Journal article
Anti-obesity medication for weight loss in early nonresponders to behavioral treatment: a randomized controlled trial
Nature medicine
07 Mar 2025
PMID: 40055520
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Current guidelines recommend behavioral treatment (BT) as the first intervention for patients with obesity. However, a substantial minority (35-50%) do not achieve a clinically meaningful loss of ≥5%. Anti-obesity medications (AOMs) are recommended when target weight loss is not achieved; however, their efficacy among BT nonresponders has not been established. This double-blind, randomized controlled proof-of-principle study evaluated whether augmenting BT with AOM improved 24-week weight loss compared to BT with placebo in early nonresponders to BT. A total of 147 adults with a body mass index ≥31 kg m
(≥28 kg m
with obesity-related comorbidity) completed an initial 4-week BT run-in. The 76 early nonresponders who lost <2.0% of initial weight were then randomized to 24 weeks of either BT plus placebo (BT + P, n = 38) or BT plus AOM (phentermine = 15.0 mg d
, n = 38). Early responders received ongoing BT and were not part of the randomized trial. The primary outcome was met; early nonresponders assigned to BT + AOM had a greater mean (±s.e.) reduction in weight of 5.9 ± 0.7% from randomization to week 24, as compared to 2.8 ± 0.7% for those assigned to BT + P (mean difference = 3.1 ± 1.0, 95% confidence interval = 1.1-5.1%, Cohen's d = 0.73, P = 0.003). Stepping up early BT nonresponders to BT + AOM improves their 24-week weight loss. ClinicalTrials.gov registration: NCT03779048 .
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Details
- Title
- Anti-obesity medication for weight loss in early nonresponders to behavioral treatment: a randomized controlled trial
- Creators
- Jena S Tronieri - University of PennsylvaniaEleanor Ghanbari - University of PennsylvaniaJonathan Chevinsky - Beth Israel Deaconess Medical CenterErica M LaFata - Drexel UniversityAlyssa M Minnick - University of PennsylvaniaSimran Rajpal - University of PennsylvaniaSeamus Y Wang - University of the SciencesKylie Burcaw - University of PennsylvaniaRobert I Berkowitz - Children's Hospital of PhiladelphiaThomas A Wadden - University of Pennsylvania
- Publication Details
- Nature medicine
- Publisher
- Nature
- Number of pages
- 23
- Grant note
- K23DK116935 / U.S. Department of Health & Human Services | NIH | National Institute of Diabetes and Digestive and Kidney Diseases (National Institute of Diabetes & Digestive & Kidney Diseases)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Psychological and Brain Sciences (Psychology); WELL Center
- Web of Science ID
- WOS:001439541600001
- Scopus ID
- 2-s2.0-86000305257
- Other Identifier
- 991022040669904721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Biochemistry & Molecular Biology
- Cell Biology
- Medicine, Research & Experimental