scholarly journals Liraglutide for Weight Management in the Real World: Significant Weight Loss Even if the Maximal Daily Dose Is Not Achieved

Obesity Facts ◽  
2021 ◽  
pp. 1-7
Author(s):  
Liesbet Trenson ◽  
Sander Trenson ◽  
Falco van Nes ◽  
Carolien Moyson ◽  
Matthias Lannoo ◽  
...  
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Weight Management ◽  
Real World ◽  
Subcutaneous Administration ◽  
Maximum Tolerated Dose ◽  
Significant Weight Loss ◽  
Additional Weight ◽  
Obstructive Sleep ◽  
Daily Dose

<b><i>Introduction:</i></b> Obesity is a global health challenge, and pharmacologic options are emerging. Once daily subcutaneous administration of 3 mg liraglutide, a glucagon like peptide-1 analogue, has been shown to induce weight loss in clinical trials, but real-world effectiveness data are scarce. <b><i>Methods:</i></b> It is a single-centre retrospective cohort study of patients who were prescribed liraglutide on top of lifestyle adaptations after multidisciplinary evaluation. In Belgium, liraglutide is only indicated for weight management if the BMI is &#x3e;30 kg/m<sup>2</sup> or ≥27 kg/m<sup>2</sup> with comorbidities such as dysglycaemia, dyslipidaemia, hypertension, or obstructive sleep apnoea. No indication is covered by the compulsory health care insurance. Liraglutide was started at 0.6 mg/day and uptitrated weekly until 3 mg/day or the maximum tolerated dose. Treatment status and body weight were evaluated at the 4-month routine visit. <b><i>Results:</i></b> Between June 2016 and January 2020, liraglutide was prescribed to 115 patients (77% female), with a median age of 47 (IQR 37.7–54.0) years, a median body weight of 98.4 (IQR 90.0–112.2) kg, a BMI of 34.8 (IQR 32.2–37.4) kg/m<sup>2</sup>, and an HbA1c level of 5.6%. Five (4%) patients did not actually initiate treatment, 9 (8%) stopped treatment, and 8 (7%) were lost to follow-up. At the 4-month visit, the median body weight had decreased significantly by 9.2% to 90.8 (IQR 82.0–103.5) kg (<i>p</i> &#x3c; 0.001). Patients using 3.0 mg/day (<i>n</i> = 60) had lost 8.0 (IQR 5.8–10.4) kg. The weight loss was similar (<i>p</i> = 0.9622) in patients that used a lower daily dose because of intolerance: 7.4 (IQR 6.2–9.6) kg for 1.2 mg (<i>n</i> = 3), 7.8 (IQR 4.1–7.8) kg for 1.8 mg (<i>n</i> = 16), and 9.0 (IQR 4.8–10.7) kg for 2.4 mg/day (<i>n</i> = 14). Weight loss was minimal if liraglutide treatment was not started or stopped prematurely (median 3.0 [IQR 0.3–4.8] kg, <i>p</i> &#x3c; 0.001, vs. on treatment). Further analysis showed an additional weight reduction of 1.8 kg in the patients that had started metformin &#x3c;3 months before the start of liraglutide (<i>p</i> &#x3c; 0.001). The main reasons for liraglutide discontinuation were gastrointestinal complaints (<i>n</i> = 5/9) and drug cost (<i>n</i> = 2/9). <b><i>Conclusion:</i></b> In this selected group of patients, the majority complied with liraglutide treatment over the initial 4-month period and achieved a significant weight loss, irrespective of the maximally tolerated maintenance dose. Addition of metformin induced a small but significant additional weight loss.

scholarly journals Obstructive sleep apnoea and 12-month weight loss in adults with class 3 obesity attending a multidisciplinary weight management program

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sophie Kobuch ◽  
Fiona Tsang ◽  
Ritesh Chimoriya ◽  
Daniel Gossayn ◽  
Sarah O’Brien ◽  
...  
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Weight Management ◽  
Body Weight Loss ◽  
Sleep Apnoea ◽  
Management Program ◽  
Weight Management Program ◽  
Cpap Therapy ◽  
Significant Weight Loss ◽  
Obstructive Sleep

Abstract Background Although there is a strong association between obesity and obstructive sleep apnoea (OSA), the effects of OSA and CPAP therapy on weight loss are less well known. The aim of this study in adults with class 3 obesity attending a multidisciplinary weight management program was to assess the relationship between OSA and CPAP usage, and 12-month weight change. Methods A retrospective cohort study of all patients commencing an intensive multidisciplinary publicly funded weight management program in Sydney, Australia, between March 2018 and March 2019. OSA was diagnosed using laboratory overnight sleep studies. Demographic and clinical data, and use of CPAP therapy was collected at baseline and 12 months. CPAP use was confirmed if used ≥4 h on average per night on download. Results Of the 178 patients who joined the program, 111 (62.4 %) completed 12 months in the program. At baseline, 63.1 % (n=70) of patients had OSA, of whom 54.3 % (n=38) were using CPAP. The non-OSA group had more females compared to the OSA with CPAP group and OSA without CPAP group (90.2 % vs. 57.9 % and 62.5 %, respectively; p=0.003), but there were no significant baseline differences in BMI (50.4±9.3 vs. 52.1±8.7 and 50.3±9.5 kg/m2, respectively; p=0.636). There was significant weight loss across all three groups at 12 months. However, there were no statistically significant differences across groups in the percentage of body weight loss (OSA with CPAP: 6.3±5.6 %, OSA without CPAP: 6.8±6.9 %, non-OSA: 7.2±6.5 %; p=0.844), or the proportion of patients who achieved ≥5 % body weight loss (OSA with CPAP: 57.9 %, OSA without CPAP: 59.4 %, non-OSA: 65.9 %; p=0.743). In patients with T2DM, there was a significant reduction in HbA1c from baseline to 12 months (7.8±1.7 % to 7.3±1.4 %, p=0.03), with no difference between groups (p=0.997). Conclusions This multidisciplinary weight management program resulted in significant weight loss at 12 months, regardless of OSA diagnosis or CPAP use in adults with class 3 obesity. Larger studies are needed to further investigate the effects of severity of OSA status and CPAP use in weight management programs. Until completed, this study suggests that the focus should remain on implementing lifestyle changes and weight management regardless of OSA status.

THE BENEFIT OF SHORT-TERM WEIGHT LOSS WITH ANTI-OBESITY MEDICATIONS IN REAL-WORLD CLINICAL PRACTICE

2019 ◽  
Vol 25 (10) ◽  
pp. 1022-1028
Author(s):  
Kelly Shibuya ◽  
Khawla F. Ali ◽  
Xinge Ji ◽  
Alex Milinoivh ◽  
Janine Bauman ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Weight Loss ◽  
Body Weight ◽  
Body Mass ◽  
Real World ◽  
Significant Weight Loss ◽  
Short Term ◽  
Absolute Weight ◽  
Tertiary Healthcare

Objective: The effectiveness of anti-obesity medications (AOMs) outside of clinical trials is unclear. The objective of this study was to compare the short-term effectiveness of AOMs in real-world practice. Methods: This retrospective study included adults aged ≥18 years, with body mass index ≥30 kg/m2 or ≥27 kg/m2 with at least one obesity-related comorbidity who were prescribed phentermine hydrochloride, phenterminetopiramate, bupropion-naltrexone, or lorcaserin for 12 consecutive weeks between 2006 and 2016 at a large tertiary healthcare system. Propensity score–matched cohorts were created for each pair of AOMs. The primary outcomes were percent and absolute weight loss from baseline after 12 weeks. A prediction model was constructed to estimate weight loss with different AOMs based on demographic and clinical data. Results: Of the 3,411 patients included in this study, patients lost an average of 3.45% of body weight from baseline. All AOMs were associated with a significant weight loss from baseline ( P<.0001). Patients lost the highest percentage of body weight on phentermine hydrochloride (3.75 ± 5.66%), followed by phentermine-topiramate (3.63 ± 5.7%), bupropion-naltrexone (2.66 ± 5.03%), and lorcaserin (1.84 ± 6.69%). In propensity-matched cohorts, patients taking phentermine hydrochloride lost more weight than those taking lorcaserin or bupropion-naltrexone, and patients taking phentermine topiramate lost more weight than patients taking lorcaserin. Conclusion: In real-world practice, AOMs are associated with clinically meaningful weight loss of 2 to 4% after 12 weeks. In this study, phentermine hydrochloride and phentermine topiramate produced the most weight loss. AOMs should be seriously considered as part of the armamentarium to treat patients with obesity. Abbreviations: AOM = anti-obesity medication; BMI = body mass index; EMR = electronic medical record; FDA = Food and Drug Administration; T2D = type 2 diabetes

Weight Management and Weight Loss Strategies of Professional Jockeys

2002 ◽  
Vol 12 (1) ◽  
pp. 1-13 ◽  
Author(s):  
Jan M. Moore ◽  
Anna F. Timperio ◽  
David A. Crawford ◽  
Cate M. Burns ◽  
David Cameron-Smith
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Weight Management ◽  
Weight Control ◽  
Response Rate ◽  
Management Strategies ◽  
Management Plan ◽  
Rapid Weight Loss ◽  
Additional Weight ◽  
The Impact

Jockeys are required to maintain very low body weight and precise weight control during competition. This study examined the weight loss and weight management strategies of professional horseracing jockeys in the state of Victoria, Australia. An anonymous, self-completed questionnaire was administered (55% response rate, n=116). Almost half (43%) reported that maintaining riding weight was difficult or very difficult, with 75% routinely skipping meals. In preparation for racing, 60% reported that they typically required additional weight loss, with 81% restricting food intake in the 24 hours prior to racing. Additionally, sauna-induced sweating (29%) and diuretics (22%) were frequently employed to further aid in weight loss prior to racing. These rapid weight loss methods did not differ between the 51% of jockeys who followed a weight management plan compared to those who did not. The impact of these extreme weight loss practices on riding performance and health remains unknown.

Abstract #615: Hispanic People Achieve Clinically Significant Weight loss with Liraglutide 3.0 Mg for Weight Management

2015 ◽  
Vol 21 ◽  
pp. 121
Author(s):  
Patrick O’Neil ◽  
W. Timothy Garvey ◽  
J. Michael Gonzalez-Campoy ◽  
Pablo Mora ◽  
Rafael Violante Ortiz ◽  
...  
Keyword(s):  
Weight Loss ◽  
Weight Management ◽  
Significant Weight Loss ◽  
Hispanic People ◽  
Clinically Significant

scholarly journals Reduction of Cardio-Metabolic Risk and Body Weight through a Multiphasic Very-Low Calorie Ketogenic Diet Program in Women with Overweight/Obesity: A Study in a Real-World Setting

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1804
Author(s):  
Elena Tragni ◽  
Luisella Vigna ◽  
Massimiliano Ruscica ◽  
Chiara Macchi ◽  
Manuela Casula ◽  
...  
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Waist Circumference ◽  
Real World ◽  
Metabolic Complications ◽  
Multi Centre Study ◽  
Low Calorie ◽  
Ketogenic Diets ◽  
Real World Setting ◽  
Overweight Or Obesity

Background: The prevention and treatment of obesity and its cardio-metabolic complications are relevant issues worldwide. Among lifestyle approaches, very low-calorie ketogenic diets (VLCKD) have been shown to lead to rapid initial weight loss, resulting in better long-term weight loss maintenance. As no information on VLCKD studies carried on in a real-world setting are available, we conducted this multi-centre study in a real-world setting, aiming at assessing the efficacy and the safety of a specific multiphasic VLCKD program in women with overweight or obesity. Methods: A multi-center, prospective, uncontrolled trial was conducted in 33 outpatient women (age range 27–60 y) with overweight or obesity (BMI: 30.9 ± 2.7 kg/m2; waist circumference: 96.0 ± 9.4 cm) who started a VLCKD dietary program (duration: 24 weeks), divided into four phases. The efficacy of VLCKD was assessed by evaluating anthropometric measures and cardiometabolic markers; liver and kidney function biomarkers were assessed as safety parameters. Results: The VLCKD program resulted in a significant decrease of body weight and BMI (−14.6%) and waist circumference (−12.4%). At the end of the protocol, 33.3% of the participants reached a normal weight and the subjects in the obesity range were reduced from 70% to 16.7%. HOMA-IR was markedly reduced from 3.17 ± 2.67 to 1.73 ± 1.23 already after phase 2 and was unchanged thereafter. Systolic blood pressure decreased after phase 1 (−3.5 mmHg) and remained unchanged until the end of the program. Total and LDL cholesterol and triglycerides were significantly reduced by VLCKD along with a significant HDL cholesterol increase. Liver, kidney and thyroid function markers did not change and remained within the reference range. Conclusions: The findings of a multi-center VLCKD program conducted in a real-world setting in a cohort of overweight/obese women indicate that it is safe and effective, as it results in a major improvement of cardiometabolic parameters, thus leading to benefits that span well beyond the mere body weight/adiposity reduction.

scholarly journals The efficiency of obesity treatment in patients with insomnia and obstructive sleep apnea syndrome

2015 ◽  
Vol 13 (2) ◽  
pp. 25-32
Author(s):  
Natal'ya V. Strueva ◽  
Galina A. Mel'nichenko ◽  
Mikhail G. Poluektov ◽  
Larisa V. Savel'eva
Keyword(s):  
Weight Loss ◽  
Obstructive Sleep Apnea ◽  
Body Weight ◽  
Sleep Apnea ◽  
Sleep Disorders ◽  
Sleep Apnea Syndrome ◽  
Obese Patients ◽  
Obstructive Sleep ◽  
Apnea Syndrome ◽  
Clinically Significant

The aim of this study was to investigate the relationship between the dynamics of body weight and sleep disorders in the treatment of obesity.Materials and methods. The study included 200 obese patients: 83 men and 117 women.Results. Complaints about problems sleeping (snoring, hypersomnia, insomnia, etc.) were present in 78% of obese patients. 89 patients were under the observation of an endocrinologist for 7 ± 1 months, they were divided into three matched by age, sex and BMI groups: patients with obstructive sleep apnea syndrome (OSAS) (n = 42), the second – with the syndrome of insomnia (n = 19), the third (control group) – patients without sleep disorders (n = 24). After treatment of obesity the weight loss in patients with insomnia syndrome was -2.5 [-4; 0]kg, in patients with OSAS -7 [-18; -2] kg, in patients without sleep disorders -6.5 [-12; -2.25] kg. Clinically significant weight reduction was reached in 25 (59.5%) patients with OSAS; 3 (16%) – with insomnia syndrome; 15 (62.5%) – without sleep disorders.Conclusion. Thus, the insomnia syndrome essentially influences the obesity treatment results – most of patients with this sleep disorder (81.2%) do not achieve clinically significant weight loss. The presence and severity of breathing disorders during sleep do not prevent weight loss. However, with the regular use of CPAP-therapy in patients with OSAS has a tendency of greater reduction of body weight. 

scholarly journals SUN-543 Real World Evidence of Successful Weight Management for the Obese Population: Complete Reversal of Obesity Related Metabolic Co-Morbidities and Weight Loss in Patients Attending a Multidisciplinary Weight Management Clinic in Australia

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Zoe Rock ◽  
Juliana Chen ◽  
Joanna Jaques ◽  
Bernard L Champion ◽  
Reginald V Lord ◽  
...  
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Weight Management ◽  
Exercise Physiology ◽  
Body Weight Loss ◽  
Total Body Weight ◽  
Management Interventions ◽  
Co Morbidity ◽  
Total Body ◽  
Total Body Weight Loss

Abstract Over 2.5 billion people worldwide are overweight or obese. Multidisciplinary weight management interventions have evolved to address the complexity of weight loss for those with one or more chronic diseases, and the trend of weight regain. The aim of these interventions is to encourage sustainable lifestyle changes, resulting in weight loss and weight maintenance and improvements in comorbidities. While some prospective clinical trials have demonstrated efficacy, results are often not reported by real life practices. The aim of this study was to evaluate the effectiveness of a Sydney based multidisciplinary weight management clinic with endocrinology, dietetics, exercise physiology, psychology, and bariatric surgical domains. All patients who attended the clinic for weight loss purposes between March 2017 and April 2019 were included (n=220). A retrospective chart review was conducted. Patient data on weight, BMI, waist circumference, body composition measurements, and selected blood test results and co-morbidities were analysed. All patient therapy included endocrinological input for co-morbidity identification and management, lifestyle intervention (dietetic and exercise physiology input) with optional adjunct pharmacotherapy or psychological counselling. Of the 220 cohort, 20 of the patients had sleeve gastrectomy. Patient retention in the clinic after the first consultation was 85% (n=186), a high rate within the weight management community. 59% of patients achieved a minimum of 5% total body weight loss, including 18% who achieved greater than 10% total body weight loss. Additionally, 31% of patients lost enough weight to decrease their BMI class by up to 2 or more classes. Of the gastric sleeve cohort average excess body weight loss was 32kg (21-56kg) enhanced by multidisciplinary care in the lead up to surgery. Across the cohort some patients completely reversed co-morbidities; including dyslipidaemia (n=1), hypertension (n=3), NAFLD (n=1), pre-diabetes (n=8) and type 2 diabetes (n=3), OSA (n=1). These results demonstrate that obesity is a chronic condition that can be successfully managed. We have demonstrated significant durable weight loss and improvement in metabolic co-morbidities with holistic coordinated care. Future directions include translating this model of care into standard practice in Australia and other countries where obesity to date not received the same coordinated approach as other chronic conditions.

scholarly journals 0653 Positive Effects of Long Term Continuous Positive Airway Pressure Therapy on Blood Pressure in Obstructive Sleep Apnea Patients

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A249-A249
Author(s):  
R Shirahama ◽  
T Tanigawa ◽  
K Tomooka ◽  
L Fan Yun ◽  
A Ikeda ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Weight Loss ◽  
Obstructive Sleep Apnea ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Cpap Therapy ◽  
Significant Weight Loss ◽  
Cpap Adherence ◽  
Obstructive Sleep

Abstract Introduction Obstructive sleep apnea (OSA) is one of the common causes of hypertension. Therefore, we examine the longitudinal effect of continuous positive airway pressure (CPAP) therapy and its adherence on blood pressure among OSA patients. Methods One thousand two hundred ninety-three (male 1,130, female 163) patients, who were diagnosed with OSA and underwent CPAP therapy were investigated for longitudinal changes (24 months observation period) in the levels of blood pressure and body weight. The longitudinal analyses were performed by mixed effect model. Multiple Imputation with Chained Equations was also used to impute missing data. Good CPAP adherence is defined as more than 70% of the time using CPAP more than 4hours at all the measuring. Poor CPAP adherence is defined as less than 70% of the time using CPAP more than 4hours at all the measuring time points. Results The patient group with good CPAP adherences), compared to poor CPAP adherence, showed significant diastolic blood pressure reduction in 24 months follow-up period (β=-0.13, p=0.03) despite a lack of significant weight loss (β=-0.02, p=0.59). However, no significant associations were found between systolic blood pressure and CPAP adherence (β=-0.14, p=0.11). Conclusion CPAP therapy was found to have a longitudinal effect on diastolic blood pressure despite a lack of significant weight loss. Support  

scholarly journals Frequency of self-monitoring of blood glucose in relation to weight loss and A1C during intensive multidisciplinary weight management in patients with type 2 diabetes and obesity

2019 ◽  
Vol 7 (1) ◽  
pp. e000659 ◽  
Author(s):  
Shaheen Tomah ◽  
Noor Mahmoud ◽  
Adham Mottalib ◽  
David M Pober ◽  
Mhd Wael Tasabehji ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Body Weight ◽  
Blood Glucose ◽  
Weight Management ◽  
Average Frequency ◽  
Baseline Body Mass Index ◽  
Self Monitoring ◽  
Median Change

ObjectiveWe evaluated the relationship between frequency of self-monitoring of blood glucose (SMBG) and body weight, A1C, and cardiovascular risk factors in patients with type 2 diabetes (T2D) and obesity enrolled in a 12-week intensive multidisciplinary weight management (IMWM) program.Research design and methodsWe conducted a retrospective analysis of 42 patients who electronically uploaded their SMBG data over 12 weeks of an IMWM program and divided them into tertiles based on their average frequency of SMBG per day. Mean (range) SMBG frequencies were 2.3 (1.1–2.9) times/day, 3.4 (3–3.9) times/day, and 5 (4–7.7) times/day in the lowest, middle, and highest tertiles, respectively. Anthropometric and metabolic parameters were measured at baseline and after 12 weeks of intervention.ResultsParticipants in the highest tertile achieved a median change (IQR) in body weight of −10.4 kg (−7.6 to −14.4 kg) compared with −8.3 kg (−5.2 to −12.2 kg), and −6.9 kg (−4.2 to −8.9 kg) in the middle and lowest tertiles, respectively (p=0.018 for trend). Participants in the highest tertile had a median change (IQR) in A1C of −1.25% (−0.6 to −3.1%) compared with −0.8% (−0.3% to −2%) and −0.5% (−0.2% to −1.2%) in the middle and lowest tertiles, respectively (p=0.048 for trend). The association between change in body weight and SMBG frequency remained significant after adjusting for age, sex, baseline body mass index, diabetes duration, and use of insulin therapy.ConclusionsIncreased frequency of SMBG during IMWM is associated with significantly better weight loss and improvement of A1C in patients with T2D and obesity. These findings may suggest future clinical recommendations aimed at increasing SMBG frequency to achieve the most favorable outcomes.

Sign in / Sign up

Export Citation Format

Share Document