A Toronto-based clinic’s approach to treating obesity may benefit not only the body but also the mind.
The Lifestyle Metabolism Centre (LMC), directed by endocrinologist Dr. Ronnie Aronson, has just completed a 15-month study examining the efficacy of its multidisciplinary approach to weight loss. The LMC team includes a dietician to help patients in nutritional counselling, a kinesiologist to address lifestyle and activity issues and the novel addition of an occupational therapist to facilitate behaviour modification.
Of the 141 patients who completed the six-month initial phase, 61% were successful at losing the targeted 5% or more of their body weight, with an average weight loss of 10 kg. At followup about nine months later, 63.6% of responding patients (28 of 44) had maintained the weight loss or had lost even more weight.
But an even more striking result was that among the successful patients, mean depression scores improved by a dramatic 57.2%, going from an overall rating of mild depression to minimal depression on the Beck Depression Inventory. Anxiety scores on the State-Trait Anxiety Inventory improved by an average 39.4% and mean quality of life scores improved by 8.9%.
Dr. Aronson noted this improvement in depression and mood is actually better than results from antidepressants, and avoids the need for medications.
“It’s very interesting that these patients on average would be considered depressed at the start,” Dr. Aronson said. “It’s a self-perpetuating cycle. In these people who come to us, their unhappiness with their weight has become sufficiently an issue in their life that it’s leading to depressed mood. And then once you have depressed mood, you don’t feel as confident and that may lead to worse habits, and worse weight.”
The improvements in depression did not correlate with weight loss. This, Dr. Aronson said, reflects the importance of the improved activity and other measures of success achieved in part with the occupational therapists, outside of weight. “On a larger societal scale, it says that people need support out there. People benefit from exposure to someone like an occupational therapist, but unfortunately, because of our health structures, you can’t get that in most situations.”
Dr. Aronson added that with so many fad diets around, people undertake many weight loss attempts and then gain the weight back. This kind of rebounding adds to an overall sense of failure that can be difficult to overcome.
Patients in the study had experienced an average of 5.8 severe weight cycles (10 kg gain or loss) and were all admitted to the program by referral. Their ages ranged from 25 to 65, with an average starting weight of 106.9 kg and mean BMI of 38. The cost of the program was $980.
Source: © The Medical Post 2002
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