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American Journal of Clinical Nutrition, Vol. 78, No. 2, 209-214, August 2003
© 2003 American Society for Clinical Nutrition


ORIGINAL RESEARCH COMMUNICATION

Leisure-time activity is an important determinant of long-term weight maintenance after weight loss in the Sibutramine Trial on Obesity Reduction and Maintenance (STORM trial)1,2,3

Marleen A van Baak, Edgar van Mil, Arne V Astrup, Nick Finer, Luc F Van Gaal, Jannik Hilsted, Peter G Kopelman, Stephan Rössner, W Philip James and Wim HM Saris for the STORM Study Group

1 From the Department of Human Biology, Nutrition and Toxicology Research Institute (NUTRIM), Maastricht University, Maastricht, Netherlands (MAvB, EvM, and WHMS); the Research Department of Human Nutrition, The Royal Veterinary and Agricultural University, Copenhagen (AVA); the Centre for Obesity Research, Luton & Dunstable Hospital, Luton, United Kingdom (NF); the Department of Diabetology and Metabolism, University Hospital of Antwerp, Antwerp, Belgium (LFVG); Hvidovre Hospital, Hvidovre, Denmark (JH); the Directorate of Diabetes & Metabolism, Royal London University Hospital, London (PGK); the Obesity Unit, Huddinge University Hospital, Huddinge, Sweden (SR); and the Rowett Research Institute, Aberdeen, United Kingdom (WPJ).

Background: The success rate of long-term maintenance of weight loss in obese patients is usually low. To improve the success rate, determinants of long-term weight maintenance must be identified.

Objective: The objective of the study was to identify determinants of long-term success in weight maintenance in obese subjects who completed the Sibutramine Trial on Obesity Reduction and Maintenance (n = 261), a multicenter European study of weight loss and weight maintenance in obesity that combines sibutramine treatment with dietary restriction and advice on exercise and behavior.

Design: We studied weight maintenance over 18 mo in subjects who had completed a 6-mo weight-loss phase. Factors included in the analysis were initial body weight, the percentage of initial body weight lost, dietary intake, various components of physical activity (measured with the Baecke questionnaire), the type of treatment (sibutramine or placebo), age, and sex.

Results: Multiple regression analysis identified treatment group (sibutramine or placebo), the percentage of the initial body weight that was lost during the 6-mo weight-loss phase, and the leisure-time physical activity index as significant determinants of weight maintenance. Together, these 3 factors explained 20% of the variation in weight maintenance (P < 0.001). Dietary factors, age, and sex were not significant predictors of weight-maintenance success in this study.

Conclusions: Weight-maintenance success after weight loss is positively influenced by sibutramine treatment during weight maintenance, by a greater initial weight loss, and by a higher leisure-time physical activity index, which reflects higher levels of activities such as walking and cycling and lower levels of television viewing.




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