Half of the Danish population are obese, while 17 percent cope with weight problems. Worldwide, practically 40 percent are obese and 13 percent cope with weight problems.
The condition is connected with increased danger for sudden death, in addition to sequelae such as Type 2 diabetes, heart diseases, cancer, and infertility.
Weight gain back after a preliminary effective weight reduction in individuals with weight problems, makes up an essential and unsolved issue. Until now, no well-documented research study on which treatment technique is best for preserving a healthy weight reduction has actually been offered.
Researchers at University of Copenhagen and Hvidovre Hospital have actually finished an astonishing research study, which has actually been released on the planet’s most priced quote medical journal, The New England Journal of Medicine By screening 4 various kinds of treatment following a diet-induced weight reduction, the scientists show for the very first time how it is possible for individuals with weight problems to preserve long-lasting weight reduction, states Professor Signe Torekov at the Department of Biomedical Sciences.
Change in body weight. Credit: Karina Kj ærgård Kranker
In a randomized medical trial, the group of scientists has actually shown an extremely reliable treatment after a diet-induced weight reduction, by integrating moderate to vigorous-intensive workout with appetite-inhibiting weight problems medication, an analog to the appetite-inhibiting hormonal agent GLP-1.
“This is new knowledge for doctors, dietitians, and physical therapists to use in practice. This is evidence that we have been missing,” discusses Signe Torekov, who has actually been heading the research study.
“The problem is that people are fighting against strong biological forces when losing weight. The appetite increases simultaneously with decreased energy consumption, and this counteracts weight loss maintenance. We have an appetite-stimulating hormone, which increases dramatically when we lose weight, and simultaneously the level of appetite-suppressing hormones drops dramatically. In addition, a weight loss can provoke loss of muscle mass, while the body reduces the energy consumption. Thus, when the focus in obesity treatment has been on how to obtain a weight loss – rather than how to maintain a weight loss – it is really difficult to do something about your situation,” states Signe Torekov.
Highly effective when integrating treatments
215 Danes with weight problems and low physical fitness rankings took part in the research study. The individuals at first followed a low calorie diet plan over 8 weeks, where they each lost around 13 kg, which brought considerable enhancements to their health with a drop in blood sugar level level and high blood pressure.
The individuals were then arbitrarily divided into 4 groups. Two of the groups got placebo medication, while the 2 other groups got weight problems medication. Among the 2 placebo groups, one group followed a workout program of minimum 150 minutes of exercise at moderate strength or 75 minutes at vigorous-intensity throughout the week or a mix of the 2, while the other group kept their existing level of exercise. The 2 groups getting weight problems 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 Kj ærgård Kranker
All individuals in the research study were weighed month-to-month and got dietary and diet plan therapy with the concentrate on healthy weight reduction according to the standards from the Danish health and food administrations.
After one year, the group with workout alone and the group with weight problems medication alone kept the weight reduction of 13 kg and health enhancements. The placebo group got half of the weight back with degeneration of all danger aspects, for instance for advancement of Type 2 diabetes and heart disease.
The most remarkable enhancements took place in the mix group, which followed the workout program and got weight problems medication. The scientists observed extra weight reduction in this group, and the overall weight reduction was around 16 kg over one year. The health advantages were likewise double that of each of the single treatments, i.e., two times the loss of fat mass while maintaining muscle mass, greater physical fitness rankings, lowered blood sugar level and enhanced lifestyle.
The 2 groups that worked out increased their physical fitness score, lost fat mass, and got muscle mass. This might show a much healthier weight reduction than for individuals, who had actually just lost fat mass without increasing the physical fitness score.
“It is an important aspect to highlight, as you do not necessarily get a healthier body from losing weight if, at the same time, you lose a lot of muscle mass,” states Signe Torekov.
“It is great news for public health that a significant weight loss can be maintained with exercise for approximately 115 minute per week performed mostly at vigorous-intensity, such as cycling. And that by combining exercise with obesity medication, the effect is twice as good as each of the individual treatments.”
With the research study, the scientists now hope individuals with weight problems, together with their care company, can produce a helpful structure for preserving the weight reduction.
Fundamental way of life modification
Signe Torekov mentions that many individuals with weight problems have actually attempted to slim down prior to, just to gain back the weight. This takes place, since the basic recommendations is to consume much healthier and work out more.
“Without a follow-up on whether people actually have support to perform exercise, the treatment will not be enough. Therefore, we also followed up with the participants on an ongoing basis to ensure that they received the support they needed in order to exercise. That is necessary, because maintaining weight loss is extremely hard. People need to understand this. Once you have lost weight, you are not “cured.” “The ongoing exercise and effort will likely need to continue for many years,” states Signe Torekov.
“Our study also demonstrates that without a structured treatment plan, there is a high risk of gaining the weight back. There were 12 individual consultations over the course of a year, including weighing and diet advice from Danish authorities according to guidelines for healthy weight maintenance. This was just not enough for the placebo group without exercise program, in this group all health benefits gained by weight loss during the eight week program were gone after one year, despite frequent weighing and diet and nutritional counseling based on official guidelines,” Torekov states.
According to Signe Torekov, this highlights the significance of taking part in a shared weight upkeep program based upon feedback when beginning a weight-loss program.
“Therefore, it is important that there is a system for supporting people with obesity in maintaining the lifestyle change. Our study can help with this, because we can say this actually works to doctors, dietitians and municipalities, if they create a structured, joint treatment plan with the individual using ongoing follow-ups,” states Torekov.
Reference: “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.ScMed, 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
