[Evaluation of the effectiveness of extensive, ambulatory, non-pharmacological obesity treatment program]

The aim of the study was an attempt to answer following questions: 1. Is extensive, non-pharmacological obesity treatment programme effective and is reduced body weight likely to be maintained in the long term? 2. What is the influence of the programme on some components of metabolic syndrome? 3. What is the effect of the programme on levels of leptin and insulin as indexes of weight reduction effectiveness? An informed consent to participate in the treatment was given by 37 women (GB) aged 19-47 yrs. (mean 36 +/- 7.7); with BMI 36 +/- 4.9 kg/m2. Control group (GK) was composed of 16 women aged 21-40 yrs. A 3-month extensive, ambulatory, non-pharmacological obesity treatment programme was offered to study subjects. Anthropometric, biochemical and hormonal assessment was performed before treatment (0), after 3 months--at the end of treatment (3), and after one year (R). After 3 months a reduction of body weight was observed in 34 persons (92%) whereas in 1 person (2.7%) body weight was stable and in 2 (5.4%) body weight increased. Body weight reduction was accompanied by beneficial changes in metabolic parameters. After one-year follow-up reduced body weight was maintained in 33 persons (89%), however, insulin and leptin levels and HOMA index increased significantly when compared to those observed during active treatment and were comparable with initial values. In the control group a significant increase in BMI, insulin and leptin levels and HOMA index was observed after one-year follow-up.

1. The extensive, non-pharmacological obesity treatment programme is effective because enables the reduction of body weight by 10% and patients are likely to maintain reduced body weight for one year. 2. The programme brings out metabolic benefits and enables to maintain them after its discontinuance. 3. The rebound increase in leptin and insulin levels after 9 months since active treatment has been discontinued may be an unfavourable prognostic factor in terms of maintenance of reduced body weight and indicates that the programme should be repeated in some patients groups.