Skip to main content
Mijn bibliotheek
Shop
Nieuws Boeken Tijdschriften E-learning Web-tv Video Audio
Tips voor Mijn BSL
UITGEBREID ZOEKEN
Inloggen
Top
Quality of Life Research
Gepubliceerd in: Quality of Life Research 5/2016

01-05-2016

Health-related quality of life in two randomized controlled trials of phentermine/topiramate for obesity: What mediates improvement?

Auteurs: Ronette L. Kolotkin, Kishore M. Gadde, Craig A. Peterson, Ross D. Crosby

Gepubliceerd in: Quality of Life Research | Uitgave 5/2016

Log in om toegang te krijgen
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail
    Link delen
publish
Publiceer nu

Abstract

Purpose

Phentermine/topiramate combination therapy resulted in significant weight loss and improvements in cardiometabolic risk factors in patients with obesity/overweight in two published 56-week randomized, placebo-controlled trials (EQUIP and CONQUER). The purpose of the current study was to examine whether phentermine/topiramate is also associated with greater improvements in health-related quality of life (HRQOL) and whether HRQOL improvements are solely attributable to weight reduction.

Methods

Patients in EQUIP (n = 751) had a body mass index (BMI) ≥ 35 with no obesity-related comorbidity. Patients in CONQUER (n = 1623) had a BMI ≥ 27 and ≤ 45 and at least two obesity-related comorbid conditions. HRQOL was assessed with Impact of Weight on Quality of Life-Lite (IWQOL-Lite) and Medical Outcomes Study Short Form (SF-36) (CONQUER only).

Results

Significant improvements in both obesity-specific and physical HRQOL were observed at 56 weeks in both trials (p < .0001). In EQUIP, BMI reduction fully mediated improvements in IWQOL-Lite total score (p < .0001). In CONQUER, both BMI reduction (all p values <.0001) and change in depressive symptoms (all p values <.025) were significant mediators of improved IWQOL-Lite total score and SF-36 Physical Component Summary score. Gender, psychiatric history, and baseline triglycerides moderated these relationships.

Conclusions

Both trials demonstrated that treatment with phentermine/topiramate improved HRQOL compared with placebo. Although reduction in BMI accounted for the majority of improvements in obesity-specific and physical HRQOL, decrease in depressive symptoms was also a significant mediator. Results highlight the predominance of weight reduction as a key factor in improving HRQOL in obesity.
vorige artikel Living with invisible illness: social support experiences of individuals with systemic lupus erythematosus
volgende artikel Interaction between the Kansas City Cardiomyopathy Questionnaire and the Pocock’s clinical score in predicting heart failure outcomes
Literatuur
1.
Gadde, K. M., Allison, D. B., Ryan, D. H., Peterson, C. A., Troupin, B., Schwiers, M. L., et al. (2011). Effects of low-dose, controlled-release, phentermine plus topiramate combination on weight and associated comorbidities in overweight and obese adults (CONQUER): A randomised, placebo-controlled, phase 3 trial. Lancet, 377(9774), 1341–1352.CrossRefPubMed
2.
Allison, D. B., Gadde, K. M., Garvey, W. T., Peterson, C. A., Schwiers, M. L., Najarian, T., et al. (2012). Controlled-release phentermine/topiramate in severely obese adults: A randomized controlled trial (EQUIP). Obesity (Silver Spring), 20(2), 330–342.CrossRef
3.
Fujioka, K., Seaton, T. B., Rowe, E., Jelinek, C. A., Raskin, P., Lebovitz, H. E., et al. (2000). Weight loss with sibutramine improves glycaemic control and other metabolic parameters in obese patients with type 2 diabetes mellitus. Diabetes, Obesity & Metabolism, 2(3), 175–187.CrossRef
4.
Rejeski, W. J., Focht, B. C., Messier, S. P., Morgan, T., Pahor, M., & Penninx, B. (2002). Obese, older adults with knee osteoarthritis: Weight loss, exercise, and quality of life. Health Psychology, 21(5), 419–426.CrossRefPubMed
5.
Kolotkin, R. L., Davidson, L. E., Crosby, R. D., Hunt, S. C., & Adams, T. D. (2012). Six-year changes in health-related quality of life in gastric bypass patients versus obese comparison groups. Surgery for Obesity and Related Diseases, 8, 625–633.CrossRefPubMedPubMedCentral
6.
Aasprang, A., Andersen, J. R., Vage, V., Kolotkin, R. L., & Natvig, G. K. (2013). Five-year changes in health-related quality of life after biliopancreatic diversion with duodenal switch. Obesity Surgery, 23(10), 1662–1668.CrossRefPubMedPubMedCentral
7.
Warkentin, L. M., Das, D., Majumdar, S. R., Johnson, J. A., & Padwal, R. S. (2014). The effect of weight loss on health-related quality of life: Systematic review and meta-analysis of randomized trials. Obesity Reviews, 15(3), 169–182.CrossRefPubMed
8.
Maciejewski, M. L., Patrick, D. L., & Williamson, D. F. (2005). A structured review of randomized controlled trials of weight loss showed little improvement in health-related quality of life. Journal of Clinical Epidemiology, 58(6), 568–578.CrossRefPubMed
9.
Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis : A regression-based approach. In. NY: Guilford Press.
10.
Kolotkin, R. L., Crosby, R. D., Kosloski, K. D., & Williams, G. R. (2001). Development of a brief measure to assess quality of life in obesity. Obesity Research, 9(2), 102–111.CrossRefPubMed
11.
Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606–613.CrossRefPubMedPubMedCentral
12.
Kolotkin, R. L., & Crosby, R. D. (2002). Psychometric evaluation of the Impact of Weight on Quality of Life-Lite questionnaire (IWQOL-Lite) in a community sample. Quality of Life Research, 11(2), 157–171.CrossRefPubMed
13.
Ware, J. E., Snow, K. K., Kosinski, M., & Gandek, B. (1993). SF-36 health survey: Manual and interpretation guide. Boston: Health Institute, New England Medical Center.
14.
Löwe, B., Kroenke, K., Herzog, W., & Gräfe, K. (2004). Measuring depression outcome with a brief self-report instrument: Sensitivity to change of the Patient Health Questionnaire (PHQ-9). Journal of Affective Disorders, 81(1), 61–66.CrossRefPubMed
15.
16.
Fontaine, K. R., & Barofsky, I. (2001). Obesity and health-related quality of life. Obesity Reviews, 2(3), 173–182.CrossRefPubMed
17.
Kolotkin, R. L., Meter, K., & Williams, G. R. (2001). Quality of life and obesity. Obesity Reviews, 2(4), 219–229.CrossRefPubMed
18.
Wee, C. C., Davis, R. B., Huskey, K. W., Jones, D. B., & Hamel, M. B. (2013). Quality of life among obese patients seeking weight loss surgery: The importance of obesity-related social stigma and functional status. Journal of General Internal Medicine, 28(2), 231–238.CrossRefPubMedPubMedCentral
19.
Astrup, A., Madsbad, S., Breum, L., Jensen, T. J., Kroustrup, J. P., & Larsen, T. M. (2008). Effect of tesofensine on bodyweight loss, body composition, and quality of life in obese patients: A randomised, double-blind, placebo-controlled trial. Lancet, 372(9653), 1906–1913.CrossRefPubMed
20.
Di Francesco, V., Sacco, T., Zamboni, M., Bissoli, L., Zoico, E., Mazzali, G., et al. (2007). Weight loss and quality of life improvement in obese subjects treated with sibutramine: A double-blind randomized multicenter study. Annals of Nutrition & Metabolism, 51(1), 75–81.CrossRef
21.
Kaukua, J. K., Pekkarinen, T. A., & Rissanen, A. M. (2004). Health-related quality of life in a randomised placebo-controlled trial of sibutramine in obese patients with type II diabetes. International Journal of Obesity and Related Metabolic Disorders, 28(4), 600–605.CrossRefPubMed
22.
Merideth, C. H. (2006). A single-center, double-blind, placebo-controlled evaluation of lamotrigine in the treatment of obesity in adults. Journal of Clinical Psychiatry, 67(2), 258–262.CrossRefPubMed
23.
Brandão, I., Ramalho, S., Pinto-Bastos, A., Arrojado, F., Faria, G., Calhau, C., et al. (2015). Metabolic profile and psychological variables after bariatric surgery: Association with weight outcomes. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, 1–6. doi:10.​1007/​s40519-015-0199-7.
24.
East, C., Willis, B. L., Barlow, C. E., Grannemann, B. D., FitzGerald, S. J., DeFina, L. F., et al. (2010). Depressive symptoms and metabolic syndrome in preventive healthcare: The Cooper Center longitudinal study. Metabolic Syndrome and Related Disorders, 8(5), 451–457.CrossRefPubMed
25.
Kamezaki, F., Sonoda, S., Nakata, S., Okazaki, M., Tamura, M., Abe, H., et al. (2011). Elevated depressive symptoms are associated with hypertriglyceridemia in Japanese male workers. Internal Medicine, 50(21), 2485–2490.CrossRefPubMed
26.
Glueck, C. J., Tieger, M., Kunkel, R., Tracy, T., Speirs, J., Streicher, P., et al. (1993). Improvement in symptoms of depression and in an index of life stressors accompany treatment of severe hypertriglyceridemia. Biological Psychiatry, 34(4), 240–252.CrossRefPubMed
27.
Kraemer, H. C., Wilson, G. T., Fairburn, C. G., & Agras, W. S. (2002). Mediators and moderators of treatment effects in randomized clinical trials. Archives of General Psychiatry, 59(10), 877–883.CrossRefPubMed
28.
Pazzagli, C., Mazzeschi, C., Laghezza, L., Reboldi, G. P., & De Feo, P. (2013). Effects of a multidisciplinary lifestyle intervention for obesity on mental and physical components of quality of life: the mediatory role of depression. Psychological Reports, 112(1), 33–46.CrossRefPubMed
29.
Williamson, D. A., Rejeski, J., Lang, W., Van Dorsten, B., Fabricatore, A. N., & Toledo, K. (2009). Impact of a weight management program on health-related quality of life in overweight adults with type 2 diabetes. Archives of Internal Medicine, 169(2), 163–171.CrossRefPubMedPubMedCentral
30.
Palmeira, A. L., Markland, D. A., Silva, M. N., Branco, T. L., Martins, S. C., Minderico, C. S., et al. (2009). Reciprocal effects among changes in weight, body image, and other psychological factors during behavioral obesity treatment: A mediation analysis. The International Journal of Behavioral Nutrition and Physical Activity, 6, 9.CrossRefPubMedPubMedCentral
31.
Jepsen, R., Aadland, E., Robertson, L., Kolotkin, R. L., Andersen, J. R., & Natvig, G. K. (2015). Physical activity and quality of life in severely obese adults during a two-year lifestyle intervention programme. Journal of Obesity, 2015, 314194.CrossRefPubMedPubMedCentral
32.
Nilsen, V., Bakke, P. S., Rohde, G., & Gallefoss, F. (2014). Predictors of health-related quality of life changes after lifestyle intervention in persons at risk of type 2 diabetes mellitus. Quality of Life Research, 23(9), 2585–2593.CrossRefPubMedPubMedCentral
33.
Doll, H. A., Petersen, S. E., & Stewart-Brown, S. L. (2000). Obesity and physical and emotional well-being: Associations between body mass index, chronic illness, and the physical and mental components of the SF-36 questionnaire. Obesity Research, 8(2), 160–170.CrossRefPubMed
34.
Heo, M., Allison, D. B., Faith, M. S., Zhu, S., & Fontaine, K. R. (2003). Obesity and quality of life: mediating effects of pain and comorbidities. Obesity Research, 11(2), 209–216.CrossRefPubMed
35.
Korhonen, P. E., Seppala, T., Jarvenpaa, S., & Kautiainen, H. (2014). Body mass index and health-related quality of life in apparently healthy individuals. Quality of Life Research, 23(1), 67–74.CrossRefPubMed
36.
Jagielski, A. C., Brown, A., Hosseini-Araghi, M., Thomas, G. N., & Taheri, S. (2014). The association between adiposity, mental well-being, and quality of life in extreme obesity. PLoS ONE, 9(3), e92859.CrossRefPubMedPubMedCentral
37.
Rothberg, A. E., McEwen, L. N., Kraftson, A. T., Neshewat, G. M., Fowler, C. E., Burant, C. F., et al. (2014). The Impact of Weight Loss on Health-Related Quality-of-Life: Implications for cost-effectiveness analyses. Quality of Life Research, 23(4), 1371–1376.CrossRefPubMedPubMedCentral
Metagegevens
Titel
Health-related quality of life in two randomized controlled trials of phentermine/topiramate for obesity: What mediates improvement?
Auteurs
Ronette L. Kolotkin
Kishore M. Gadde
Craig A. Peterson
Ross D. Crosby
Publicatiedatum
01-05-2016
Uitgeverij
Springer International Publishing
Gepubliceerd in
Quality of Life Research / Uitgave 5/2016
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-015-1153-x

Andere artikelen Uitgave 5/2016

Quality of Life Research 5/2016 Naar de uitgave

OriginalPaper

Does reporting behaviour bias the measurement of social inequalities in self-rated health in Indonesia? An anchoring vignette analysis

OriginalPaper

The course of health status and (health-related) quality of life following fracture of the lower extremity: a 6-month follow-up study

OriginalPaper

Effects of motivational enhancement therapy plus cognitive behaviour therapy on depressive symptoms and health-related quality of life in adults with type II diabetes mellitus: a randomised controlled trial

OriginalPaper

Gender differences in the effect of social support on health-related quality of life: results of a population-based prospective cohort study in old age in Germany

Brief Communication

Language bias and self-rated health status among the Latino population: evidence of the influence of translation in a wording experiment

OriginalPaper

Changes in life-space mobility and quality of life among community-dwelling older people: a 2-year follow-up study