Thomas Wadden

Author Correction: Tirzepatide after intensive lifestyle intervention in adults with overweight or obesity: the SURMOUNT-3 phase 3 trial Author Correction: Tirzepatide after intensive lifestyle intervention in adults with overweight or obesity: the SURMOUNT-3 phase 3 trial Nat Med. 2024 Feb 27. doi: 10.1038/s41591-024-02883-1. Online ahead of print. Authors Thomas A Wadden 1 , Ariana M Chao 2 , Sriram Machineni 3 , Robert Kushner 4 , Jamy Ard 5 , Gitanjali Srivastava 6 7 , Bruno Halpern 8 , Shuyu Zhang 9 , Jiaxun Chen 9 , Mathijs C Bunck 9 , Nadia N Ahmad 9 , Tammy Forrester 9 Affiliations 1 Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA. wadden@pennmedicine.upenn.edu. 2 Johns Hopkins School of Nursing, Baltimore, MD, USA. 3 Division of Endocrinology and Metabolism, Department of Medicine, Albert Einstein College of Medicine, Bronx, …

BackgroundThe relationship between theoretically relevant psychosocial and behavioral variables and outcomes of metabolic and bariatric surgery remains unclear. Some studies have found that the presence of psychopathology, disordered eating, and impulsivity, either prior to surgery or during the early postoperative period, is associated with suboptimal postoperative weight loss. Other studies have not found these relationships.SettingTwo large, urban university health systems.ObjectiveExamine the relationship between psychopathology, disordered eating, and impulsivity and weight loss 24 months postoperatively.MethodsParticipant characteristics were collected using validated interviews, patient reported outcome measures, and computerized assessment methods. Linear mixed effect models were used to test the association of the variables of interest on percent weight loss (%WL).ResultsThree hundred …

Over the last century, hundreds of evaluations have been conducted to examine weight-management interventions related to diet, physical activity, and behavior therapy. These investigations have contributed to a growing body of knowledge that has consistently advanced the field of obesity treatment, while also revealing some persistent challenges. This narrative review summarizes key findings from randomized controlled trials conducted in adults that have combined diet, physical activity, and behavior therapy, an approach variously referred to as behavioral treatment, comprehensive lifestyle modification, or intensive lifestyle intervention. The review shows that current behavioral approaches induce average reductions in baseline body weight of 5 to 10% at 6 to 12 months. Such losses have proven effective in reducing the risk of type 2 diabetes in persons with impaired glucose tolerance and in improving other …

Objective To explore the efficacy and safety of semaglutide 2.4 mg in people with overweight/obesity who were also being treated with antidepressants (ADs). Methods Across the Semaglutide Treatment Effect for People with obesity (STEP) 1–3 and 5 trials, adults with overweight/obesity and type 2 diabetes (STEP 2 only) were enrolled. People with severe major depressive disorder within 2 years prior to screening or with a patient health questionnaire‐9 score ≥15 at screening were excluded. Participants were categorized into subgroups according to baseline AD status (on/off ADs) in this post hoc exploratory analysis of the STEP trials. Results Of 3683 participants randomized, 539 were on ADs at baseline. Mean body weight change from baseline to week 68 was greater for semaglutide versus placebo, regardless of baseline AD use. In STEP 1, for participants on ADs at baseline, mean change from …

The effects of tirzepatide, a glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist, on weight reduction after successful intensive lifestyle intervention are unknown. This double-blind, placebo-controlled trial randomized (1:1) adults with body mass index ≥30 or ≥27 kg/m2 and at least one obesity-related complication (excluding diabetes), who achieved ≥5.0% weight reduction after a 12-week intensive lifestyle intervention, to tirzepatide maximum tolerated dose (10 or 15 mg) or placebo once weekly for 72 weeks (n = 579). The treatment regimen estimand assessed effects regardless of treatment adherence in the intention-to-treat population. The coprimary endpoint of additional mean per cent weight change from randomization to week 72 was met with changes of −18.4% (standard error (s.e.) 0.7) with tirzepatide and 2.5% (s.e. 1.0) with placebo (estimated treatment …

The original protocol was approved on December 19, 2018 during the funding application process (NIH/NIDDK 1K23DK116935). Two protocol amendments were made prior to the start of recruitment. First, the study medication was changed from liraglutide (the medication proposed in the original K23 funding application) to phentermine, and medication-specific sections of the protocol, including medication-related inclusion/exclusion criteria, were modified accordingly (IRB-approved May 13, 2019). The second amendment included the following minor changes (IRB-approved July 18, 2019): replacing cholecystokinin (CCK) with insulin in a neuropeptide hormone panel; adding a prespecified secondary analysis of changes in past-week VAS ratings of appetite, adding exploratory questionnaires (Philadelphia Mindfulness Questionnaire, Yale Food Addiction questionnaire, sleep hours/week); specifying that the electrocardiogram (ECG) would occur at screening and that the first BT session would start immediately after the baseline assessment visit; updating the portion size of the liquid test meal for males vs. females; and specifying that only randomized participants would complete a cardiometabolic and lipid panel at the randomization visit.

BackgroundIt is not known whether behavioral weight loss can attenuate blood oxygen level-dependent responses to food stimuli.ObjectivesThis randomized controlled trial assessed the effects of a commercially available behavioral weight loss program (WW, WeightWatchers) compared to a wait-list control on blood oxygen level-dependent response to food cues.MethodsFemales with obesity (N= 61) were randomized to behavioral weight loss or wait-list control. At baseline and follow-up, participants completed assessments that included functional magnetic resonance imaging scans to assess response to images of high-calorie foods (HCF) or low-calorie foods (LCF), and neutral objects.ResultsThere were no significant between-group differences in change from baseline to follow-up in any regions of the brain in response to viewing HCF or LCF. From baseline to follow-up, participants in behavioral weight loss …

Nearly 30 years ago, Pories and colleagues published a landmark case series provocatively titled “Who Would Have Thought It? An Operation Proves to Be the Most Effective Therapy for Adult-Onset Diabetes Mellitus.” 1 The operation was the gastric bypass for obesity. The excellent wellcontrolled study published in this issue of JAMA by Courcoulas and colleagues2 provides the most robust evidence to date of the long-term efficacy of bariatric surgery for improving control of type 2 diabetes. Effective therapies are critically needed for this disease, which affects more than 14% of adults in the US, is associated with a high burden of both physical and mental health complications, and incurs annual direct medical costs of $306.6 billion. 3, 4The study by Courcoulas et al pools the results of 4 separate randomized clinical trials (RCTs), all designed to evaluate the effectiveness of bariatric surgery, compared with …