TOPLINE:
The addition of supervised exercise to obesity pharmacotherapy has shown greater potential for maintaining weight loss and improving body composition after treatment termination than pharmacotherapy alone.
METHODOLOGY:
- Despite significant weight loss achieved with incretin-based obesity pharmacotherapies, their high costs and gastrointestinal adverse events lead to high discontinuation rates with subsequent regaining of weight and body fat.
- Researchers investigated if a strategy involving both exercise and , a -like peptide-1 receptor agonist, was better than either intervention alone in terms of maintaining weight loss and body composition after treatment termination.
- They conducted a 1-year posttreatment analysis of the S-LiTE study, including 109 adults with obesity (age, 18-65 years; body mass index, 32-43) who completed an 8-week low-calorie diet resulting in ≥ 5% weight loss.
- Participants were then randomly allocated to a 52-week weight loss maintenance intervention with either liraglutide or placebo alone or liraglutide or placebo plus supervised exercise.
- The primary outcome was the change in body weight (kg) from randomization to 1 year after the termination of weight maintenance intervention (0-104 weeks), and the secondary outcome was the change in body-fat percentage from 0 to 104 weeks.
TAKEAWAY:
- From week 0 to week 104, supervised exercise plus liraglutide led to 5.1 kg lower weight gain (P = .040) and a 2.3%-point greater decrease in body-fat percentage (P = .026) than liraglutide alone.
- During the 1 year after treatment termination (52-104 weeks), those in the liraglutide group regained 6 kg (95% CI, 2.1-10.0) more than those who were in the supervised exercise plus placebo group, and 2.5 kg (95% CI, -1.5 to 6.5) more than those who received supervised exercise plus liraglutide.
- After 1 year of treatment termination (week 104), the supervised exercise plus liraglutide group had significantly higher odds of maintaining a weight loss of ≥ 10% of initial body weight than the liraglutide (odds ratio [OR], 4.2; 95% CI, 1.6-10.8) or placebo (OR, 7.2; 95% CI, 2.4-21.3) groups.
- The combination of exercise and liraglutide also improved physical functioning along with energy and fatigue scores.
IN PRACTICE:
“Future lifestyle-based treatments during obesity pharmacotherapy may further improve body weight and composition outcomes, with an additional focus on strategies and tools to maintain healthy physical activity habits after termination of pharmacotherapy,” the researchers wrote.
SOURCE:
This study, with lead author Simon Birk Kjær Jensen, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark, was published online in eClinicalMedicine.
LIMITATIONS:
Fewer participants from the placebo group took part in this posttreatment study. Across all treatment groups, participants who attended the posttreatment study had a better mean treatment response during the active treatment than those who did not attend.
DISCLOSURES:
The study was funded by the Novo Nordisk Foundation and Helsefonden. Some authors declared participating in advisory boards and receiving research grants and lecture fees from various sources including Novo Nordisk.
A version of this article first appeared on Medscape.com.