Beyond weight reduction: Improvements in quality of life after an intensive lifestyle intervention in subjects with severe obesity

Figures & data

Table I. Characteristics of participants at baseline in the intensive lifestyle intervention (ILI) group and the control group. Data are given as mean values (standard deviation) or number of subjects and percentages.

	ILI (n = 67)		Control (n = 33)
	n	%	n	%	P value
Female/Male	43/24 64.2/35.8		21/12 63.6/36.4		0.958^a
Age (y)	44.8 (10.4)		38.5 (9.8)		0.005^b
Height (cm)	172.1 (8.5)		172.3 (10.4)		0.925^b
Body weight (kg)	126.3 (20.3)		127.1 (21.6)		0.865^b
Body mass index (kg/m^2)	42.5 (4.8)		42.8 (6.3)		0.762^b
BES	15.3 (7.7)^c		15.7 (8.7)		0.808^b
HADS-A	6.2 (4.0)^d		7.0 (4.4)		0.424^b
HADS-D	4.9 (3.8)^d		4.3 (3.5)		0.459^b
SF-36 PCS	41.0 (9.0)^e		42.1 (9.0)		0.585^b
SF-36 MCS	45.2 (12.1)^e		44.7 (12.2)		0.843^b
Highest education					0.074^a
Primary and/or secondary school	7^d	11.9	7	21.2
High school	28^d	47.5	20	60.6
Higher education	24^d	40.7	6	18.2

BES = Binge Eating Scale; HADS-A = Hospital Anxiety and Depression Scale–Anxiety; HADS-D = Hospital Anxiety and Depression Scale–Depression; SF-36 PCS = SF-36 Physical Component Summary; SF-36 MCS = SF-36 Mental Component Summary.

^aChi-square.

^bIndependent samples t test.

^cn = 61.

^dn = 59.

^en = 57.

Table II. Between-group differences in changes in binge eating, mental health, and quality of life variables from week 0 to week 10–14. Data are mean values (standard deviation or 95% CI).

	ILI	Control	Between-group differences, Mean (95% CI)	P value^a
BES	–7.7 (7.2)^c	–1.2 (6.6)^b	–6.4 (–9.4, –3.4)	P < 0.0001
HADS-A	–1.6 (3.0)^d	0.2 (2.2)^b	–1.7 (–2.9, –0.5)	P = 0.005
HADS-D	–2.5 (3.1)^d	0.5 (1.7)^b	–3.0 (–4.0, –2.0)	P < 0.0001
SF-36 PCS	8.0 (6.3)^e	–0.1 (5.8)^b	8.0 (5.4, 10.7)	P < 0.0001
SF-36 MCS	7.7 (11.1)^e	0.0 (7.1)^b	7.6 (3.8, 11.5)	P < 0.0001

BES = Binge Eating Scale; HADS-A = Hospital Anxiety and Depression Scale–Anxiety; HADS-D = Hospital Anxiety and Depression Scale–Depression; SF-36 PCS = SF-36 Physical Component Summary; SF-36 MCS = SF-36 Mental Component Summary.

^aIndependent samples t test.

^bn = 33.

^cn = 61.

^dn = 59.

^en = 57.

Figure 1A–E: Mean (95% CI) scores of quality of life (self-reported binge eating (A), anxiety (B), depression (C), physical (D) and mental (E) health) during the study period in the intervention and the control group ^#P < 0.006 for differences in changes between ILI-group and controls, *P = 0.001 for changes within the ILI-group from week 10-14 to six months, **P < 0.03 for changes within the ILI-group from six to 12 months, ***P < 0.04 for changes within the ILI-group from week 0 to 12 months. Abbreviations: BES = Binge Eating Scale, HADS-A = Hospital Anxiety and Depression Scale – Anxiety, HADS-D = Hospital Anxiety and Depression Scale – Depression; SF-36 PCS = SF-36 Physical Component Summary; SF-36 MCS = SF-36 Mental Component Summary.

Figure 2A–C: The prevalence of suggestive binge eaters (A, n = 61), possible cases of anxiety (B, n = 59) and depression (C, n = 59) within the ILI-group at Week 0, week 10–14, six and 12 months. All P < 0.005 for change in the proportion of participants characterized as suggestive binge eaters and possible cases of anxiety disorders and depression across the four measurement time points.

Table III. Associations between weight change and changes in binge eating and health-related quality of life.

Independent variables and model	n	B	95% CI	Adjusted R^2	P value
	Dependent variable: Δ Weight week 0 to week 10–14
Δ BES week 0 to 10–14	61	0.222	0.018, 0.425	0.059	0.033
Adjusted^a	54	0.170	–0.033, 0.372	0.067	0.098
Δ HADS-A week 0 to 10–14	59	0.038	–0.491, 0.567	–0.017	0.887
Adjusted^a	53	–0.067	–0.586, 0.452	0.030	0.797
Δ HADS-D week 0 to 10–14	59	0.077	–0.424, 0.578	–0.016	0.759
Adjusted^a	53	0.105	–0.408, 0.618	0.032	0.683
Δ SF-36 PCS week 0 to 10–14	57	–0.334	–0.578, –0.091	0.105	0.008
Adjusted^a	50	–0.351	–0.588, –0.113	0.164	0.005
Δ SF-36 MCS week 0 to 10–14	57	0.146	0.004, 0.289	0.055	0.044
Adjusted^a	50	0.142	–0.002, 0.286	0.080	0.053
	Dependent variable: Δ Weight week 0 to 12 months
Δ BES week 0 to 12 months	58	0.555	0.136, 0.974	0.096	0.010
Adjusted^a	51	0.548	0.116, 0.981	0.062	0.014
Δ HADS-A week 0 to 12 months	56	–0.443	–1.635, 0.749	–0.008	0.460
Adjusted^a	50	–0.621	–1.844, 0.602	–0.050	0.312
Δ HADS-D week 0 to 12 months	56	–0.045	–1.209, 1.119	–0.018	0.939
Adjusted^a	50	0.412	–0.855, 1.679	–0.065	0.516
Δ SF-36 PCS week 0 to 12 months	54	–0.554	–0.915, –0.193	0.138	0.003
Adjusted^a	47	–0.548	–0.945, –0.151	0.095	0.008
Δ SF-36 MCS week 0 to 12 months	54	0.153	–0.122, 0.427	0.005	0.269
Adjusted^a	47	0.087	–0.205, 0.378	–0.063	0.552

Δ = change from baseline to week 10–14 or 12 months; BES = Binge Eating Scale; HADS-A = Hospital Anxiety and Depression Scale–Anxiety; HADS-D = Hospital Anxiety and Depression Scale–Depression; SF-36 PCS = SF-36 Physical Component Summary; SF-36 MCS = SF-36 Mental Component Summary.

^aAdjusted for age, gender, and education.