Personality characteristics impact sibutramine's effectiveness - Obesity

Nutrition Research Newsletter, Dec, 2003 by K. Elfhag, S. Rossner, A. Carlsson

Predicting an effective treatment of obesity is difficult and very individualized. There is a need for weight loss predictors that would allow a better match of client to treatment. A recent study attempted to identify those persons who will lose the most weight in treatment with sibutramine. Sibutramine, a recently developed drug for weight management, has satiety-enhancing properties. The Sibutramine Trial on Obesity Reduction and Maintenance (STORM) study reported that about one-half of the patients achieved a 10% weight loss effect in 6 months using this drug treatment. Now there is little information on who benefits most from sibutramine.

Researchers were interested in identifying predictors of 6 months of weight loss in treatment including sibutramine. To 60 so they studied psychological aspects that could affect appetite and behavior. The personality aspects considered in this study are mainly those presumed to be related to eating. Participants included 30 men and women with a mean BMI of 40 [ or -] 4 kg/ [m.sup.2] with an age range of 20 to 64 years. The treatment consisted of 15 mg of sibutramine administered daily along with monthly dietary advice. Weight loss following 6 months of treatment was evaluated. The psychological assessment included the Rorschach method (Comprehensive System) and the Beck Depression Inventory.

A multiple linear regression model including the Rorschach predictors' physical demand states (animal movement, designated as FM) being intrusive or difficult to hold and a dependency orientation (food contents) could explain 47% of 6 months of weight loss. A model including initial weight loss in addition to the Rorschach predictors explained 58% of the 6-month weight loss.

Personality factors did predict greater weight loss. Particularly, individuals with difficulties concerning physical demand states, which include hunger, could have reduced their eating behavior with enhanced satiety, allowing for greater weight loss. Increased satiety from sibutramine could also have aided individuals with a dependent need for food to limit food intake. Additionally, initial weight loss was a predictor of greater weight loss in this study.

K. Elfhag, S. Rossner, A. Carlsson, et al. Sibutramine treatment in obesity: Predictors of weight loss including Rorschach personality data. Obesity Research; 11: pp 13911399 (November 2003). [Correspondence: Kristina Elfhag, Obesity Unit, M73, Huddinge University Hospital, SE-141 86 Stockholm, Sweden. E-mail: Kristina.elfhag@medhs.ki.se].