Modifying diet and exercise in multiple sclerosis (MoDEMS): A randomized controlled trial for behavioral weight loss in adults with multiple sclerosis and obesity

• Published in: Multiple sclerosis Vol. 29; no. 14; pp. 1860 - 1871
• Main Authors: Bruce, Jared M, Cozart, Julia S, Shook, Robin P, Befort, Christie, Siengsukon, Catherine F, Simon, Stephen, Lynch, Sharon G, Mahmoud, Rola, Drees, Betty, Posson, Paige, Hibbing, Paul R, Huebner, Joanie, Bradish, Taylor, Robichaud, Jade, Bruce, Amanda S
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01-12-2023; Sage Publications Ltd
• Subjects: Body weight loss; Clinical significance; Exercise; Intervention; Mobility; Multiple sclerosis; Obesity; Physical activity; Quality of life; Risk factors; Weight control; weight loss; Obesity; exercise; diet; neurologic disease; multiple sclerosis
• ISSN: 1352-4585; 1477-0970
• DOI: 10.1177/13524585231213241

Background:
Obesity is a risk factor for developing multiple sclerosis (MS) and MS-related disability. The efficacy of behavioral weight loss interventions among people with MS (pwMS) remains largely unknown.
Objective:
Examine whether a group-based telehealth weight loss intervention produces clinically significant weight loss in pwMS and obesity.
Methods:
Seventy-one pwMS were randomized to the weight loss intervention or treatment-as-usual (TAU). The 6-month program promoted established guidelines for calorie reduction and increased physical activity. Anthropometric measurements, mobility tasks, self-report questionnaires, and accelerometry were used to assess changes at follow-up.
Results:
Mean percent weight loss in the treatment group was 8.6% compared to 0.7% in the TAU group (p < .001). Sixty-five percent of participants in the intervention achieved clinically meaningful weight loss (⩾ 5%). Participants in the treatment group engaged in 46.2 minutes/week more moderate-to-vigorous physical activity than TAU participants (p = .017) and showed improvements in quality of life (p = .012). Weight loss was associated with improved mobility (p = .003) and reduced fatiguability (p = .008).
Conclusion:
Findings demonstrate the efficacy of a behavioral intervention for pwMS and obesity, with clinically significant weight loss for two-thirds of participants in the treatment condition. Weight loss may also lead to improved mobility and quality of life.