Exploratory analysis of eating- and physical activity-related outcomes from a randomized controlled trial for weight loss maintenance with exercise and liraglutide single or combination treatment

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Weight regain after weight loss remains a major challenge in obesity treatment and may involve alteration of eating and sedentary behavior after weight loss. In this randomized, controlled, double-blind trial, adults with obesity were randomized, in a 1:1:1:1 ratio stratified by sex and age group (<40 years and ≥40 years), to one-year weight loss maintenance with exercise, the GLP-1 receptor agonist liraglutide, or the combination, as compared with placebo, after low-calorie diet-induced weight loss. Primary outcome was change in body weight, which has been published. Here, we investigated the effects of weight loss maintenance with exercise, liraglutide, or the combination on weight loss-induced changes in the pre-specified explorative outcomes, eating and sedentary behavior in 130 participants who completed the trial according to the study protocol (exercise (n = 26), liraglutide (n = 36), combination (n = 29), and placebo (n = 39)). One year after weight loss, the placebo group had decreased postprandial appetite suppression score by 14%, and increased sedentary time by 31 min/day and regained weight. Liraglutide prevented the decrease in postprandial appetite suppression score compared with placebo (0% vs. −14%; P = 0.023) and maintained weight loss. Exercise after weight loss did not increase appetite or sedentary behavior compared with placebo, despite increased exercise energy expenditure and maintained weight loss. The combination of exercise and liraglutide increased cognitive restraint score (13% vs. −9%; P = 0.042), reflecting a conscious restriction of food intake, and decreased sedentary time by 41 min/day (−10 vs. 31 min/day; 95%CI, −82.3 to −0.2; P = 0.049) compared with placebo, which may have facilitated the additional weight loss. Targeting both eating and sedentary behavior could be the most effective for preventing weight regain. Trial registration: EudraCT number, 2015-005585-32; clinicaltrials.gov number, NCT04122716.

TidsskriftNature Communications
Udgave nummer1
Antal sider11
StatusUdgivet - 2022

Bibliografisk note

Funding Information:
We would like to thank all the study participants for their participation in the S-LITE trial. Conduction of the trial would not have been possible without help from pre-graduate students and other staff at the Hvidovre University Hospital. The study was supported by an Excellence grant from the Novo Nordisk Foundation (NNF16OC0019968, received by SST), by a grant from the Novo Nordisk Foundation (NNF15CC0018486, Tripartite Immunometabolism Consortium, received by SST), by Helsefonden, the Danish Diabetes Academy (received by CJ), and the Faculty of Health and Medical Sciences, University of Copenhagen (received by JRL). Novo Nordisk supplied study medication, and Cambridge Weight Plan supplied Cambridge diet products and accelerometers. The funders of the study had no role in study design, data collection and analysis, or manuscript writing.

Publisher Copyright:
© 2022, The Author(s).

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