Effectiveness of Gradual Versus Rapid Weight Loss
- Conditions
- Obesity
- Interventions
- Other: Gradual weight loss (GWL) programOther: Rapid weight loss (RWL) program
- Registration Number
- NCT03776552
- Lead Sponsor
- The Hospital of Vestfold
- Brief Summary
This randomized controlled trial aims to compare the 1-year effectiveness of an initial rapid weight loss (RWL) program and a gradual weight loss (GWL) program.
- Detailed Description
A total of at least 286 participants will be randomized to either a 16-week rapid weight loss (RWL) program; \[an 8-week low-energy-diet (\<1000 kcal/day) - followed by an 8-week gradual increase in energy intake (4 weeks \<1300 kcal/day and 4 weeks \<1500 kcal/day)\], or a 16-week gradual weight loss (GWL) program (controls); \[estimated total energy expenditure minus 800-1000 kcal/day\]. Thereafter, all participants (both groups) will undergo a 36-week comprehensive weight maintenance program.
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- All
- Target Recruitment
- 293
-
• Willing and able to give informed consent for participation in the study
- Living in the eastern part of Norway, mainly Oslo, Buskerud, Vestfold and Akershus
- Understanding Norwegian language written and spoken easily
- BMI ≥30.0 kg/m2
- Stable body weight (<5 kg self-reported weight change) during the last 3 months before inclusion
-
• Pregnancy and breast-feeding mothers
- Suspected non-compliance with regards to visits and/or diet
- Severe chronic disease (endocrine disease, heart disease, neurological disease, lung disease, disease in the gastrointestinal tract, kidney disease, rheumatism or cancer).
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Gradual weight loss (GWL) program Gradual weight loss (GWL) program 16-week GWL-program (estimated total energy expenditure minus 800-1000 kcal/day) followed by a 36-weight loss maintenance program. Rapid weight loss (RWL) program Rapid weight loss (RWL) program 16-week rapid weight loss (RWL) program \[8-week LED (\<1000 kcal/day) - followed by an 8-week gradual increase in energy intake (4 weeks \<1300 kcal/day and 4 weeks \<1500 kcal/day)\] followed by a 36-weight loss maintenance program.
- Primary Outcome Measures
Name Time Method Change in body weight from baseline to 12 months Baseline to 1-year Percent total body weight loss (%TBWL) at 12 months follow-up
- Secondary Outcome Measures
Name Time Method Changes in blood pressure 4-month and 1-year Systolic and diastolic blood pressure (mm/Hg)
Changes in glucose parameters 4-month and 1-year HbA1c (mmol/mol)
Changes in lipids 4-month and 1-year Total-cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides (mmol/l)
Changes in body composition 2 4-month and 1-year Dual-energy X-ray Absorptiometry (DXA) in selected participants
Changes in CRP 4-month and 1-year CRP (mg/L)
Changes in Health Related Quality of Life 1 4-month and 1-year Generic questionnaire: Short Form-36 Health Survey, SF36. Each item is scored on a 0 to 100 range so that the lowest and highest possible scores are 0 and 100, respectively. Scores for each of the 8 domains and summary scores for physical and mental health will be calculated
Changes in Health Related Quality of Life 3 4-month and 1-year Weight-related Symptom Measure (WRSM). The validated obesity specific WRSM measures 20 symptoms commonly related to being overweight or obese, including foot problems, joint pain, sensitivity to cold, shortness of breath, etc. using two different sets of items. The first set assesses whether or not a patient is experiencing specific symptoms, and the second set rates the level of the distress of the symptoms with values from zero ("not at all") to six ("bothers a very great deal"). The first set creates an additive scale summing symptoms from 0-20, while the second forms a symptom distress scale ranging from 0-120.
Proportions of participants with a TBWL of ≥ 5%, ≥10% and ≥15% at 52-week 1-year TBWL of ≥ 5%, ≥10% and ≥15% at 52-week follow-up
Changes in anthropometric measures 4-month and 1-year Waist and hip circumference (cm)
Changes in body composition 1 4-month and 1-year Bioelectrical Impedance Analysis (BIA)
Change in weight from baseline to 4 months 4-month Percent total body weight loss (%TBWL) at 4 months follow-up
Changes in Health Related Quality of Life 2 4-month and 1-year Obesity specific questionnaire: IWQOL-lite. The IWQOL-Lite is a 31-item measure of weight-related quality of life. There are five domain scores (Physical Function, Self-Esteem, Sexual Life, Public Distress and Work) and a total score. Scores for all domains and total score range from 0-100, with lower scores indicating greater impairment.
Changes in symptoms of depression and anxiety 4-month and 1-year Hospital Anxiety and Depression Scale (HADS). The validated generic HADS measures symptoms of anxiety and depression using 14 items scored from 0-3 It is decomposed into two domains measuring depression (HADS-D) and anxiety (HADS-A), both consisting of seven items yielding a score from 0-21.
Changes in eating behavior 4-month and 1-year The Three Factor Eating Questionnaire -R 21 (TFEQ-R21) measures eating behaviour and has been validated for use in individuals with obesity and will be used in the study. It consists of 21 items comprising three domain scores; (1) uncontrolled eating; assessing the tendency to lose control over eating when feeling hungry or when exposed to external stimuli, (2) cognitive restraint; assessing the conscious restriction of food intake to control body weight or body shape, and (3) emotional eating; assessing overeating related to negative mood states. The domain scores were transformed to 0-100 scales to facilitate comparison; a higher score indicates more uncontrolled, restraint, or emotional eating.
Trial Locations
- Locations (1)
Vestfold Hospital Trust
🇳🇴Tønsberg, Norway