medwireNews: A randomized trial supports giving people with obesity liraglutide to maintain weight loss after an 8-week diet, particularly if it is combined with regular vigorous exercise.
Indeed, people randomly assigned to follow the combined approach continued to lose weight, compared with no significant change or weight regain in the other groups.
As reported in The New England Journal of Medicine, 195 of 215 people with obesity (but not diabetes) successfully lost at least 5% of their bodyweight during an 8-week dietary intervention (average loss of 13.1 kg from baseline of 109.7 kg) and were randomly assigned to one of four weight maintenance groups.
Over the following 52 weeks, people assigned to the placebo group regained an average of 6.1 kg, which Signe Torekov (University of Copenhagen, Denmark) and study co-authors say “was accompanied by deterioration in all associated metabolic health-related improvements.”
They stress: “This result shows the critical importance of implementing structured treatment after weight loss.”
People assigned to undertake an exercise program regained an average of 2.0 kg, which was significantly less than the placebo group. The researchers note that the exercise program “was predominantly of vigorous intensity,” was “structured but flexible” to fit with participants’ personal needs, and was overseen by a qualified instructor.
Study participants in the exercise group also significantly improved their cardiorespiratory fitness, increased their lean mass, and reduced their fat mass.
Torekov and team say the improvements in cardiorespiratory fitness were of “a magnitude that has been associated with a decreased risk of cardiovascular disease and decreased all-cause mortality,” adding that the exercise strategy “also maintained improvements in general and emotional health.”
Use of liraglutide 3.0 mg/day on its own was associated with a nonsignificant average weight loss of 0.7 kg, which was again a significant improvement versus the placebo group, but combining this with exercise resulted in a significant average 3.4 kg weight loss, along with the benefits observed for exercise alone.
People using liraglutide, with or without exercise, also had significant reductions in glycated hemoglobin, on top of those achieved during the diet phase, but only the combined approach resulted in improved insulin sensitivity and physical functioning.
Of note, although the group taking liraglutide alone had the expected significant increase in heart rate with glucagon-like peptide-1 receptor agonist use, this was not observed in the group that was also doing regular exercise.
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