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Looking ahead in the treatment of obesity

from Cathy Nonas

Saturday started with a great upbeat talk by Tom Wadden, Ph.D. from the University of Pennsylvania, on the importance of lifestyle modification to reduce weight. Dr. Wadden is this year's recipient of the TOPS Research Achievement Award. Beginning with a prescient albeit depressing quote from one of the godfathers of obesity research, Mickey Stunkard, who said in 1958 that some people could lose weight but most would regain it, Dr. Wadden took us through the lifecycle of behavior modification to prove to us that although we still have a lot of work to do, our patients are doing better. Using the success of the Diabetes Prevention Program as a stepping stone, the Look AHEAD study created a model for intensive lifestyle intervention.

The design included 24 in-person meetings for the first 6 months and 2 meetings per month for the next 6 months, as well as monthly maintenance meetings. The results of the first 4 years from Look AHEAD showed that indeed, although some people do regain weight, the good news is that a significant number who lose 5 to 10 percent do keep some if not all weight off after 4 years with intensive lifestyle treatment. Furthermore, at 4 years, the cardiovascular risks were reduced. The results have been so promising that the recent CMS and U.S. Preventative Task Force guidances both include the importance of intensive lifestyle treatment for obesity. Although Mickey Stunkard's words still echo, it was good to hear that more than 50 years later, we can amend his words to say that although some will regain weight, many will not regain all of it. more

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