Innovative Swiss programme offers new hope for long term weight-loss

Swiss researchers found that more than half a group of morbidly obese patients maintained a 10 kg weight reduction and overall 70% of their patients succeeded in avoiding further weight gain after five years.

“This is a phenomenal success rate. Finding a way to help patients maintain their weight loss over a long period of time is difficult and these findings show that it is indeed possible for many people,” said the study’s leader, Dr. Séverine Buclin of the University Hospital in Geneva, Switzerland.

The programme goes beyond standard obesity treatment approaches of a diet and exercise regime to include a comprehensive array of skills-building workshops addressing issues such as identifying the triggers for bingeing, reconnecting with the body through dance therapy and tuning in to hunger and fullness signals.

While many programmes are successful in getting people to lose weight, long-term success rates are poor, with most dieters regaining their initial weight loss within a year. Very few – perhaps 5% – manage to keep the weight off in the long term.

The new study, presented on Saturday at the European Congress on Obesity, found that broadening the strategy resulted in 70% of patients either maintaining their initial weight loss or losing further weight over five years.

The study involved 33 obese patients with an average body mass index of 40. The patients were hospitalized for two weeks, with weekends at home, and were enrolled in an intense and comprehensive programme that was founded on a diet cut by 500 calories a day, an exercise regime of three walks per week and 10 sessions of cognitive-behavioural psychotherapy. The programme also included the unusual addition of practical educational workshops that addressed topics such as eating with pleasure, detecting hidden fat, how to shop for food, exercise motivation, identifying triggers for bingeing and developing strategies for avoiding it, reconnecting with hunger and satiety sensations, feeling the body through dance therapy and expressing emotion through art therapy.

During the five years that followed the hospital stay, each patient was seen once every two months by a family practice doctor trained in obesity treatment. They were weighed and given basic counselling during these sessions. No diet drugs were used in the programme.

At the end of the five years, the patients were examined again and completed a questionnaire investigating their psychosocial state and eating patterns. Only 30% of the patients had regained weight since the hospital stay. A total of 15% weighed about the same as they did when they left the hospital and 55% had lost more weight, on average 10kg in total.

The researchers found that psychosocial difficulties, such as professional stress and family problems, reduced the chance of success and that those who regained weight were more likely to have an eating disorder and tended to eat a higher-fat diet than those who succeeded.

The strategy is one that is easy to apply in communities and the costs – about 2,500 euros per patient for the initial programme – are reasonable for governments or insurers to reimburse, Buclin said.

“These results show that the future of weight-loss management should involve giving patients access over several years to both individual and group follow-up sessions with primary care doctors trained in obesity treatment and that motivational workshops that educate patients and give them tools to help them keep their weight down should be included in obesity treatment programmes,” Buclin added.

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