Background: Obesity (BMI ≥ 30 kg/m2) is a chronic disease which is associated with disturbances in metabolism and eating behaviour as well as increased risk for numerous somatic and mental diseases. Lifestyle interventions are generally considered effective if they induce weight loss ≥ 5% which promotes significant improvements in cardiometabolic health. However, the heterogeneous nature of the disease may necessitate a more wholesome approach in assessing the effects of obesity treatment. Here, we provide a comprehensive description of changes in behavioural, physiological and psychological health measures in response to an extensive combined lifestyle intervention.
Methods: Data were collected from 91 adult patients with obesity (75 women), recruited via the Obesity Center CGG in Rotterdam. The 75-week lifestyle intervention comprised physical activity, psychoeducation and a healthy normocaloric diet. We assessed physiological health (anthropometrics, metabolic parameters) and psychological health (IWQoL-Lite, HADS) eating behaviour (DEBQ) and physical activity (IPAQ). Outcomes were compared between baseline and 75 weeks of treatment.
Results: There was a 5.5% decrease in BMI (40.2 kg/m2 ± 5.8 vs 38.0 ± 6.2, p<.001) along with a 6.1% decrease in waste circumference (115.1 cm ± 14.4 vs 107.5 cm ± 15.9, p<.001) as well as decreases in insulin (145 pmol/l; 84.5–216 vs 118 pmol/l; 69–160, p<.001), leptin (45.5 ng/ml± 15.3 vs. 39.8 ng/ml± 15.6, p=.010) and improvements in lipid profiles, liver enzymes and immune parameters. These changes were accompanied by improvements in psychological well-being (IWQoL-Lite (p<.001), HADS total and depression score (p<.01 and p<.001, respectively), decreased problematic eating behaviour (DEBQ (p<.01)) and increases in physical activity (IPAQ, p<.05).
Conclusion: Although weight loss was rather moderate, patients showed a broad variety of metabolic, psychological and behavioural improvements. Future research should assess the precise mechanisms promoting these beneficial effects.