PMID: 8581790Sep 1, 1995Paper

The case for randomized clinical trials on the treatment of obesity

Obesity Research
M P Stern

Abstract

Some say that randomized clinical trials on weight loss are unnecessary ("the benefits are 'obvious'") and others say that such trials are not feasible because too few participants will succeed in maintaining weight loss. Although the intermediate term benefits of weight loss are beyond dispute (lowering of blood pressure, lipids, blood sugar, etc.), there is no proof that these benefits will translate into long term benefits, i.e., lower rates of cardiovascular disease and/or lower overall mortality. While this extrapolation may seem obvious, the clinical trials' literature is full of unexpected, adverse side effects of theoretically appealing therapies (e.g., higher mortality with clofibrate and higher cardiovascular disease rates with estrogen treatment in men). Although there is clearly a voluntary component to food ingestion, there are also powerful physiological forces at work which impact on energy balance. For example, individuals of similar height and weight may nevertheless have widely different daily energy expenditures and hence energy requirements. It has been shown in Pima Indians that those with low energy expenditure (i.e., those who are "fuel efficient") are more prone to future weight gain than those with high...Continue Reading

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Citations

Nov 1, 1996·Nutrition·D F Williamson
May 15, 2007·Gastroenterology·Cynthia L OgdenKatherine M Flegal
Jan 9, 2004·Endocrinology and Metabolism Clinics of North America·Cynthia L OgdenKatherine M Flegal
May 4, 2000·The Medical Clinics of North America·D B Allison, S E Saunders

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