%) of the drug group dropped out due to side effects compared to 12 percent for the placebo group.
Dropouts During the First Month
<15% of the drug group dropped out during the first month
Fifteen percent (15%) of the drug group dropped out in the first month due to side effects.
Diet
Diet: 1200 calories per day for those 249 lbs or less
The following calorie intake was prescribed based on a person’s body weight:
- 1200 calories per day for those weighing 249 lbs or less
- 1500 calories per day for those weighing 250-299 lbs
- 1800 calories per day for those weighing 300-349 lbs
- 2000 calories per day for those weighing 350 lbs or more
Diet Composition
Diet composition: 15-20% protein, 30% or less fat
“All participants were instructed to consume a balanced deficit diet of conventional foods that provided approximately 15–20% of energy from protein, 30% or less energy from fat, and the remainder from carbohydrate,” the paper notes.
Exercise
Exercise: 25 minutes of brisk walking per day for 6 months; 50 minutes per day for next 6 months
Patients were “encouraged, during the first 6 months, to gradually increase to 180 min/week of planned moderately vigorous physical activity (typically brisk walking). [ This is the equivalent of 25 minutes per day. ]
“Participants were further instructed to keep daily records of their activity, to increase their lifestyle activity, and to engage in strength training, if desired. During months 7–12, they were encouraged to aim for up to 360 min of activity per week. [ This is the equivalent of 50 minutes per day. ]”
Group Therapy
Group therapy held once a week for first 4 months, then every other week
“All participants in both treatment groups received an intensive program of BMOD that was delivered to groups of 10–20 persons by registered dietitians, behavioral psychologists, or exercise specialists.
“Group meetings lasted 90 min (including the weigh-in) and were held weekly for the first 16 weeks, every other week for the next 12 weeks, and monthly thereafter (yielding a total of 28 sessions).”
REFERENCE
Wadden TA, Foreyt J, Foster G, Hill J, Klein S, O’Neil PM, Perri M, Pi-Sunyer FX, Rock C, Erickson J, Maier H, Kim D, Dunayevich E. Weight loss with naltrexone sr/bupropion sr combination therapy as an adjunct to behavior modification: The cor-bmod trial. Obesity (Silver Spring). 2010 Jun 17, Epub ahead of print.
AUTHOR’S CONTACT INFORMATION
Thomas A. Wadden
Department of Psychiatry
Center for Weight and Eating Disorders
University of Pennsylvania School of Medicine
Philadelphia, Pennsylvania, USA
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