Skip to main content
SpringerLink
Log in

A 2-year multifactor approach of weight loss maintenance

  • Original Research Paper
  • Published:
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity Aims and scope Submit manuscript

Abstract

The overarching problem in the treatment of obesity is the consistency with which weight in treatment is regained. The aim of this study is to follow-up the patient using a multifactor approach (cognitive-behavioral therapies, diet and physical activity counselling, an “on-off” prescription of orlistat) during 4 years in order to assess the efficacy of this specific long-term weight loss maintenance program. Weight maintenance is defined as a weight change of <2.5% of the study entry body weight. Fifty obese patients having previously lost at least 10% of their weight by any weight loss program before entering the maintenance multifactor approach were enrolled. Ninety percent of the patients maintained more than 10% weight loss after 2 years. All the physical characteristics remained similar between study entry and 2 years after the weight loss maintenance programme. Waist and hip as well as fat mass did not show any significant differences and the mean fat mass remained stable 2 years later. In addition, all the psychological parameters analysed remained stable and in a normal range. In conclusion, this multifactor approach shows promising interim results at year-2. The multifactor approach with an “on-off” prescription of orlistat seems to be appropriate for the long term weight loss maintenance. But considering the clinical and psychological diversity of the patients, this approach has to be individually adapted for patients presenting eating behavior disorders which need a particular follow-up.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Stern JS, Hirsch J, Blair SN, et al. Weighing the options: criteria for evaluating weight-management programs. The committee to develop criteria for evaluating the outcomes of approaches to prevent and treat obesity. Obes Res 1995; 3: 591–604.

    Article  CAS  PubMed  Google Scholar 

  2. Douketis JD, Macie C, Thabane L, et al. Systematic review of long-term weight loss studies in obese adults: clinical significance and applicability to clinical practice. Int J Obes 2005; 29: 1153–67.

    Article  CAS  Google Scholar 

  3. Atkinson RL. Combined drug treatment of obesity. Obes Res 1995; 3: 497S–500S.

    Article  CAS  PubMed  Google Scholar 

  4. Van Italie TB. Cardiac dysfunction in obese dieters: a potentially lethal complication of rapid massive weight loss. Am J Clin Nutr 1984; 39: 695–702.

    Google Scholar 

  5. Garrows JS. The safety of dieting. Proc Nutr Soc 1995; 50: 493–9.

    Article  Google Scholar 

  6. Pi-Sunyer FX. Medical hazards of obesity. Ann Intern Med 1993; 119: 655–60.

    Article  CAS  PubMed  Google Scholar 

  7. Kopelman PG. Obesity as a medical problem. Nature 2000; 404: 635–43.

    CAS  PubMed  Google Scholar 

  8. Goldstein DJ. Beneficial health effects or modest weight loss. Int J Obes 1992; 6: 397–415.

    Google Scholar 

  9. Glenny AM, Meara SO, Melville A, et al. The treatment and prevention of obesity: a systematic review of literature. Int J Obes 1997; 21: 715–37.

    Article  CAS  Google Scholar 

  10. Perri MG. The maintenance of treatment effects in the long-term management of obesity. Clin Psychol Sci Pract 1998; 5: 526–43.

    Article  Google Scholar 

  11. Win RR, Hill JO. Successful weight loss maintenance. Annu Rev Nutr 2001; 21: 323–41.

    Article  Google Scholar 

  12. Wing RR, Tate DF, Gorin AA, et al. A self-regulation program for maintenance of weight loss. N Engl J Med 2006; 355: 1563–71.

    Article  CAS  PubMed  Google Scholar 

  13. Lahti-Koski M, Männistö S, Pietinen P, et al. Prevalence of weight cycling and its relation to health indicators in Finland. Obes Res 2005; 13: 333–41.

    Article  PubMed  Google Scholar 

  14. Stevens J, Truesdale KP, McClain JE, et al. The definition of weight maintenance. Int J Obes 2006; 30: 391–9.

    Article  CAS  Google Scholar 

  15. Golay A, Jaccard AL, Habicht F, et al. Effect of orlistat in obese patients with binge eating disorder. Obes Res 2005; 13: 1701–8.

    Article  CAS  PubMed  Google Scholar 

  16. Golay A, Volery M, Rieker A, et al. Approche cognitivo-comportementale. Flammarion Médecine-Sciences 2004; 34: 246–52.

    Google Scholar 

  17. Carrard I, Haenni C, Golay A, et al. Obésité et troubles du comportement alimentaire: comment faire. Rev Med Suisse 2005; 1: 825–9.

    CAS  PubMed  Google Scholar 

  18. Golay A, Lagger G, Giordan A. Motivating patients with chronic diseases. Journal of medicine and the person 2007; 5: 57–63.

    Google Scholar 

  19. Golay A, Lagger G, Giordan A. Motiver pour changer: un modèle d’éducation thérapeutique pour patient diabétique. Médecine des maladies métaboliques 2007; Suppl 1: 1S28–1S32.

    Google Scholar 

  20. Bernstein M, Sloutskis D, Kumanyika S, et al. Data-based approach for developing a physical activity frequency questionnaire. Am J Epidemiol 1998; 147: 147–54.

    Article  CAS  PubMed  Google Scholar 

  21. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders (DSM-IVTM), Fourth Edition. Washington, DC, American Psychiatric Association, 1994, p 731.

    Google Scholar 

  22. Garner DM, Olmstead MA, Polivy J. Development and validation of a multidimensional eating disorder inventory for anorexia nervosa and bulimia. Int J Eating Dis 1983; 2: 15–34.

    Article  Google Scholar 

  23. Zigmond AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 1983; 67: 361–70.

    Article  CAS  PubMed  Google Scholar 

  24. Ward LC, Heitmann BL. Assessment of body composition by bioelectrical impedance analysis without the need for measurement of height. Clin Nutr 2001; 20: 21–6.

    Article  CAS  PubMed  Google Scholar 

  25. Wing RR, Phelan S. Long-term weight loss maintenance. Am J Clin Nutr 2005; 82: 222–5.

    Google Scholar 

  26. Jeffery RW, Drewnowski A, Epstein LH, et al. Longterm maintenance of weight: current status. Health Psychol 2000; 19: 5–16.

    Article  CAS  PubMed  Google Scholar 

  27. Phelan S, Wing RR. Prevalence of successful weight loss. Arch Intern Med 2005; 165: 2430.

    PubMed  Google Scholar 

  28. Dietary guidelines for Americans, 2005. 6th ed. Washington (DC): U.S. Department of Health and human services, U.S. Department of Agriculture; 2005.

  29. Greene LF, Malpede CZ, Henson CS, et al. Weight maintenance 2 years after participation in a weight loss program promoting low-energy density foods. Obesity 2006; 14: 1795–801.

    Article  PubMed  Google Scholar 

  30. A statement of the American Diabetes Association, the North American Association for the Study of Obesity, and the American Society for Clinical Nutrition. Weight management using lifestyle modification in the prevention and management of Type 2 Diabetes: rationale and strategies. Diabetes Care 2004; 27: 2067–73.

    Article  Google Scholar 

  31. Vogels N, Diepvens K, Westerterp-Plantenga MS. Predictors of long-term weight maintenance. Obes Res 2005; 13: 2162–8.

    Article  PubMed  Google Scholar 

  32. Anderson JW, Konz EC, Frederich RC, et al. Longterm weight-loss maintenance: a meta-analysis of US studies. Am J Clin Nutr 2001; 74: 579–84.

    CAS  PubMed  Google Scholar 

  33. Hills AP, Byrne NM. Physical activity in the management of obesity. Clin Dermatol 2004; 22: 315–8.

    Article  PubMed  Google Scholar 

  34. Weinsier RL, Hunter GR, Desmond RA, et al. Free-living activity energy expenditure in women successful and unsuccessful at maintaining a normal body weight. Am J Clin Nutr 2002; 75: 499–504.

    CAS  PubMed  Google Scholar 

  35. Kruger J, Blanck HM, Gillespie C. Dietary and physical activity behaviours among adults successful at weight loss maintenance. Int J Behav Nutr Phys Act 2006; 19: 3–17.

    Google Scholar 

  36. Kruger J, Heidi M, Blanck HM, et al. Dietary practices dining out behaviour, and physical activity correlates of weight loss maintenance. Prev Chronic Dis 2008; 5(1). http://www.cdc.gov/pcd/issues/2008/jan/06_0158.htm.

  37. O’Neil PM, Brown JD. Weighing the evidence: benefits of regular weight monitoring for weight control. J Nutr Educ Behav 2005; 37: 319–22.

    Article  PubMed  Google Scholar 

  38. Wadden TA, Crerand CE, Brock J. Behavioral treatment of obesity. Psychiatr Clin North Am 2005; 28: 151–70.

    Article  PubMed  Google Scholar 

  39. Wing RR, Tate DF, Gorin AA, et al. Stop regain: are there negative effects of daily weighing? J Consult Clin Psychol 2007; 75: 652–6.

    Article  PubMed  Google Scholar 

  40. Wadden TA, Butryn ML, Wilson C. Lifestyle modification for the management of obesity. Gastroentorology 2007; 132: 2226–38.

    Article  Google Scholar 

  41. Hill JO, Wyatt H, Phelan S, et al. The national weight Control Registry: Is it useful in helping deal with our obesity epidemic? J Nutr Educ Behav 2005; 37: 206–10.

    Article  PubMed  Google Scholar 

  42. Davidson MH, Hauptman J, DiGirolamo M, et al. Weight Control and Risk Factor Reduction in Obese Subjects treated for 2 years with Orlistat. JAMA 1999; 281: 278–80.

    Article  Google Scholar 

  43. Richelsen B, Tonstad S, Rössner S, et al. Effect of orlistat on weight regain and on cardiovascular risk factors following a very-low-calorie diet in abdominally obese patients. A three-year-randomized placebo controlled study. Diabetes Care 2007; 30: 27–32.

    Article  CAS  PubMed  Google Scholar 

  44. Rucker D, Padwal R, Li SK, et al. Long term pharmacotherapy for obesity and overweight: updated metaanalysis. BMJ 2007; 335: 1194–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Leibel RL, Rosenbaum M, Hirsch J. Changes in energy expenditure resulting from altered body weight. N Engl J Med 1995; 332: 621–8.

    Article  CAS  PubMed  Google Scholar 

  46. Bray G. Evaluation of drugs for treating obesity. Obes Res 1995; 3 (Suppl 4): 425S–34S.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Service of Therapeutic Education for Chronic Diseases, Department of Community Medicine and Primary Care, Geneva University Hospital and University of Geneva, 1211, Geneva, Switzerland

    V. Makoundou, E. Bobbioni-Harsch, J.-P. Gachoud, F. Habicht, Z. Pataky &  A. Golay

Authors
  1. V. Makoundou
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. E. Bobbioni-Harsch
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J.-P. Gachoud
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. F. Habicht
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Z. Pataky
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. A. Golay
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A. Golay.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Makoundou, V., Bobbioni-Harsch, E., Gachoud, JP. et al. A 2-year multifactor approach of weight loss maintenance. Eat Weight Disord 15, e9–e14 (2010). https://doi.org/10.1007/BF03325275

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03325275

Keywords

Search

Navigation