[Prognostic markers for weight loss in the treatment of obesity]

The aim of the study was to identify prognostic metabolic markers for long-term weight loss outcome in obese women. Forty female obese patients underwent a dietary intervention of 36 weeks treatment with a 4.2 MJ/d low-fat high carbohydrate diet and were followed-up two and a half years after cessation of treatment. The maximum weight loss (mean 16.2 kg. 95% CI 14.2-18.2) was positively associated to pre-treatment 24-h energy expenditure (EE) (p < 0.01), fat oxidation (%) (p < 0.02), plasma dihydrotestosterone (DHT) (p < 0.01), and to postprandial noradrenaline concentration (p < 0.04). Together these factors could explain 41% of the variation in maximum weight loss. After 36 weeks only 24-h EE and DHT had predictive power on weight loss. Weight losses in upper and lower tertiles of DHT concentrations were 17.7 kg (14.1-21.4) and 9.8 kg (6.2-13.3) (p < 0.02) and the adjusted relative risk of losing < 10 kg in the upper compared to the lower DHT tertile was 12% (4-32%). At two and a half years follow-up 21 patients had maintained some of the weight loss (54%), while 14 patients had maintained > 5 kg weight loss (36%). High levels of pre-treatment DHT were also associated with better weight loss at two and a half years follow-up. The study suggests that long-term weight loss outcome may be predicted by pre-treatment metabolic and hormonal factors in obese women.