Home Versus Clinic Based Weight Loss Management Program On Markers For Metabolic Syndrome

Supervised clinic-based weight-loss management programs are the “gold” standard for treatment; however, these programs commonly impose limitations of access and cost to patients. In contrast, unsupervised home-based weight-loss management programs offer a cost-effective and accessible therapeutic strategy for patients at risk for cardiometabolic diseases. PURPOSE: The aim of this study was to evaluate the effectiveness of an unsupervised home-based weight-loss management program on markers for MetS. METHODS: Women and men who were overweight or obese (n = 23; mean ± SEM, age = 50.3 ± 9.3 years, body mass index (BMI) = 34.4 ± 6.1 kg/m2) completed a 3-month weight-loss program consisting of a reduced energy intake to 1200 - 1500 kcals/day combined with a progressive walking program targeting 300 min/wk. Participants were randomized to either supervised care (n = 12) or an unsupervised home-based (n = 11) program. Following weight-loss patients were monitored for an additional 3 moths to monitor their management of weight-loss. Markers (fasting glucose, HDL-C, and triglycerides (Tg), waist circumference (WC), and systolic (SBP) and diastolic blood pressure (DBP)) of MetS were determined at baseline, and 3- and 6-months. RESULTS: At baseline, no differences were observed between groups for markers of MetS. A significant time effect was observed for Tg (p = 0.014), WC (p < 0.001), and SBP (p = 0.019). A significant time x group interaction was observed for Tg (p = 0.039). After 3 months, both groups showed reductions in WC by 7.2-8.6% (p < 0.05) with no difference between groups. At 6 months, both groups continued weight-loss with WC reduced by 7.8-12.7% (p < 0.05) when compared to baseline. The clinic group showed a lower Tg at 3 months (139.3 ± 87.5 vs 95.1 ± 51.4 mg/dL, p = 0.146) where the home group increased slightly (111.3 ± 99.7 vs 141.4 ± 103.9 mg/dL, p = 0.563). At 6 months, Tg in the clinic group remained relatively unchanged (84.9 ± 27.7 mg/dL), where the home group decreased (84.5 ± 57.5 mg/dL, p = 0.007). CONCLUSION: At the conclusion of 6 months, both home-based and clinic-based programs resulted in improved waist circumference and Tg concentrations. Overall, home-based weight-loss management programs may provide patients a cost-effective and accessible treatment strategy. Supported by: Supported by SIUE STEP Award.