Weight gain following an employer-based randomized trial evaluating the treatment of obesity with and without anti-obesity medication.

Abstract

Background: A pragmatic randomized controlled trial (RCT) reported superior weight loss when anti-obesity medications (AOMs) were added to a 1-year employer-based weight management program (WMP+Rx) compared to WMP alone. Evidence regarding sustainability of weight loss, upon trial completion, is lacking. This report aims to evaluate weight loss sustainability upon completion of the RCT.

Methods: This retrospective, observational report, analyzed data from subjects post-completion of the previous RCT. The main outcome was the mean change in body weight from baseline (end visit of the previous RCT) to 24 months.

Results: Of 199 subjects included in the RCT, 185 subjects who had pre-trial (prior to the previous RCT) and baseline weight (end visit of the previous RCT) were included in this report. Both groups; [WMP+Rx; 97 subjects, (52.4 %)] and [WMP; 88 subjects (47.6 %)] demonstrated an increase in mean body weight during the observational follow-up period; 5.2 % (95 % CI: 3.4 %, 7 %) and 6.3 % (95 % CI: 4.5 %, 8.1 %) for the WMP+Rx and 1.3 % (95 % CI: -0.6 %, 3.1 %) and 2.1 % (95 % CI: 0.3 %, 4 %) for the WMP, at 12 and 24 months, respectively. Higher percentages of individuals who gained of > 5 % of baseline weight was observed in the WMP+Rx vs WMP group; (47 %) vs (28 %) [odds ratio OR 3.16 (95 % CI: 1.19, 8.37), (P = 0.02)] and (51 %) vs (39 %) [OR 2.85 (95 %CI: 0.93,8.74), (P = 0.067)], at 12 and 24 months, respectively.

Conclusions: Weight loss achieved with WMP with or without AOMs was not maintained at 12 and 24 months. Chronic obesity management is needed for sustainable outcomes.