Relationship Between Perceptions of Obesity Causes and Weight Loss Expectations Among Adults.

OBJECTIVE: To examine relationships between the demographic characteristics of subjects with obesity seeking pharmaceutical-assisted weight loss and their weight loss expectations and perceptions of the causes of their obesity. METHODS: A total of 225 adults with obesity completed an obesity perceptions questionnaire (OPQ), which included 4 attribution subscales: biological, psychological, environmental, and lifestyle. Relations were analyzed among OPQ subscales, subject characteristics, and self-perceived ideal 12-month weight loss. RESULTS: Subjects desired to lose 26.4% (SD, 7.7%) of their body weight (ideal weight loss). Ideal weight loss correlated positively with the OPQ biological subscale (P = .008), body mass index (P < .001), female sex (P < .001), and past weight loss attempts (P < .001). Cronbach α was good (>.70) only for the psychological subscale. White race (P = .02), married status (P = .01), and high school or higher education (P = .02) were negatively correlated with ideal weight loss. CONCLUSIONS AND IMPLICATIONS: When designing interventions for preventing and treating obesity, patient perceptions should be considered.

Zonisamide for weight reduction in obese adults: a 1-year randomized controlled trial.

BACKGROUND: Obese individuals who have failed to achieve adequate weight loss with lifestyle changes have limited nonsurgical therapeutic options. We evaluated the efficacy and tolerability of zonisamide, an antiepileptic drug, for enhancing weight loss in obese patients receiving diet and lifestyle guidance. METHODS: This was a 1-year, randomized, double-blind, placebo-controlled trial conducted from January 9, 2006, through September 20, 2011, at Duke University Medical Center. A total of 225 obese (mean [SD] body mass index, 37.6 [4.9]) participants included 134 women (59.6%) and 91 men (40.4%) without diabetes mellitus. (Body mass index is calculated as weight in kilograms divided by height in meters squared.) Interventions were daily dosing with placebo (n = 74), 200 mg of zonisamide (n = 76), or 400 mg of zonisamide (n = 75), in addition to diet and lifestyle counseling by a dietitian for 1 year. Primary outcome was change in body weight at 1 year. RESULTS: Of the 225 randomized patients, 218 (96.9%) provided 1-year follow-up assessments. Change in body weight was -4.0 kg (95% CI, -5.8 to -2.3 kg; least squares mean, -3.7%) for placebo, -4.4 kg (-6.1 to -2.6 kg; -3.9%; P = .79 vs placebo) for 200 mg of zonisamide, and -7.3 kg (-9.0 to -5.6 kg; -6.8%; P = .009 vs placebo) for 400 mg of zonisamide. In the categorical analysis, 23 (31.1%) assigned to placebo, 26 (34.2%; P = .72) assigned to 200 mg of zonisamide, and 41 (54.7%; P = .007) assigned to 400 mg of zonisamide achieved 5% or greater weight loss; for 10% or greater weight loss, the corresponding numbers were 6 (8.1%), 17 (22.4%; P = .02), and 24 (32.0%; P < .001). Gastrointestinal, nervous system, and psychiatric adverse events occurred at a higher incidence with zonisamide than with placebo. CONCLUSION: Zonisamide at the daily dose of 400 mg moderately enhanced weight loss achieved with diet and lifestyle counseling but had a high incidence of adverse events. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00275834