Half of the Danish population are obese, while 17 percent live with weight problems. Worldwide, practically 40 percent are obese and 13 percent deal with obesity.
The condition is connected with increased danger for sudden death, as well as sequelae such as Type 2 diabetes, cardiovascular diseases, cancer, and infertility.
The cravings increases all at once with reduced energy intake, and this counteracts weight loss upkeep. In addition, a weight loss can provoke loss of muscle mass, while the body lowers the energy consumption. Thus, when the focus in obesity treatment has actually been on how to obtain a weight loss– rather than how to keep a weight loss– it is really difficult to do something about your circumstance,” states Signe Torekov.
The scientists observed additional weight loss in this group, and the overall weight loss was around 16 kg over one year. That is necessary, since preserving weight loss is incredibly hard.
Weight restore after a preliminary successful weight-loss in individuals with obesity, makes up an unsolved and essential issue. Up until now, no well-documented research study on which treatment approach is best for keeping a healthy weight reduction has actually been offered.
Scientists at University of Copenhagen and Hvidovre Hospital have actually finished a spectacular study, which has been published worldwides most priced estimate medical journal, The New England Journal of Medicine. By evaluating 4 various types of treatment following a diet-induced weight loss, the scientists show for the first time how it is possible for individuals with obesity to preserve long-lasting weight loss, says Professor Signe Torekov at the Department of Biomedical Sciences.
Modification in body weight. Credit: Karina Kjærgård Kranker
In a randomized scientific trial, the group of researchers has actually shown a highly efficient treatment after a diet-induced weight reduction, by integrating moderate to vigorous-intensive workout with appetite-inhibiting obesity medication, an analog to the appetite-inhibiting hormonal agent GLP-1.
” This is new understanding for doctors, dietitians, and physiotherapists to utilize in practice. This is evidence that we have actually been missing out on,” describes Signe Torekov, who has actually been heading the study.
” The problem is that individuals are combating versus strong biological forces when slimming down. The appetite increases at the same time with decreased energy consumption, and this counteracts weight-loss maintenance. We have an appetite-stimulating hormonal agent, which increases drastically when we lose weight, and at the same time the level of appetite-suppressing hormones drops dramatically. In addition, a weight-loss can provoke loss of muscle mass, while the body lowers the energy intake. Thus, when the focus in obesity treatment has actually been on how to acquire a weight reduction– instead of how to maintain a weight loss– it is really hard to do something about your situation,” states Signe Torekov.
When integrating treatments, extremely effective
215 Danes with weight problems and low physical fitness ratings took part in the study. The participants at first followed a low calorie diet plan over eight weeks, where they each lost approximately 13 kg, which brought considerable improvements to their health with a drop in blood glucose level and blood pressure.
Two of the groups got placebo medication, while the two other groups received obesity medication. The 2 groups receiving obesity medication were likewise divided into one group with and one group without a workout program.
Change in body fat mass and lean fat mass. Credit: Karina Kjærgård Kranker
All participants in the study were weighed monthly and received dietary and diet counseling with the concentrate on healthy weight-loss according to the guidelines from the Danish health and food administrations.
After one year, the group with exercise alone and the group with obesity medication alone kept the weight loss of 13 kg and health improvements. The placebo group acquired half of the weight back with wear and tear of all risk aspects, for instance for development of Type 2 diabetes and cardiovascular disease.
The most remarkable improvements happened in the mix group, which followed the workout program and received weight problems medication. The researchers observed extra weight-loss in this group, and the total weight reduction was approximately 16 kg over one year. The health benefits were likewise double that of each of the single treatments, i.e., two times the loss of fat mass while preserving muscle mass, greater physical fitness rankings, reduced blood sugar and improved quality of life.
The two groups that exercised increased their fitness ranking, lost fat mass, and gained muscle mass. This could show a much healthier weight-loss than for people, who had just lost fat mass without increasing the physical fitness ranking.
” It is an important aspect to highlight, as you do not always get a healthier body from slimming down if, at the same time, you lose a great deal of muscle mass,” states Signe Torekov.
” It is great news for public health that a significant weight loss can be kept with exercise for approximately 115 minute weekly performed primarily at vigorous-intensity, such as biking. And that by combining exercise with obesity medication, the result is twice as excellent as each of the specific treatments.”
With the study, the researchers now hope individuals with obesity, together with their care company, can develop a beneficial framework for preserving the weight-loss.
Basic lifestyle modification
Signe Torekov explains that lots of people with obesity have actually attempted to reduce weight prior to, only to regain the weight. This takes place, due to the fact that the general recommendations is to consume healthier and work out more.
” Without a follow-up on whether people really have support to carry out workout, the treatment will not suffice. We likewise followed up with the participants on a continuous basis to ensure that they received the support they required in order to exercise. That is required, due to the fact that preserving weight reduction is incredibly tough. People require to understand this. When you have reduced weight, you are not “cured.” “The ongoing exercise and effort will likely need to continue for many years,” states Signe Torekov.
” Our research study also demonstrates that without a structured treatment strategy, there is a high risk of acquiring the weight back. There were 12 specific assessments over the course of a year, including weighing and diet recommendations from Danish authorities according to standards for healthy weight upkeep. This was simply inadequate for the placebo group without workout program, in this group all health benefits gained by weight reduction during the eight week program were pursued one year, regardless of regular weighing and diet and dietary therapy based upon main guidelines,” Torekov states.
According to Signe Torekov, this underscores the significance of getting involved in a mutual weight maintenance program based on feedback when beginning a weight-loss program.
” Therefore, it is very important that there is a system for supporting individuals with obesity in keeping the lifestyle modification. Our research study can assist with this, since we can state this actually works to towns, dietitians and doctors, if they create a structured, joint treatment strategy with the individual utilizing ongoing follow-ups,” says Torekov.
Recommendation: “Healthy Weight Loss Maintenance with Exercise, Liraglutide, or Both Combined” by Julie R. Lundgren, M.D., Ph.D., Charlotte Janus, Ph.D., Simon B.K. Jensen, M.Sc., Christian R. Juhl, M.D., Lisa M. Olsen, M.Sc., Rasmus M. Christensen, B.Sc.Med., Maria S. Svane, M.D., Ph.D., Thomas Bandholm, Ph.D., Kirstine N. Bojsen-Møller, M.D., Ph.D., Martin B. Blond, M.D., Ph.D., Jens-Erik B. Jensen, M.D., Ph.D., Bente M. Stallknecht, M.D., D.M.Sc., Jens J. Holst, M.D., D.M.Sc., Sten Madsbad, M.D., D.M.Sc., and Signe S. Torekov, Ph.D., 6 May 2021, New England Journal of Medicine.DOI: 10.1056/ NEJMoa2028198.
