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Towards a personalised approach for obesity treatment: one size does not fit all
  1. Michelle Kelsey1,2,
  2. Neha Pagidipati1,2
  1. 1 Duke Clinical Research Institute, Durham, North Carolina, USA
  2. 2 Division of Cardiology, Department of Medicine, Duke University, Durham, NC, USA
  1. Correspondence to Dr Michelle Kelsey, Duke Clinical Research Institute, Durham, North Carolina NC 27710, USA; michelle.kelsey{at}

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Achieving and maintaining weight loss is notoriously difficult, but also incredibly important. Obesity is associated with numerous long-term health consequences, including malignancy, respiratory conditions, musculoskeletal stress, chronic pain, depression and cardiovascular disease.1 One of the challenges of weight loss interventions is the substantial heterogeneity of treatment response. This variability has been demonstrated across lifestyle, pharmacological and surgical treatments. Behavioural strategies, such as diet and exercise regimens, can have widely disparate effects among individuals, ranging from completely ineffective to leading to long-term weight loss.2 Even randomised trials of weight loss medications or types of bariatric surgery can show significant variability in treatment response.3

While many weight management strategies have been tried, few have focused specifically on predictors of response to a given intervention. Tijssen et al 4 address this critical gap in the evidence by characterising weight loss in the Randomised Evaluation of Secondary Prevention by Outpatient Nurse Specialists-2 (RESPONSE-2) Trial, and by identifying predictors of success. RESPONSE-2 was a multicentre clinical trial conducted in the Netherlands that randomised patients with recent hospitalisation or revascularisation for coronary artery disease to usual care versus one or more interventions for smoking cessation, increasing physical activity or weight loss.5 Participants were referred by a nurse and offered free participation in these widely available community-based programmes based on their risk profiles and …

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  • Contributors Both authors wrote and critically reviewed the editorial.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Commissioned; externally peer reviewed.

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