Abstract
BACKGROUND: Current recommendations support bariatric surgery among the morbidly obese as an option to mitigate future risk of cardiovascular disease, diabetes and hypertension. To date, there is little evidence on the effect of extensive lifestyle interventions among those high-risk individuals in reducing the need for such procedures.
METHODS: The purpose of the present study is to examine the efficacy of an intensive lifestyle workplace intervention on significant body weight and cardiovascular disease risk factors across the spectrum of obesity. Changes in BMI are being measured from baseline to 6 months follow up, along with corresponding improvements in cardio-metabolic risk. In addition, the decrease in participants meeting criteria for bariatric surgery over the study period is examined. Bariatric surgery criteria were defined as BMI≥40 or BMI between 35 and 40 and at least one of the following co-morbidities: diabetes, hypertension, or high cholesterol. Short term results (at 9-12 weeks follow-up) of this study are being presented at AHA 2014 in March.
RESULTS: The study population consisted of 152 individuals (49±10 years, 78% female) with BMI≥27 at baseline and complete data at 6 month follow-up. A total of 71 (47%) participants lost at least 10 % of their body weight. Additionally, 37% dropped an entire BMI category. Of note, 39%(16 of 41) who were classified as BMI>40 were in BMI 35-39 at follow-up, respectively 44%(14 of 32) of individuals in the BMI category 35-39 successfully moved to the BMI category 30-34 at 6 months follow-up. Forty-five participants (35% of total) initially met criteria for bariatric surgery. At 6 months of follow-up 40% (18 of 45, p<0.001) of these candidates no longer needed bariatric surgery.
CONCLUSIONS: Worksites can be effective for achieving clinically important reductions in body weight and diminish the potential need for procedures among a small proportion of morbidly obese individuals. Many lifestyle interventions succeed in achieving short term reductions but are unable to sustain them over longer periods. Our program shows promising results at 6 months and continued follow up will allow us to determine whether workplace wellness interventions similar to ours are a viable and lasting alternative to bariatric surgery.
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