RESUMO
Objective. To assess the one-year effectiveness on weight loss of a 3-week balneotherapy program (BT). Method. A Zelen double consent randomised controlled trial to compare one-year BMI loss between a 3-week BT program versus usual care (UC) for overweight or obese patients (BMI: 27-35 kg/m(2)), associated or not with a dietary motivational interview (DMI) during the follow-up, using a 2 × 2 factorial design. Main analysis was a per protocol analysis comparing patients attending BT to patients managed by UC, matched on sex, overweight or obese status, DMI randomisation and a propensity score to attend BT or to be managed by UC. Results. From the 257 patients who completed the follow-up, 70 patients of each group could be matched. Mean BMI loss was 1.91 kg/m(2) [95%CI: 1.46; 2.35] for the BT patients and 0.20 kg/m(2) [-0.24; 0.64] for the UC patients (P < 0.001), corresponding to a significant BT benefit of 1.71 kg/m(2) [1.08; 2.33]. There was no significant effect of DMI and no interaction with BT or UC. No adverse reaction was observed for patients attending BT. Conclusion. A 3-week BT program provided a significant one-year benefit over the usual GP dietary advice for overweight and obese patients.
RESUMO
OBJECTIVE: To identify anthropometric and behavioral characteristics associated with weight maintenance after an obesity treatment. STUDY DESIGN: Adolescents (n = 72) enrolled in a 9-month obesity treatment were observed 1 and 2 years after discharge. Two groups, "successful" versus "limited or no success," were created on the basis of the differences in body mass index (BMI) z-score between inclusion and end of follow-up. Anthropometric and behavioral characteristics were compared between groups. RESULTS: Both groups showed a decrease in BMI z-score between inclusion and end of follow-up, 2.09 +/- 0.68 SD for the successful group and 0.65 +/- 0.43 SD for the group with limited or no success. Groups did not differ during treatment for any of the anthropometric characteristics considered, whereas differences clearly appeared 1 year after treatment and generally stabilized during the second year. Later adiposity rebound, trend for lower BMI in the mother, and, during follow-up, lower total energy intake, more energy at breakfast, and less snacking and television were recorded in the successful group. CONCLUSIONS: Weight loss maintenance can neither be predicted with anthropometry during treatment nor with behavioral characteristics at inclusion, but can be estimated 1 year after discharge. Early life factors should also be taken into account for predicting treatment outcome.
