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Impact of weight loss on the metabolic syndrome

International Journal of Obesity volume 31, pages 1442–1448 (2007)Cite this article

Abstract

Objective:

To evaluate the effects of weight loss on the risk of having metabolic syndrome after 1 year of treatment with lifestyle modification alone, pharmacotherapy alone (sibutramine) or the combination of the two.

Design:

Randomized, controlled, 1-year clinical trial.

Patients:

One hundred and eighty women and 44 men, 18–65 years of age, with a body mass index of 30–45 kg/m2, free of uncontrolled hypertension or type 1 or 2 diabetes.

Intervention:

Fifteen milligrams of sibutramine per day alone, lifestyle modification counseling alone, sibutramine plus lifestyle modification counseling or sibutramine plus brief lifestyle modification counseling.

Measurements:

The metabolic syndrome, as defined by the Adult Treatment Panel III.

Results:

Before treatment, 34.8% of the participants had the metabolic syndrome. Metabolic syndrome was more prevalent in Caucasians than African Americans (42.5 vs 20.3%; P<0.03), in males than females (65.1 vs 34.9%; P<0.002) and in older (>44 years) than younger (⩽44 years) participants (47.5 vs 20.8%; P<0.0001). After 1 year of treatment, a moderate decrease in weight (8.0±8.7 kg) resulted in significant reductions in the prevalence of metabolic syndrome from 34.8 to 27.2% of all participants (P<0.02). Logistic regression analyses indicated that for each 1 kg of weight lost, the odds of metabolic syndrome were reduced by 8% (CI=0.89–0.97; P<0.003). Lifestyle modification either alone (P<0.04), or in combination with sibutramine (P<0.05), significantly reduced the prevalence of metabolic syndrome compared with sibutramine alone. The group effect was removed after controlling for weight loss.

Conclusions:

The metabolic syndrome was prevalent in over one-third of obese individuals who sought weight loss treatment, and the prevalence differed by age, sex and ethnicity. Moderate weight loss markedly reduced the odds of metabolic syndrome in this sample.

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Acknowledgements

Funding agencies were not involved in the design or conduct of the study; collection, management, analysis, or interpretation of the data; or preparation, review, or approval of the manuscript. Drs Wadden and Phelan designed the study. Drs Berkowitz, Sarwer, Womble and Cato treated the patients and contributed to the revision of the paper with critical input from the other authors. Ms Rothman provided administrative, technical and logistic support and assembled the data. Dr Phelan analyzed the data and prepared the first draft of the manuscript, which was revised with the critical input from Dr Wadden and the other coauthors. All authors have approved the submission of the manuscript. Dr Phelan, as the principal investigator of this secondary study, had full access to all the data in the investigation and takes responsibility for the integrity of the data, the accuracy of the data analysis and acknowledgement of all author contributions. This research was supported by grants DK56124 and DK065018 from the National Institutes of Diabetes Digestive and Kidney Disease. Abbott Laboratories provided the medication used in the study. Drs Wadden and Berkowitz have served as consultants to Abbott laboratories, which manufacture sibutramine.

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Authors and Affiliations

  1. Brown Medical School/The Miriam Hospital, Providence, RI, USA

    S Phelan

  2. University of Pennsylvania School of Medicine, Philadelphia, PA, USA

    T A Wadden, R I Berkowitz, D B Sarwer, L G Womble, R K Cato & R Rothman

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  1. S Phelan
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Correspondence to S Phelan.

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Phelan, S., Wadden, T., Berkowitz, R. et al. Impact of weight loss on the metabolic syndrome. Int J Obes 31, 1442–1448 (2007). https://doi.org/10.1038/sj.ijo.0803606

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