One-year effectiveness of a 3-week balneotherapy program for the treatment of overweight or obesity

Thierry Hanh, Patrick Serog, Jérôme Fauconnier, Pierre Batailler, Florence Mercier, Christian F Roques, Patrick Blin, Thierry Hanh, Patrick Serog, Jérôme Fauconnier, Pierre Batailler, Florence Mercier, Christian F Roques, Patrick Blin

Abstract

Objective. To assess the one-year effectiveness on weight loss of a 3-week balneotherapy program (BT). Method. A Zelen double consent randomised controlled trial to compare one-year BMI loss between a 3-week BT program versus usual care (UC) for overweight or obese patients (BMI: 27-35 kg/m(2)), associated or not with a dietary motivational interview (DMI) during the follow-up, using a 2 × 2 factorial design. Main analysis was a per protocol analysis comparing patients attending BT to patients managed by UC, matched on sex, overweight or obese status, DMI randomisation and a propensity score to attend BT or to be managed by UC. Results. From the 257 patients who completed the follow-up, 70 patients of each group could be matched. Mean BMI loss was 1.91 kg/m(2) [95%CI: 1.46; 2.35] for the BT patients and 0.20 kg/m(2) [-0.24; 0.64] for the UC patients (P < 0.001), corresponding to a significant BT benefit of 1.71 kg/m(2) [1.08; 2.33]. There was no significant effect of DMI and no interaction with BT or UC. No adverse reaction was observed for patients attending BT. Conclusion. A 3-week BT program provided a significant one-year benefit over the usual GP dietary advice for overweight and obese patients.

Figures

Figure 1
Figure 1
Flow chart of patient recruitment.
Figure 2
Figure 2
Weight variation (kg) from baseline for matched and all patients.

References

    1. WHO. Obesity and overweight. 2011, .
    1. Kraschnewski JL, Boan J, Esposito J, et al. Long-term weight loss maintenance in the United States. International Journal of Obesity. 2010;34(11):1644–1654.
    1. Finkelstein EA, Fiebelkorn IC, Wang G. National medical spending attributable to overweight and obesity: how much, and who’s paying? Health Affairs. 2003;(supplement):p. W3.
    1. Wadden TA, Butryn ML, Byrne KJ. Efficacy of lifestyle modification for long-term weight control. Obesity Research. 2004;12, supplement:151S–162S.
    1. Wadden TA, Womble LG, Sarwer DB, Berkowitz RI, Clark VL, Foster GD. Great expectations: I’m losing 25% of my weight no matter what you say. Journal of Consulting and Clinical Psychology. 2003;71(6):1084–1089.
    1. Gutenbrunner C, Bender T, Cantista P, Karagülle Z. A proposal for a worldwide definition of health resort medicine, balneology, medical hydrology and climatology. International Journal of Biometeorology. 2010;54(5):495–507.
    1. Fioravanti A, Iacoponi F, Bellisai B, Cantarini L, Galeazzi M. Short- and long-term effects of spa therapy in knee osteoarthritis. American Journal of Physical Medicine and Rehabilitation. 2010;89(2):125–132.
    1. Forestier R, Desfour H, Tessier JM, et al. Spa therapy in the treatment of knee osteoarthritis: a large randomised multicentre trial. Annals of the Rheumatic Diseases. 2010;69(4):660–665.
    1. Horvath K, Kulisch A, Nemeth A, Bender T. Evaluation of the effect of balneotherapy in patients with osteoarthritis of the hands: a randomized controlled single-blind follow-up study. Clinical Rehabilitation. 2012;26(5):431–441.
    1. Biro S, Masuda A, Kihara T, Tei C. Clinical implications of thermal therapy in lifestyle-related diseases. Experimental Biology and Medicine. 2003;228(10):1245–1249.
    1. Enikeeva NA, Kitaiskaia LS, Antoniuk MV. Atherosclerosis: feasibility of non-pharmacological correction of some risk factors. Klinicheskaia Meditsina. 1999;77(3):25–28.
    1. Ivanov EM, Antoniuk MV. The potentials for the balneotherapy of obesity using arsenic-containing mineral water. Voprosy Kurortologii, Fizioterapii, i Lechebnoĭ Fizicheskoĭ Kultury. 1998;(3):11–14.
    1. Olah M, Koncz A, Feher J, Kalmanczhey J, Olah C, Nagy G. The effect of balneotherapy on antioxidant, inflammatory, and metabolic indices in patients with cardiovascular risk factors (hypertension and obesity)—a randomised, controlled, follow-up study. Contemporary Clinical Trials. 2011;32(6):793–801.
    1. Armstrong MJ, Mottershead TA, Ronksley PE, Sigal RJ, Campbell TS, Hemmelgarn BR. Motivational interviewing to improve weight loss in overweight and/or obese patients: a systematic review and meta-analysis of randomized controlled trials. Obesity Reviews. 2011;12(9):709–723.
    1. Clinical Guidelines on the Identification. Evaluation, and treatment of overweight and obesity in adults—the evidence report. National Institutes of Health. Obesity Research. 1998;6(2):51S–209S.
    1. Klein S, Burke LE, Bray GA, et al. Clinical implications of obesity with specific focus on cardiovascular disease: a statement for professionals from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism. Circulation. 2004;110(18):2952–2967.
    1. Svetkey LP, Stevens VJ, Brantley PJ, et al. Comparison of strategies for sustaining weight loss: the weight loss maintenance randomized controlled trial. Journal of the American Medical Association. 2008;299(10):1139–1148.
    1. Zelen M. A new design for randomized clinical trials. New England Journal of Medicine. 1979;300(22):1242–1245.
    1. Zelen M. Randomized consent designs for clinical trials: an update. Statistics in Medicine. 1990;9(6):645–656.
    1. INPES. La santé vient en mangeant. 2002, .
    1. Dehejia RH, Wahba S. Propensity score-matching methods for nonexperimental causal studies. Review of Economics and Statistics. 2002;84(1):151–161.
    1. Adamson J, Cockayne S, Puffer S, Torgerson DJ. Review of randomised trials using the post-randomised consent (Zelen’s) design. Contemporary Clinical Trials. 2006;27(4):305–319.
    1. Franz MJ, VanWormer JJ, Crain AL, et al. Weight-loss outcomes: a systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up. Journal of the American Dietetic Association. 2007;107(10):1755–1767.
    1. Jebb SA, Ahern AL, Olson AD, Aston LM, Holzapfel C, Stoll J. Primary care referral to a commercial provider for weight loss treatment versus standard care: a randomised controlled trial. Lancet. 2011;378(9801):1485–1492.
    1. Jolly K, Aveyard P. Provision of commercial weight management programmes. Lancet. 2011;378(9801):1444–1445.
    1. Jolly K, Lewis A, Beach J, Denley J, Adab P, Deeks JJ. Comparison of range of commercial or primary care led weight reduction programmes with minimal intervention control for weight loss in obesity: lighten Up randomised controlled trial. British Medical Journal. 2011;343d6500
    1. Foster GD, Wadden TA, Makris AP, et al. Primary care physicians’ attitudes about obesity and its treatment. Obesity Research. 2003;11(10):1168–1177.
    1. Dansinger ML, Tatsioni A, Wong JB, Chung M, Balk EM. Meta-analysis: the effect of dietary counseling for weight loss. Annals of Internal Medicine. 2007;147(1):41–50.
    1. Eckel RH. Clinical practice. Nonsurgical management of obesity in adults. The New England Journal of Medicine. 2008;358(18):1941–1950.
    1. Sarwer DB, Green AVS, Vetter ML, Wadden TA. Behavior therapy for obesity: where are we now? Current Opinion in Endocrinology, Diabetes and Obesity. 2009;16(5):347–352.
    1. Turk MW, Yang K, Hravnak M, Sereika SM, Ewing LJ, Burke LE. Randomized clinical trials of weight loss maintenance: a review. Journal of Cardiovascular Nursing. 2009;24(1):58–80.
    1. Smith SR, Weissman NJ, Anderson CM, et al. Multicenter, placebo-controlled trial of lorcaserin for weight management. New England Journal of Medicine. 2010;363(3):245–256.
    1. Kang JG, Park CY. Anti-obesity drugs: a review about their effects and safety. Diabetes and Metabolism Journal. 2012;36(1):13–25.
    1. Tsai AG, Wadden TA. Systematic review: an evaluation of major commercial weight loss programs in the United States. Annals of Internal Medicine. 2005;142(1):56–66.
    1. Fioravanti A, Cantarini L, Bacarelli MR, De Lalla A, Ceccatelli L, Blardi P. Effects of Spa therapy on serum leptin and adiponectin levels in patients with knee osteoarthritis. Rheumatology International. 2011;31(7):879–882.
    1. Henry BA, Clarke IJ. Adipose tissue hormones and the regulation of food intake. Journal of Neuroendocrinology. 2008;20(6):842–849.

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