Randomized trial of lifestyle modification and pharmacotherapy for obesity
Randomized trial of lifestyle modification and pharmacotherapy for obesity
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DOI：
10.1056/nejmoa050156
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发表时间：
2005-11-17
影响因子：
158.5
通讯作者：
Stunkard, AJ
中科院分区：
文献类型：
--
作者：
Wadden, TA;Berkowitz, RI;Stunkard, AJ
背景减肥药物被推荐作为饮食、运动和行为治疗综合方案的辅助治疗，但通常在处方中很少或不改变生活方式。在这项为期一年的试验中，我们随机分配了224名肥胖成年人，让他们每天单独接受15 mg西布曲明，由初级保健提供者在8次访问中提供，每次10至15分钟;单独接受生活方式改变咨询，在30次小组会议中提供;西布曲明加上30次生活方式改变咨询小组会议（即，联合治疗）;或西布曲明加初级保健提供者提供的简短生活方式改变咨询，每次10到15分钟，共8次。所有的受试者都规定了每天1200至1500千卡的饮食和相同的运动regime.ResultsAt一年，受试者谁接受联合治疗失去了12.1+/-9.8公斤的平均值（+/-SD），而那些接受西布曲明单独失去了5.0+/-7.4公斤，那些治疗的生活方式改变单独失去了6.7+/-7.9公斤，西布曲明加短期治疗组体重减轻7.5 ± 8.0 kg（P
BackgroundWeight-loss medications are recommended as an adjunct to a comprehensive program of diet, exercise, and behavior therapy but are typically prescribed with minimal or no lifestyle modification. This practice is likely to limit therapeutic benefits.MethodsIn this one-year trial, we randomly assigned 224 obese adults to receive 15 mg of sibutramine per day alone, delivered by a primary care provider in eight visits of 10 to 15 minutes each; lifestyle-modification counseling alone, delivered in 30 group sessions; sibutramine plus 30 group sessions of lifestyle-modification counseling (i.e., combined therapy); or sibutramine plus brief lifestyle-modification counseling delivered by a primary care provider in eight visits of 10 to 15 minutes each. All subjects were prescribed a diet of 1200 to 1500 kcal per day and the same exercise regimen.ResultsAt one year, subjects who received combined therapy lost a mean (+/-SD) of 12.1+/-9.8 kg, whereas those receiving sibutramine alone lost 5.0+/-7.4 kg, those treated by lifestyle modification alone lost 6.7+/-7.9 kg, and those receiving sibutramine plus brief therapy lost 7.5+/-8.0 kg (P