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Phenotype-tailored lifestyle interventions show promising weight reduction leads to obese adults

Obesity is a chronic multifactorial disease, which is increasing globally at an alarming rate.



A person with obesity is at the next risk of metabolic and cardiovascular events. Weight reduction in obese or obese people improves metabolic parameters, reduces the danger of heart problems, and increases the standard of life.

Study: Phenotype tailored lifestyle intervention on weight reduction and cardiometabolic risk aspects in adults with obesity: a single-centre, non-randomised, proof-of-concept study. Image Credit: Peakstock / Shutterstock.com

Background

Lifestyle interventions play a major role in weight management, which commonly includes the consumption of a low-calorie weight loss program, together with moderately intense physical activity. So far, no specific weight loss program has been designed specifically for weight reduction.

Diets which are wealthy in macronutrients or involve specific meal timings usually are not related to any superior advantages as compared to straightforward treatments by way of weight reduction. Nevertheless, an improved metabolic profile has been observed when genetic data was considered while designing a customized weight reduction weight loss program.

Weight loss program-based interventions for weight reduction in obese people have to be based on their health status, particularly hypertension, type 2 diabetes, or cardiovascular diseases. So far, no diet-based intervention has been developed to stop or manage obesity. Subsequently, there’s an urgent have to formulate a way of life and weight loss program intervention that considers the behavioral and pathophysiological features of obesity. 

Based on behavioral and pathophysiologic characteristics, obesity phenotypes have been categorized into hedonic eating behavior, homeostatic eating, and abnormal energy expenditure. So far, researchers have yet to find out whether weight loss program and lifestyle interventions customized to those phenotypes could yield a greater consequence as compared to straightforward lifestyle interventions.

In regards to the Study

A recent eClinicalMedicine journal study developed and assessed the effectiveness of a phenotype-tailored lifestyle intervention on weight reduction, physiologic parameters, and cardiometabolic risk aspects in obese adults. 

The present proof-of-concept study is a single-centered, non-randomized trial that has been related to a single intervention team. All participants, which consisted of each men and ladies, were adults, and body mass index (BMI) values exceeding 30 kg/m2.

The study was divided into two phases. Individuals who were related to the primary phase received the usual lifestyle intervention (SLI), whereas those within the second phase were subjected to phenotype-tailored lifestyle intervention (PLI).

Participants were assigned to respective phases based on their enrolment time. To this end, the primary phase was conducted between August 2020 and February 2021, whereas the second phase occurred from March 2021 to September 2021.

Each phase comprised screening, in-person physiologic testing, two days of coaching on the load loss program, and twelve weeks of tailored lifestyle intervention. At week 12, phenotype parameters were measured.

Study findings

A complete of 211 participants were screened, 81 of whom received SLI, and 84 were subjected to PLI. About 88.5% of the participants made it to the 12-week weight assessment. A lot of the participants were women, white, with a median age of roughly 43 years.

PLI resulted in additional weight reduction as in comparison with SLI. Moreover, as in comparison with the SLI group, participants within the PLI group exhibited reduced fat mass, waist circumference, anxiety rating, in addition to triglyceride and levels of cholesterol.

The PLI group was also related to a lower reduction in resting energy expenditure (REE) and greater enhancement in lean mass percentage. Nevertheless, no improvement was present in glycemia, blood pressure, and inflammatory markers.

These observations suggest that PLI is more useful in individuals with obesity or obesity-related comorbidities. Notably, the PLI group exhibited improvements in abnormal satiation and emotional eating related to obesity.

In the longer term, long-term randomized studies are needed to find out whether the positive metabolic results would persist during weight maintenance. Other physiological and metabolic variables also needs to be assessed to develop a greater PLI protocol. 

Conclusions

The present study has many limitations, including its short study period and sequential two-phase trial design without significant baseline characteristic differences between the groups. The non-blinded and non-randomized nature of the study generated inherent treatment bias.

As well as, the vast majority of the participants were white women, which compromised the generalizability of the study. This proof-of-concept study also assessed the outcomes only after 12 weeks of intervention, which is comparable to previous studies reporting significant weight reduction after six months of intervention.

Despite these limitations, PLI was found to be more useful than SLI in weight reduction amongst individuals with obesity.

Journal reference:

  • Cifuentes, L., Ghusn, W., Feris, F., et al. (2023) Phenotype tailored lifestyle intervention on weight reduction and cardiometabolic risk aspects in adults with obesity: a single-centre, non-randomised, proof-of-concept study. eClinicalMedicine 58. doi:10.1016/j.eclinm.2023.101923
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