National Trends in Antiobesity Medication Use

Stafford, Randall S.; Radley, David

doi:10.1001/archinte.163.9.1046

Cited by 100 publications

(70 citation statements)

References 26 publications

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“…Although phentermine is not approved by the Food and Drug Administration (FDA) for long-term use, it is the most commonly prescribed anorexiant medication in the United States, 192 presumably because it is less expensive than sibutramine. Phentermine was approved by the FDA Ͼ30 years ago, when the criteria needed for approval were less rigorous than they are currently.…”

Section: Phenterminementioning

confidence: 99%

Clinical Implications of Obesity With Specific Focus on Cardiovascular Disease

Klein¹,

Burke²,

Bray³

et al. 2004

Circulation

802

284

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Abstract-Obesity adversely affects cardiac function, increases the risk factors for coronary heart disease, and is an independent risk factor for cardiovascular disease. The risk of developing coronary heart disease is directly related to the concomitant burden of obesity-related risk factors. Modest weight loss can improve diastolic function and affect the entire cluster of coronary heart disease risk factors simultaneously. This statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism reviews the relationship between obesity and the cardiovascular system, evaluates the effect of weight loss on coronary heart disease risk factors and coronary heart disease, and provides practical weight management treatment guidelines for cardiovascular healthcare professionals. The data demonstrate that weight loss and physical activity can prevent and treat obesity-related coronary heart disease risk factors and should be considered a primary therapy for obese patients with cardiovascular disease.

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Section: Phenterminementioning

confidence: 99%

Clinical Implications of Obesity With Specific Focus on Cardiovascular Disease

Klein¹,

Burke²,

Bray³

et al. 2004

Circulation

802

284

View full text Add to dashboard Cite

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“…40,41 The UK government aims to reverse the rising tide of obesity and overweight in the population. 42 This study has developed an intervention, following guidelines recommended by NICE, 20 and shown its implementation to be feasible in primary care.…”

Section: Implications For Clinical Practicementioning

confidence: 99%

Weight-management interventions in primary care: a pilot randomised controlled trial

Nanchahal¹,

Townsend²,

Letley³

et al. 2009

Br J Gen Pract

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There is a paucity of randomised controlled trials of weight management in primary care. AimTo ascertain the feasibility of a full trial of a nurse-led weight-management programme in general practice. Design of studyFactorial randomised control trial. SettingPrimary care, UK. MethodA total of 123 adults (80.3% women, mean age 47.2 years) with body mass index ≥27 kg/m 2 , recruited from eight practices, were randomised to receive structured lifestyle support (n = 30), structured lifestyle support plus pedometer (n = 31), usual care (n = 31), or usual care plus pedometer (n = 31) for a 12-week period. ResultsA total of 103 participants were successfully followed up. The adjusted mean difference in weight in structured support compared to usual care groups was -2.63 kg (95% confidence interval [CI] = -4.06 to -1.20 kg), and for pedometer compared to no pedometer groups it was -0.11 kg (95% CI = -1.52 to 1.30 kg). One in three participants in the structuredsupport groups (17/50, 34.0%) lost 5% or more of their initial weight, compared to less than one in five (10/53, 18.9%) in usual-care groups; provision of a pedometer made little difference (14/48, 29.2% pedometer; 13/55, 23.6% no pedometer). Difference in waist circumference change between structured-support and usual-care groups was -1.80 cm (95% CI = -3.39 to -0.20 cm), and between the pedometer and no pedometer groups it was -0.84 cm (95% CI = -2.42 to 0.73 cm). When asked about their experience of study participation, most participants found structured support helpful. ConclusionThe structured lifestyle support package could make substantial contributions to improving weightmanagement services. A trial of the intervention in general practice is feasible and practicable.

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“…Most obese people have little chance to make use of professional help for weight management because of clinicians not referring patients for professional help, financial costs that are seldom covered by medical insurance and lack of time for frequent visits. 6,7 Moreover, most primary care practitioners offer insufficient lifestyle education in contrast to frequent prescription of medications 8 because of inadequate training in behavioral counseling, not dedicating sufficient time for counseling during the typical outpatient visit, and additional labor costs for staffing. 9 Remote healthcare programs using the Internet have the potential to overcome some of these barriers and are expected to have a supplemental role or serve as an alternative in obesity care through promoting lifestyle modifications.…”

Section: Introductionmentioning

confidence: 99%

Effect of web-based lifestyle modification on weight control: a meta-analysis

et al. 2011

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Objective: Web-based treatment programs are attractive in primary care because of their ability to reach numerous individuals at low cost. Our aim of this meta-analysis is to systematically review the weight loss or maintenance effect of the Internet component in obesity treatment programs. Methods: MEDLINE and EMBASE literature searches were conducted to identify studies investigating the effect of Web-based individualized advice on lifestyle modification on weight loss. Randomized controlled trials that consisted of a Web-user experimental and non-Web user control group were included. Weight changes in the experimental group in comparison with the control group were pooled with a random-effects model. Results: A total of 23 studies comprising 8697 participants were included. Overall, using the Internet had a modest but significant additional weight-loss effect compared with non-Web user control groups (À0.68 kg, P ¼ 0.03). In comparison with the control group, stratified analysis indicated that using the Internet as an adjunct to obesity care was effective (À1.00 kg, Po0.001), but that using it as a substitute for face-to-face support was unfavorable ( þ 1.27 kg, P ¼ 0.01). An additional effect on weight control was observed when the aim of using the Internet was initial weight loss (À1.01 kg; P ¼ 0.03), but was not observed when the aim was weight maintenance ( þ 0.68 kg; P ¼ 0.26). The relative effect was diminished with longer educational periods (P-trend ¼ 0.04) and was insignificant (À0.20 kg; P ¼ 0.75) in studies with educational periods of 12 months or more. Conclusion: The current meta-analysis indicates that the Internet component in obesity treatment programs has a modest effect on weight control. However, the effect was inconsistent, largely depending on the type of usage of the Internet or the period of its use.

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National Trends in Antiobesity Medication Use

Cited by 100 publications

References 26 publications

Clinical Implications of Obesity With Specific Focus on Cardiovascular Disease

Clinical Implications of Obesity With Specific Focus on Cardiovascular Disease

Weight-management interventions in primary care: a pilot randomised controlled trial

Effect of web-based lifestyle modification on weight control: a meta-analysis

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