Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Paper
  • Published:

Psychobehavioral and nutritional predictors of weight loss in obese women treated with sibutramine

International Journal of Obesity volume 29, pages 208–216 (2005)Cite this article

Abstract

OBJECTIVE:

To reveal whether baseline body mass index (BMI), and psychobehavioral and nutritional markers were significant predictors of the change in BMI observed after 4 and 12 months in obese women enrolled in a weight reduction program, including low-energy diet, increased physical activity, cognitive behavior therapy and sibutramine. The impact of changes in psychobehavioral and nutritional markers observed after 4 and 12 months of treatment on BMI changes was also investigated.

DESIGN:

During a double-blind placebo-controlled 4-month period, subjects received either sibutramine (10 mg/day) or placebo. Then, an open phase with sibutramine administered to all patients continued until month 12.

SUBJECTS:

In total, 80 obese women (age: 43.9±10.6 y, BMI: 36.7±4.8 kg/m2).

MEASUREMENTS:

The dependent variable was change in BMI while baseline BMI, mode of treatment, the Beck depression score, the three items (dietary restraint, disinhibition and perceived hunger) of the Eating Inventory (EI), energy and macronutrient intakes were independent variables. At 1-week dietary records were analyzed using a computer software for assessing energy and macronutrient intake.

RESULTS:

Multiple regression analysis revealed that the BMI loss at month 4 was significantly influenced by mode of treatment and initial BMI, whereas a borderline negative relationship was observed with the baseline restraint score. Baseline BMI, depression score, restraint score and total energy intake predicted weight loss at month 12. These predictive variables accounted for 43.8% of the variance in BMI loss at 12 months. When relationships between the BMI loss and changes in all included psychobehavioral and nutritional parameters were considered after 12 months of treatment, a drop in the disinhibition score of the EI appeared the only significant factor affecting the BMI decrease.

CONCLUSIONS:

Our results suggest that psychobehavioral and nutritional characteristics can be used as predictors of weight loss in response to a comprehensive weight management program including pharmacological treatment with sibutramine.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2

Similar content being viewed by others

References

  1. Flatt J-P, Tremblay A . Substrate balances and weight maintenance. In: Bray GA, Bouchard C, James WPT (eds) Handbook of obesity. Marcel Dekker: New York; 1998. pp 528–532.

    Google Scholar 

  2. Beck AT, Ward CH, Mendeson M, Mock J, Erbaugh J . An inventory for measuring depression. Arch Gen Psychiat 1961; 4: 561–571.

    Article  CAS  Google Scholar 

  3. Clark MM, Niaura R, King TK, Pera V . Depression, smoking, activity level, and health status: pretreatment predictors of attrition in obesity treatment. Addict Behav 1996; 21: 509–513.

    Article  CAS  Google Scholar 

  4. Delahanty LM, Meigs JB, Hayden D, Williamson DA, Nathan DM . Psychological and behavioral correlates of baseline BMI in the Diabetes Prevention Program (DPP). Diabetes Care 2002; 25: 1992–1998.

    Article  Google Scholar 

  5. Hainer V, Kunesova M, Parizkova J, Stich V . Depression score and Eating Inventory in obese women followed for two years after initial one-month VLCD treatment [Abstract]. Int J Obes Relat Metab Disord 1997; 21 (suppl 2): S113.

    Google Scholar 

  6. Stunkard AJ, Messick S . The three-factor eating questionnaire to measure dietary restraint, disinhibition and hunger. J Psychosom Res 1985; 29: 71–83.

    Article  CAS  Google Scholar 

  7. Foster GD, Wadden TA, Swain RM, Stunkard AJ, Platte P, Vogt RA . The Eating Inventory in obese women: clinical correlates and relationship to weight loss. Int J Obes Relat Metab Disord 1998; 22: 778–785.

    Article  CAS  Google Scholar 

  8. Adami GF, Gandolfo P, Meneghelli A, Gianetta E, Camerini G, Scopinaro N . Preoperative eating behavior and weight-loss following gastric banding for obesity. Obes Surg 1996; 6: 244–246.

    Article  CAS  Google Scholar 

  9. Westerterp-Plantenga MS, Kempen KP, Saris WHM . Determinants of weight maintenance in women after diet-induced weight reduction. Int J Obes Relat Metab Disord 1998; 22: 1–6.

    Article  CAS  Google Scholar 

  10. Lejeune MP, van Aggel-Leijssen DP, van Baak MA, Westerterp-Plantenga MS . Effects of dietary restraint vs. exercise during weight maintenance in obese men. Eur J Clin Nutr 2003; 57: 1338–1344.

    Article  CAS  Google Scholar 

  11. Westenhoefer J, von Falck B, Stellfeldt A, Fintelmann S . Behavioural correlates of successful weight reduction over 3 y Results from the Lean Habits Study. Int J Obes Relat Metab Disord 2004; 28: 334–335.

    Article  CAS  Google Scholar 

  12. Womble LG, Williamson DA, Greenway FL, Redmann SM . Psychological and behavioral predictors of weight loss during drug treatment for obesity. Int J Obes Relat Metab Disord 2001; 25: 340–345.

    Article  CAS  Google Scholar 

  13. Kelly F, Wade AG, Jones SP, Johnson SG . Sibutramine hydrochloride vs. dexfenfluramine: weight loss in obese subjects [abstract]. Int J Obes Relat Metab Disord 1994; 18 (Suppl 2): 61.

    Google Scholar 

  14. Hansen DL, Toubro S, Stock MJ, Macdonald IA, Astrup A . The effect of sibutramine on energy expenditure and appetite during chronic treatment without dietary restriction. Int J Obes Rel Metab Disord 1999; 23: 1016–1024.

    Article  CAS  Google Scholar 

  15. James WPT, Astrup A, Finer N, Hilsted J, Kopelman P, Rossner S, Saris WHM, Van Gaal LF . Effect of sibutramine on weight maintenance after weight loss: a randomised trial. Lancet 2000; 356: 2119–2125.

    Article  CAS  Google Scholar 

  16. Berkowitz RI, Wadden TA, Tershakovec AM, Cronquist JL . Behavior therapy and sibutramine for the treatment of adolescent obesity. JAMA 2003; 289: 1805–1812.

    Article  CAS  Google Scholar 

  17. Bray GA, Blackburn GL, Ferguson JM, Greenway FL, Jain AK, Mendel CM, Mendels J, Ryan DH, Schwartz SL, Scheinbaum ML, Seaton TB . Sibutramine produces dose-related weight loss. Obes Res 1999; 7: 189–198.

    Article  CAS  Google Scholar 

  18. Guy-Grand B, Apfelbaum M, Crepaldi G, Gries A, Lefebvre P, Turner P . International trial of long-term dexfenfluramine in obesity. Lancet 1989; 11: 1142–1145.

    Article  Google Scholar 

  19. Hansen DL, Astrup A, Toubro S, Finer N, Kopelman P, Hilsted J, Rossner S, Saris WHM, Van Gaal LF, James WPT, Goulder M, for the STORM study group. Predictors of weight loss and maintenance during 2 years of treatment by sibutramine in obesity. Results from the European multi-centre STORM trial. Int J Obes Rel Metab Disord 2001; 25: 496–501.

    Article  CAS  Google Scholar 

  20. Sjostrom L, Rissanen A, Andersen T, Boldrin M, Golay A, Kopperschaar HP, Krempf M . Randomized placebo-controlled trial of orlistat for weight loss and prevention of weight regain in obese patients. European Multicentric Orlistat Study Group. Lancet 1998; 352: 167–172.

    Article  CAS  Google Scholar 

  21. Karhunen L, Franssila-Kallunki A, Rissanen P, Valve R, Kolehmainen M, Rissanen A, Uusitupa M . Effect of orlistat treatment on body composition and resting energy expenditure during a two-year weight-reduction programme in obese Finns. Int J Obes Relat Metab Disord 2000; 24: 1567–1572.

    Article  CAS  Google Scholar 

  22. Grilo CM . On the relationship of attempting to lose weight, restraint, and binge eating in outpatients with binge eating disorder. Obes Res 2000; 8: 638–645.

    Article  Google Scholar 

  23. McGuire MT, Jeffrey RW, French SA, Hannan PJ . The relationship between restraint and weight and weight-related behaviors among individuals in a community weight gain prevention trial. Int J Obes Relat Metab Disord 2001; 25: 574–580.

    Article  CAS  Google Scholar 

  24. Bjorvell H, Rossner S, Stunkard AJ . Obesity, weight loss and dietary restraint. Int J Eat Disord 1986; 5: 727–734.

    Article  Google Scholar 

  25. Laporte DJ, Stunkard AJ . Predicting attrition and adherence to a very low calorie diet: a prospective investigation of the Eating Inventory. Int J Obes Relat Metab Disord 1990; 14: 197–206.

    CAS  Google Scholar 

  26. Baucom DH, Aiken PA . Effect of depressed mood on eating among nonobese dieting and nondieting persons. J Personal Soc Psychol 1981; 41: 577–585.

    Article  CAS  Google Scholar 

  27. Wadden TA, Stunkard AJ, Brownell KD, Day SC . Treatment of obesity by behaviour therapy and very low calorie diet: a pilot investigation. J Consult Clin Psychol 1984; 52: 692–694.

    Article  CAS  Google Scholar 

  28. Wadden TA, Stunkard AJ, Day SC, Gould RA, Rubin CJ . Less food, less hunger: reports of appetite and symptoms in a controlled study of a protein-sparing modified fast. Int J Obes Relat Metab Disord 1987; 11: 239–249.

    CAS  Google Scholar 

  29. Rolls BJ, Shide DJ, Thorwart ML, Ulbrecht JS . Sibutramine reduces food intake in non-dieting women with obesity. Obes Res 1998; 6: 1–11.

    Article  CAS  Google Scholar 

  30. Prewitt TE, Schmeisser D, Bowen PE, Aye P, Dolecek TA, Langenberg P, Cole T, Brace L . Changes in body weight, body composition, and energy intake in women fed high- and low-fat diets. Am J Clin Nutr 1991; 54: 304–310.

    Article  CAS  Google Scholar 

  31. Astrup A, Grunwald GK, Melanson EL, Saris WH, Hill JO . The role of low-fat diets in body weight control: meta-analysis of ad libitum dietary intervention studies. Int J Obes Relat Metab Disord 2000; 24: 1545–1552.

    Article  CAS  Google Scholar 

  32. Barkeling B, Rossner S, Bjorvell H . Effects of a high-protein meal (meat) and a high-carbohydrate meal (vegetarian) on satiety measured by automated computerized monitoring of subsequent food intake, motivation to eat and food preferences. Int J Obes Relat Metab Disord 1990; 14: 743–751.

    CAS  Google Scholar 

  33. Crovetti R, Porrini M, Santangelo A, Testolin G . The influence of thermic effect of food on satiety. Eur J Clin Nutr 1998; 52: 482–488.

    Article  CAS  Google Scholar 

  34. Kabrnova K, Braunerova R, Aldhoon B, Hlavaty P, Wagenknecht M, Kunesova M, Parizkova J, Hainer V . Association of changes in macronutrient and calcium intakes with body weight changes in obese subjects. Int J Obes Relat Metab Disord 2004; 28 (suppl 1): S138.

    Google Scholar 

  35. Westerterp-Plantenga MS, Lejeune MP, Nijs I, van Ooijen M, Kovacs EM . High protein intake sustains weight maintenance after body weight loss in humans. Int J Obes Relat Metab Disord 2004; 28: 57–64.

    Article  CAS  Google Scholar 

  36. Ben-Menachem E, Axelsen M, Johanson EH, Stagge A, Smith U . Predictors of weight loss in adults with topiramate-treated epilepsy. Obes Res 2003; 11: 556–562.

    Article  CAS  Google Scholar 

  37. Lejeune MP, Hukshorn CJ, Saris WH, Westerterp-Plantenga MS . Effect of dietary restraint during and following pegylated recombinant leptin (PEG-OB) treatment of overweight men. Int J Obes Relat Metab Disord 2003; 27: 1494–1499.

    Article  CAS  Google Scholar 

  38. Finer N, Bloom SR, Frost GS, Banks LM, Griffiths J . Sibutramine is effective for weight loss and diabetic control in obesity with type 2 diabetes: a randomised, double-blind, placebo-controlled study. Diabetes Obes Metab 2000; 2: 105–112.

    Article  CAS  Google Scholar 

  39. Scholze J . Sibutramine in clinical practice—a PMS-study with positive effects on blood pressure and metabolic parameters. Dtsch Med Wochenschr 2002; 127: 606–610.

    Article  CAS  Google Scholar 

  40. Hauner H, Meier M, Jockel KH, Frey UH, Siffert W . Prediction of successful weight reduction under sibutramine therapy through genotyping of the G-protein beta3 subunit gene (GNB3) C825 T polymorphism. Pharmacogenetics 2003; 13: 453–459.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This study was supported by the grants COST B17-40 and IGA NR/7800-4.

Author information

Authors and Affiliations

  1. Institute of Endocrinology, Obesity Management Centre, Prague, Czech Republic

    V Hainer, M Kunesova, M Hill, R Braunerova & M Wagenknecht

  2. INRA, Diabetes Department, Hotel Dieu, Paris, France

    F Bellisle

Authors
  1. V Hainer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M Kunesova
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. F Bellisle
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M Hill
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. R Braunerova
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. M Wagenknecht
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

and STO Study Group

Corresponding author

Correspondence to V Hainer.

Additional information

Co-authors: Marie Kunesova, France Bellisle, Martin Hill, Radka Braunerova, Martin Wagenknecht; and co-participants in the STO Study Group: Pavol Hlubik, Ivo Hruby, Stepan Svacina, Vladimir Stich.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hainer, V., Kunesova, M., Bellisle, F. et al. Psychobehavioral and nutritional predictors of weight loss in obese women treated with sibutramine. Int J Obes 29, 208–216 (2005). https://doi.org/10.1038/sj.ijo.0802850

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijo.0802850

Keywords

This article is cited by

Search

Advanced search

Quick links