P1161 - Weight Regain After Total Meal Replacement Very Low-calorie Diet Program With and Without Anti-obesity Medications

Sunday, October 22, 2023

3:30 PM – 7:00 PM PT

Location: Exhibit Hall

Presenting Author(s)

Lizeth Cifuentes, MD

University of Pittsburgh Medical Center
Pittsburgh, PA

Lizeth Cifuentes, MD¹, Francesca Galbiati, MD², Hussain Mahmud, MD², David Rometo, MD²
¹University of Pittsburgh Medical Center, Pittsburgh, PA; ²UPMC, Pittsburgh, PA

Introduction: The growing prevalence of obesity and obesity-associated diseases highlights the need for efficient and lasting weight loss interventions. Total meal replacement (TMR) using very low-calorie diets (VLCD) under 800 kcal/day and anti-obesity medications (AOM) are two non-surgical options requiring medical supervision known to achieve clinically significant weight loss. Here, we aimed to study the effect of adjuvant AOM on weight loss and weight regain during and after a comprehensive lifestyle program including a VLCD/TMR phase, compared to those who were not on AOM.

Methods: This is a retrospective study of patients with obesity who were enrolled in a VLCD/TMR program (OPTIFAST) at a single site. Weight data were collected for the first visit, after 6 months (± 45 days), and after 18 months (± 45 days). The primary endpoint was the amount of weight regained at 18 months as a percentage of the amount of weight lost at 6 months (WR%), comparing patients taking AOM vs. no AOM. We used the Wilcoxon test to compare between AOM groups and ANOVA to compare within the AOM groups.

Results: The study cohort consisted of 206 patients: 68% women, a mean (SD) age of 52.39 (13.05) years, and a BMI of 41.71 (7.04) kg/m2. 139 patients did not take any AOM (AOM-) while 67 patients were taking AOMs (AOM+). We observed a total body weight loss percentage (TBWL%) of -17.87% (7.02) after 6 months, and -12.10% (11.56) after 18 months. This represented a mean difference from baseline of -21.40 kg (95% CI -19.99 to -22.81; p< 0.001) at 6 months, and -14.95 kg (95% CI -12.53 to -17.36; p< 0.001) at 18 months. There were no significant differences in WL at 6 months between AOM groups. When analyzing weight regain, patients in the AOM+ group regained less weight compared with the AOM- [3.29 kg (10.19) vs. 7.61 kg (11.96); p-0.006]. This represents a lower WR% as well (31.5 % [68.7] vs. 52.16% [64.4]; p=0.04).

Discussion: The efficacy of a comprehensive lifestyle program including a VLCD/TMR can be better sustained with the addition of antiobesity medications

Figure: Figure 1. A) Weight loss outcomes at 3, 6 and 18 months in patients taking AOM (AOM+) at some point during the program compare with patients not taking AOM (AOM-). B) Total body weight regains at 18 months from maximum weight lost between patients taking AOM (AOM+) and patients not taking AOM (AOM-).

	All patients N=206	No AOMs N=139 (67%)	AOMs N=67 (33%)	p-value
Age, years	52.39 (13.05)	52.81 (13.34)	51.86 (12.73)	0.60
Sex, females	139 (67.96%)	97 (69%)	43 (65%)	0.51
BMI, kg/m2	41.71 (7.04)	41.77 (6.88)	41.64 (7.27)	0.90
Baseline weight, kg	117.95 (24.06)	119.13 (24.94)	117.37 (23.69)	0.64
Diabetes, yes	102 (49%)	58 (41%)	44 (66%)	0.001
Behavioral diagnosis at baseline, yes	87 (42.23%)	57 (40%)	30 (45.5%)	0.47
Abbreviations Used: AOM, anti-obesity medications; BMI, Body Mass Index. Data are shown as mean (standard deviation) or number (percentage).

Table: Table 1. Baseline characteristic of patients

Disclosures:

Lizeth Cifuentes indicated no relevant financial relationships.

Francesca Galbiati indicated no relevant financial relationships.

Hussain Mahmud indicated no relevant financial relationships.

David Rometo: Nestle Health Science – Advisory Board Member, single day event, Oct 2021.

Lizeth Cifuentes, MD¹, Francesca Galbiati, MD², Hussain Mahmud, MD², David Rometo, MD². P1161 - Weight Regain After Total Meal Replacement Very Low-calorie Diet Program With and Without Anti-obesity Medications, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.