Saturday, June 20, 2015

Weight Loss Clinical Trials: Weekend Links

Bill Yates
Brain Posts
Posted 17th January

Randomized clinical trials provide one of the best ways to test new obesity interventions.

These types of trials can examine effects of specific diets, new pharmacological treatment and new surgical treatments.

Here are some of the recent published trials that caught my attention in the last years.

Clicking on the title will take you to the PubMed abstract for more information. Additionally, some of the abstracts will have links to full-text manuscripts.

Lorcaserin: Safety and efficacy

This manuscript examined the results and safety of two previously published randomized trials of locarserin leading to FDA approval for obesity. Lorcaserin is a serotonin receptor 2 agonist. This manuscript noted more weight loss with this drug at one year (5.8% of body weight vs 2.5% of body weight for placebo). The drug appeared safe with no evidence of heart valve problems previously seen in some weight loss drugs.

Exercise effects in obese adolescents

In this randomized trial, obese adolescents participated in one of four groups: aerobic training, resistance training, combined aerobic and resistance and control. Body fat was measured using MRI at baseline and 6 months. The study found significant reductions in body fat in all three exercise groups compared to controls. Adolescents who had high adherence to the combined training regimen fared best.

Bariatric surgery compared to medical obesity management in type 2 diabetes

Weight loss surgery is frequently reserved for the most obese that have a significant obesity-related medical condition. Less severely obese individuals (BMI 30 to 35) with type 2 diabetes have received less attention. In this study individuals with type 2 diabetes and a BMI of between 30 and 35 were randomized to bariatric surgery or aggressive medical therapy. The bariatric surgery group at six months had higher diabetes remission rates (65% vs 0%) and greater weight loss.

Vagal nerve blockade as a treatment of obesity

The vagus nerve running from the GI tract to the brain in known to be involved in control of food intake and satiety. This study examined a clinical trial of a surgical intervention that allows for intra-abdominal vagal blockade. This trial found some evidence for superiority of vagal blockade vs sham intervention, but the effects were relatively mild and did not meet pre-study targets for significant advantage.

Inpatient treatment for severe obesity in children and adolescents

Treating severe obesity in children and adolescents is a serious clinical challenge. A group in the Netherlands examined the potential for a partial hospitalization over 6 months to boost weight loss in obese children and adolescents. The hospitalized group had greater weight loss at 6 months compared to an outpatient control group. However, these favorable outcomes were not present at 12 month and 24 months follow up.

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