Comparing Outcomes of Lifestyle Modifications Versus Pharmacological Interventions on Metabolic Syndrome in Obese Individuals: A Cohort Analysis
Abstract
Background: Metabolic syndrome in obese individuals presents a significant global health challenge, with ongoing debate regarding the optimal treatment approach. This study aimed to compare the effectiveness of lifestyle modifications versus pharmacological interventions in managing metabolic syndrome among obese individuals over a 24-month period.
Methods: This prospective cohort study enrolled 490 obese adults (BMI ≥30 kg/m²) with metabolic syndrome across three tertiary care centers. Participants were allocated to either lifestyle modification (n=245) or pharmacological intervention (n=245) groups. The lifestyle modification group received structured dietary counseling, supervised exercise programs, and behavioral support, while the pharmacological group received standardized medication regimens including metformin, antihypertensives, and statins. Primary outcomes included changes in body weight, waist circumference, blood pressure, and metabolic parameters. Secondary outcomes encompassed treatment adherence, quality of life, cost-effectiveness, and adverse events.
Results: At 24 months, the lifestyle modification group demonstrated superior outcomes in weight reduction (-8.4 ± 4.2 kg vs. -6.1 ± 3.8 kg, p=0.008) and waist circumference reduction (-7.8 ± 3.9 cm vs. -5.4 ± 3.6 cm, p=0.006). The pharmacological intervention group showed greater improvements in blood pressure (systolic: -14.8 ± 8.9 vs. -12.3 ± 8.4 mmHg, p=0.042) and glycemic control (HbA1c: -0.7 ± 0.4% vs. -0.5 ± 0.3%, p=0.018). Treatment adherence was higher in the pharmacological group (83.2% vs. 68.9% at 24 months, p=0.002). The lifestyle modification group demonstrated better cost-effectiveness (ICER: $2,834 vs. $4,256 per QALY gained) but higher dropout rates. Adverse events were more frequent in the pharmacological group (32.4% vs. 18.7%, p<0.001) but were predominantly mild to moderate in severity.
Conclusions: Both interventions demonstrated distinct advantages in managing different aspects of metabolic syndrome. Lifestyle modifications showed superior outcomes in anthropometric measures and cost-effectiveness, while pharmacological interventions achieved better results in blood pressure control, glycemic parameters, and treatment adherence. These findings suggest that personalized treatment approaches, potentially combining elements of both strategies, may be optimal for managing metabolic syndrome in obese individuals.
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