Lifestyle interventions are indicated as first-line therapy to fight obesity focusing on various aspects of a healthy lifestyle. However, as most of these lifestyle programs only include single components, we designed a multifactorial, telemedical and group-based seminar program to improve weight loss in overweight individuals.

Overweight volunteers (BMI ≥25 kg/m2) were randomized into a starting intervention group (SI, n=15) or a waiting list control group (WL, n=15). The multicomponent intervention consisted of a (1) group-based seminar program addressing low-carbohydrate nutrition, physical activity, and the carbohydrate-blood glucose-insulin relationship. Further components used were (2) low-carbohydrate formula diet, (3) flash-glucose-monitoring devices and (4) telemedical supervision. Both groups received telemedical devices at baseline. After the 12-weeks intervention phase of SI, WL started with the same intervention. Participants received monthly calls by coaches until week 26. Data were recorded before and after 12, 26 and 52 weeks of follow-up.

After 12 weeks of intervention, SI demonstrated a stronger reduction in weight compared to WL (-7.8 kg vs. -1.5 kg; P<0.001). The estimated treatment difference between both groups was -6.3 kg with 95% confidence interval (95% CI) [-7.4; -4.5] (P<0.001). Compared to WL, fat mass and eating behavior improved in SI as well (all P<0.01). Furthermore, SI improved fasting blood glucose, HbA1c, quality of life (all P<0.05), fasting insulin, blood pressure (both P<0.01), and eating behavior (P<0.001) in the within-group analysis, while WL did not show any changes. After 26 and 52 weeks of follow-up, weight reduction could be maintained in the SI-group by -9.7 kg [95% CI: -16.1; -3.2] (P<0.001) and -7.8 kg [95% CI: -15.4; -0.9] (P<0.05), respectively.

A multifactorial program leads to long-term clinically relevant weight reductions and improvements in cardiovascular risk factors in overweight individuals.


M. Röhling: None. K. Martin: None. S. Ellinger: None. S. Martin: Consultant; Self; Almased Wellness GmbH, AstraZeneca, Lilly Diabetes. K. Kempf: Speaker's Bureau; Self; cognomed, Kirchheim Verlag.

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