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Controlled Clinical Trial
. 2013:2013:325464.
doi: 10.1155/2013/325464. Epub 2013 Apr 22.

Changes in body composition, cardiovascular disease risk factors, and eating behavior after an intensive lifestyle intervention with high volume of physical activity in severely obese subjects: a prospective clinical controlled trial

Kjersti Karoline Danielsen  1 , Mette Svendsen, Sverre Mæhlum, Jorunn Sundgot-Borgen
Affiliations
Controlled Clinical Trial

Changes in body composition, cardiovascular disease risk factors, and eating behavior after an intensive lifestyle intervention with high volume of physical activity in severely obese subjects: a prospective clinical controlled trial

Kjersti Karoline Danielsen et al. J Obes. 2013.

Abstract

We examined the effects of a 10-14-weeks inpatient lifestyle modification program, including minimum 90 min of physical activity (PA) five days/week, on body composition, CVD risk factors, and eating behavior in 139 obese subjects (BMI 42.6 ± 5.2 kg/m²). Completion rate was 71% (n = 71) in the intensive lifestyle intervention (ILI) group and 85% (n = 33) among waiting list controls. Compared to controls body weight (-17.0 (95% CI: -18.7, -15.3) kg, P < 0.0001), fat mass (-15.2 (95% CI: -17.4, -13.1) kg, P < 0.0001), fat free mass (-1.2 (95% CI: -2.2, -0.2) kg, P = 0.016) and visceral fat (-86.6(95% CI: -97.4, -75.7) cm², P < 0.0001) were reduced in the ILI-group after 10-14 weeks. Within the ILI-group weight loss was -23.8 (95% CI: -25.9, -21.7) kg, P < 0.0001 and -20.3 (95% CI: -23.3, -17.3) kg, P < 0.0001, after six and 12 months, respectively. Systolic BP, glucose, triglycerides, and LDL-C were reduced, and HDL-C was increased (all P ≤ 0.006) after 10-14 weeks within the ILI group. The reduction in glucose and increase in HDL-C were sustained after 12 months (all P < 0.0001). After one year, weight loss was related to increased cognitive restraint and decreased uncontrolled eating (all P < 0.05). Thus, ILI including high volume of PA resulted in weight loss with almost maintenance of fat-free mass, favorable changes in CVD risk factors, and eating behavior in subjects with severe obesity.

Trial registration: ClinicalTrials.gov NCT01675713.

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Figures

Figure 1
Figure 1
The schedule of the nonrandomised controlled clinical trial and the prospective follow-up study; participant recruitment, assessments, and stays during the lifestyle programme at NIMI Ringerike.
Figure 2
Figure 2
Flow of participants throughout the study.
Figure 3
Figure 3
(a) Mean (95% CI) percentage weight loss during followup. (b) Mean (95% CI) percentage reduction in VFA during followup. (c) Mean (95% CI) percentage reduction in FM during followup.
Figure 4
Figure 4
BMI value for each subject within the ILI-group at week 0, week, 10–14, six, and 12 months. Note: two subjects had a BMI < 35 kg/m2 at week 0 due to a small weight reduction between the time of referring and the start of the treatment program.
Figure 5
Figure 5
The prevalence of metabolic syndrome within the ILI-group at week 0, weeks 10–14, six, and 12 months (n = 52). P < 0.0001 for change in the proportion of participants diagnosed with metabolic syndrome across the four measurement time points (Cochran's Q test).
Figure 6
Figure 6
Mean (95% CI) scores of eating behavior (TFEQ-21) at week 0, weeks 10–14, six, and 12 months followup. # P < 0.007 for differences in changes between ILI-group and controls, *P < 0.02 for changes within the ILI-group from weeks 10–14 to six months, **P = 0.012 for changes within the ILI-group from six to 12 months, and ***P < 0.04 for changes within the ILI-group from week 0 to 12 months.
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