For people with obesity who lost a substantial amount of weight on a low-calorie diet, the combination of exercise and medication significantly improved the maintenance of weight loss, and more than either strategy, according to the results of a randomized trial and no a cap.
A year after starting a moderate to vigorous exercise along with liraglutide Study participants demonstrated 9.5 kg more weight loss than those who received placebo and regular activity.
The reductions in both weight and fat loss observed with exercise and liraglutide were approximately twice that achieved at 1 year with liraglutide or exercise strategies alone, according to the study authors, which appears in New England Journal of Medicine.
Although the findings may not apply to those who cannot exercise moderately to vigorously or not, intervention in this study was nevertheless feasible in this group of obese people who had a very low physical level, according to the authors. . .
We look forward to healthy weight loss maintenance
Researcher Signe S. Torekov, doctor, said in an interview that these results provide hope that more intensive exercise regimens, with or without medication, may be helpful and well accepted among people struggling with obesity.
“When we started our study, we were told,‘ You’ll never have obese people exercising so much and for so long, ’but people were very happy with the exercise,” Dr. Torekov said. professor in the department of biomedical sciences at the University of Copenhagen.
“If you really set up a program where people are monitored and you have a feedback system, exercise is an excellent component in the treatment of obesity that should be used much more actively, not just for its component to reduce weight, but also to improve health and quality of life, ”he said in an interview.
Weight control specialist John D. Clark, MD, Ph.D., according to the results of this study, it can help inform patients about the success of different strategies that incorporate exercise and medication after initial weight loss.
“When patients are on a consistent, calorie-restricted dietary plan, we can educate them and manage expectations about what options they might have available after their initial weight loss,” Dr. Clark, University of Texas, Dallas.
“If the patient’s goal is specifically weight loss at all costs, then I can suggest,‘ consider liraglutide or liraglutide in combination with exercise, ’” he said in an interview. “Exercise improves body composition, even if you can’t be successful on your own in the next phase of your weight loss journey, as shown in this study.”
Challenges of obesity and weight loss
While it’s not uncommon for obese patients to lose a lot of weight, keeping it low is often a challenge unless the patient follows a structured weight maintenance program, according to Dr. Torekov and his co-authors.
The rapid weight recovery observed in many obese patients could be the result of reductions in total energy expenditure or increased appetite. Exercise is a strategy for maintaining weight loss, although, according to the authors, very few studies have analyzed exercise in isolation to quantify its contribution to maintenance.
Accordingly, the present study attempted to determine whether exercise, medication, or a combination of these works best for maintaining low weight.
The study incorporated liraglutide, a GLP-1 receptor agonist indicated for chronic weight control, along with a reduced calorie diet and increased physical activity, in adults with a high body mass index and as at least a weight-related comorbidity.
The phase 3 trial initiated by the researcher included 215 adults with a body mass index of 32-43. People with type 2 diabetes they were excluded. All participants followed an 8-week low-calorie diet, which consisted of 800 calories a day.
Participants who lost 5% or more of their body weight were randomized to 1 year of exercise plus liraglutide, exercise plus placebo, regular activity plus liraglutide, or regular activity plus placebo.
The exercise program, which was structured but flexible, according to the researchers, included group exercise sessions that incorporated 30 minutes of indoor cycling and 15 minutes of circuit training two days a week. Participants wore heart rate monitors during exercise to make sure they achieved moderate to vigorous intensity goals.
Instructors trained in exercise physiology individualized exercise programs planned and supervised for each participant in the study arms with exercise or exercise-only medications.
Participants from all groups attended 12 individual consultations where body weight was measured and dietary support was provided.
Weight loss with exercise and medication
Of the 215 individuals enrolled in the study, 195 lost at least 5% of body weight and continued with the random portion, the researchers reported. During the diet phase, they lost an average of 13.1 kg, which translates into an average reduction of 12% in body weight.
The mean frequency of exercise was 2.4 times per week in the plus medication exercise group and 2.5 times per week in the exercise-only group. The researchers said that about one-third of the exercise took place in group sessions and there were no differences in relative intensity between individual and group exercise regimens.
People in the exercise and medication group continued to lose more weight, so that at the end of one year, weight loss decreased even more, by an average of -3.4 kg. In contrast, weight increased by an average of 6.1 kg for the placebo group, adding a treatment difference of –9.5 kg (95% confidence interval, –13.1 to –5.9; Pg <.001), according to the report.
This treatment effect was also seen, but more muted, in the exercise-only and liraglutide-only groups, with –4.1 kg and –6.8 kg, respectively.
A significant treatment effect was observed for the most liraglutide exercise, compared to exercise alone, at –5.4 kg (Pg = 0.004), whereas the effect of treatment for the combination versus liraglutide alone was not significant in –2.7 kg (Pg = .13), the data is displayed.
The researchers said the reduction in body fat at 52 weeks was -3.9 percentage points for more liraglutide exercise compared to placebo, or about twice the reductions seen in the groups alone. exercise and liraglutide, added that the combination preserved lean mass.
Reductions in hemoglobin A1c, which are generally thought to reduce the risk of diabetes, were reduced in both the combined liraglutide and liraglutide-exercise group, according to their report.
The research was partially supported by grants from the Novo Nordisk Foundation.
This article originally appeared on MDedge.com, which is part of the Medscape professional network.