Psychobehavioral and nutritional predictors of weight loss in obese women treated with sibutramine

Abstract

OBJECTIVE:To reveal whether baseline body mass index (BMI), and psychobehavioral and nutritional markers were significant predictors of the change in BMI observed after 4 and 12 months in obese women enrolled in a weight reduction program, including low-energy diet, increased physical activity, cognitive behavior therapy and sibutramine. The impact of changes in psychobehavioral and nutritional markers observed after 4 and 12 months of treatment on BMI changes was also investigated. DESIGN: During a double-blind placebo-controlled 4-month period, subjects received either sibutramine (10 mg/day) or placebo. Then, an open phase with sibutramine administered to all patients continued until month 12. SUBJECTS: In total, 80 obese women (age: 43.9710.6 y, BMI: 36.774.8 kg/m 2 ). MEASUREMENTS: The dependent variable was change in BMI while baseline BMI, mode of treatment, the Beck depression score, the three items (dietary restraint, disinhibition and perceived hunger) of the Eating Inventory (EI), energy and macronutrient intakes were independent variables. At 1-week dietary records were analyzed using a computer software for assessing energy and macronutrient intake. RESULTS: Multiple regression analysis revealed that the BMI loss at month 4 was significantly influenced by mode of treatment and initial BMI, whereas a borderline negative relationship was observed with the baseline restraint score. Baseline BMI, depression score, restraint score and total energy intake predicted weight loss at month 12. These predictive variables accounted for 43.8% of the variance in BMI loss at 12 months. When relationships between the BMI loss and changes in all included psychobehavioral and nutritional parameters were considered after 12 months of treatment, a drop in the disinhibition score of the EI appeared the only significant factor affecting the BMI decrease. CONCLUSIONS: Our results suggest that psychobehavioral and nutritional characteristics can be used as predictors of weight loss in response to a comprehensive weight management program including pharmacological treatment with sibutramine.

Initial weight loss on an 800-kcal diet as a predictor of weight loss success after 8 weeks: the Diogenes study

“…Only one paper reports a study with more participants (n ¼ 975) (Dhurandhar et al, 1999). Other studies have been performed in smaller cohorts with less statistical power (Webster and Garrow, 1989;Wadden et al, 1992;Astrup et al, 1995;Hansen et al, 2001;Hainer et al, 2005;Fabricatore et al, 2009). In addition, this study assessed predictors of weight loss separately in women and men, and confirms that men lose weight more rapidly in the initial stage of a slimming program than women (12.67 ± 0.22 vs 9.86 ± 0.13, P ¼ 0.0001).…”

“…Substantial efforts have been made to identify predictors of weight loss in obese individuals undergoing treatment (Webster and Garrow, 1989;Astrup et al, 1995;Hansen et al, 2001;Hainer et al, 2005;Mutch et al, 2007;Fabricatore et al, 2009). However, there are no specified cut-off criteria for predicting weight loss by proper estimation of pre-treatment characteristics that are documented by the literature.…”

The Eating Inventory, body adiposity and prevalence of diseases in a quota sample of Czech adults

“…This questionnaire was used in our previous studies in obese populations. 22,28 Health assessment. Each subject asked his/her general practitioner to provide a written assessment of the presence or absence of the following diseases: hypertension, cardiovascular diseases (CVD) including ischaemic heart disease as well as cerebrovascular disease, diabetes, hyper-or dyslipidaemia, gout and arthritis and spondylitis.…”

“…A drop in the disinhibition score appeared the only significant factor influencing the body mass index (BMI) decrease in response to 1-year treatment with sibutramine. 22 Other studies suggest that disinhibition is critically involved in poor body weight control and weight gain over time 12,14 as well as with binge eating. 5,23 Lower dietary restraint and higher disinhibition and hunger scores have been associated with a poor healthrelated quality of life, greater depression and psychosocial dysfunction in severely obese subjects assessed for bariatric surgery.…”

Artificial Neural Networks and Predictive Medicine: a Revolutionary Paradigm Shift

“…inferior to 80% of total variance). (Hansen et al, 2001;Hainer et al, 2005). A possible explanation could be that obesity is a so-called complex disease, where different factors interact with multiple interactions among variables, positive and negative feedback loops, and non-linear system dynamics.…”