Ashok Krishnaswami1, Rohini Ashok2, Stephen Sidney3, Michael Okimura4, Beth Kramer5, Lindsey Hogan6, Michael Sorel7, Sheri Pruitt8, Wayne Smith9. 1. Staff Cardiologist at the San Jose Medical Center in CA. ashok.krishnaswami@kp.org. 2. Internist and Obesity Specialist at the San Jose Medical Center in CA. rohini.ashok@kp.org. 3. Associate Director of Clinical Research at the Division of Research in Oakland, CA. stephen.sidney@kp.org. 4. Retired Endocrinologist from the Roseville Medical Center in CA. michael.okimura@kp.org. 5. Venture Manager at the Permanente Medical Group in Oakland, CA. beth.kramer@kp.org. 6. Venture Manager at the Permanente Medical Group in Oakland, CA. lindsey.c.hogan@kp.org. 7. Project Analyst at the Division of Research in Oakland, CA. michael.sorel@kp.org. 8. Director of Behavior Science Integration at the Roseville Medical Center in CA. sheridpruitt@yahoo.com. 9. Staff Physician in Physical Medicine and Rehabilitation at the San Jose Medical Center in CA. wayne.smith@kp.org.
Abstract
CONTEXT: There are insufficient data on the long-term, nonsurgical, nonpharmacologic treatment of obesity. OBJECTIVE: To determine changes in weight over 5 years in participants enrolled between April 1, 2007, and December 31, 2014, in a medically supervised weight management program at Kaiser Permanente Northern California Medical Centers. The program consisted of 3 phases: Complete meal replacement for 16 weeks; transition phase, 17 to 29 weeks; and lifestyle maintenance phase, 30 to 82 weeks. DESIGN: Retrospective observational study of 10,693 participants (2777 available for analysis at 5 years); no comparator group. MAIN OUTCOME MEASURES: Average change in weight from baseline to follow-up. RESULTS: Average age was 51.1 (standard deviation = 12.4) years, and 72.8% were women. Average baseline weight in the entire cohort was 112.9 kg (standard error [SE] = 0.23). Weight (kg) significantly changed over time: 4 months, -17.3 (SE = 0.12); 1 year, -14.2 (SE = 0.12); 2 years, -8.6 (SE = 0.14); 3 years, -6.9 (SE = 0.17); 4 years, -6.5 (SE = 0.16), and 5 years, -6.4 (SE = 0.29); p < 0.0001). In those with 5-year follow-up, weight loss between 5.0 and 9.9% below baseline occurred in 16.3% (SE = 0.004, 95% CI = 15.3% - 17.2%) and weight loss of 10.0% or more of baseline occurred in 35.2% (SE = 0.01, 95% CI = 33.6% - 36.7%). CONCLUSION: The average weight change of obese adults who participated in a medically supervised weight management program, with available 5-year data, was a statistically and clinically significant 5.8% weight loss from baseline.
CONTEXT: There are insufficient data on the long-term, nonsurgical, nonpharmacologic treatment of obesity. OBJECTIVE: To determine changes in weight over 5 years in participants enrolled between April 1, 2007, and December 31, 2014, in a medically supervised weight management program at Kaiser Permanente Northern California Medical Centers. The program consisted of 3 phases: Complete meal replacement for 16 weeks; transition phase, 17 to 29 weeks; and lifestyle maintenance phase, 30 to 82 weeks. DESIGN: Retrospective observational study of 10,693 participants (2777 available for analysis at 5 years); no comparator group. MAIN OUTCOME MEASURES: Average change in weight from baseline to follow-up. RESULTS: Average age was 51.1 (standard deviation = 12.4) years, and 72.8% were women. Average baseline weight in the entire cohort was 112.9 kg (standard error [SE] = 0.23). Weight (kg) significantly changed over time: 4 months, -17.3 (SE = 0.12); 1 year, -14.2 (SE = 0.12); 2 years, -8.6 (SE = 0.14); 3 years, -6.9 (SE = 0.17); 4 years, -6.5 (SE = 0.16), and 5 years, -6.4 (SE = 0.29); p < 0.0001). In those with 5-year follow-up, weight loss between 5.0 and 9.9% below baseline occurred in 16.3% (SE = 0.004, 95% CI = 15.3% - 17.2%) and weight loss of 10.0% or more of baseline occurred in 35.2% (SE = 0.01, 95% CI = 33.6% - 36.7%). CONCLUSION: The average weight change of obese adults who participated in a medically supervised weight management program, with available 5-year data, was a statistically and clinically significant 5.8% weight loss from baseline.
Authors: Rena R Wing; Paula Bolin; Frederick L Brancati; George A Bray; Jeanne M Clark; Mace Coday; Richard S Crow; Jeffrey M Curtis; Caitlin M Egan; Mark A Espeland; Mary Evans; John P Foreyt; Siran Ghazarian; Edward W Gregg; Barbara Harrison; Helen P Hazuda; James O Hill; Edward S Horton; Van S Hubbard; John M Jakicic; Robert W Jeffery; Karen C Johnson; Steven E Kahn; Abbas E Kitabchi; William C Knowler; Cora E Lewis; Barbara J Maschak-Carey; Maria G Montez; Anne Murillo; David M Nathan; Jennifer Patricio; Anne Peters; Xavier Pi-Sunyer; Henry Pownall; David Reboussin; Judith G Regensteiner; Amy D Rickman; Donna H Ryan; Monika Safford; Thomas A Wadden; Lynne E Wagenknecht; Delia S West; David F Williamson; Susan Z Yanovski Journal: N Engl J Med Date: 2013-06-24 Impact factor: 91.245
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