JAMA Pediatr

Which intensive weight loss method is most effective in adolescents with obesity?

August 28, 2024

No differences were found in improvements in body composition or cardiometabolic health after 52 weeks among adolescents with obesity who received intermittent vs. continuous energy restriction as part of an intensive behavioral weight management program. These findings suggest that incorporating either approach into an intensive behavioral weight management program can effectively improve weight and cardiometabolic outcomes in adolescents.

The study

• In total, 97 adolescents (median age, 15 years; 50% male) with obesity and ≥1 associated complications completed the study and received either intermittent energy restriction (IER; n=43) or continuous energy restriction (CER; n=54) in 3 phases: very low-energy diet (weeks 0-4), intensive intervention (weeks 5-16), and continued intervention and/or maintenance (weeks 17-52).
• Primary outcome was BMI z score at 52 weeks in the IER vs. CER group. Insulin resistance, dyslipidemia, and hepatic function were also assessed.

Key findings

• At week 52, both groups had equally reduced BMI z scores (estimated marginal mean change, −0.28 for IER and −0.28 for CER) and reduced BMI expressed as a percentage of the 95th percentile (estimated marginal mean change, −9.56 for IER and −9.23 for CER). No differences were found in body composition or cardiometabolic outcomes between the groups.
• Both groups had a meaningful reduction in the occurrence of insulin resistance at week 16, but the difference remained significant after a year only in the CER group. There were no differences in the occurrence of dyslipidemia between baseline and week 52, with a small improvement in occurrence of impaired hepatic function tests.

Source:

Lister NB, et al. (2024, August 26). JAMA Pediatr. Intermittent Energy Restriction for Adolescents With Obesity: The Fast Track to Health Randomized Clinical Trial. https://pubmed.ncbi.nlm.nih.gov/39186288/