Obstructive sleep apnea (OSA) is one of the most frequent chronic diseases, and comorbid obesity ... more Obstructive sleep apnea (OSA) is one of the most frequent chronic diseases, and comorbid obesity occurs in more than 60% of cases. Variations in body weight influence both OSA severity and OSA-related symptoms. We prospectively assessed the impact of a weight-loss program using the Berlin score to reflect OSA risk, and we also used the Epworth Sleepiness Scale (ESS) to assess daytime sleepiness. DietSleep was a prospective multicentric cohort study investigating OSA risk and daytime sleepiness before and after weight-loss intervention. One hundred and twenty-seven patients were included (initial OSA risk 36%), most of whom were women (85.8%) with a median body mass index (BMI) of 29.7 kg/m2, and the interquartile range was (27.6; 34). The diet-based weight-loss program induced a median decrease in BMI of 3.7 kg/m2 (−5; −2.9) (body weight~12.1% (−16.0; −8.8)) over a period of 171 days (114; 269). Changes in anthropometric values were similar regarding OSA risk after adjusting for ini...
Background: Dietary intervention is a cornerstone of weight loss therapies. In obesity, a dysbiot... more Background: Dietary intervention is a cornerstone of weight loss therapies. In obesity, a dysbiotic gut microbiota (GM) is characterized by high levels of Bacteroides lineages and low diversity. We examined the GM composition changes, including the Bacteroides 2 enterotype (Bact2), in a real-world weight loss study in subjects following a high-protein hypocaloric diet with or without a live microorganisms (LMP) supplement. Method: 263 volunteers were part of this real-world weight loss program. The first phase was a high-protein low-carbohydrate calorie restriction diet with or without LMP supplements. Fecal samples were obtained at baseline and after 10% weight loss for 163 subjects. Metagenomic profiling was obtained by shotgun sequencing. Results: At baseline, the Bact2 enterotype was more prevalent in subjects with aggravated obesity and metabolic alterations. After weight loss, diversity increased and Bact2 prevalence decreased in subjects with lower GM diversity at baseline, n...
The aim of this study was to assess the impact of the nationwide total lockdown (LD) in France on... more The aim of this study was to assess the impact of the nationwide total lockdown (LD) in France on weight loss and body composition modifications in subjects participating in a weight loss program and to evaluate the impact of remote consultations on participants’ adherence to the weight loss program. The CO-RNPC study was a prospective multicentre cohort study including participants undergoing a two to six months program. The rate of weight loss in kg/week was computed before (15 days), during (99 days) and after LD (15 days). In the 1550 completing participants, body weight decreased from 87.1 kg [IQR 77.0; 100.2] to 82.3 kg [72.1; 94.3] resulting in a difference of −4.79 kg [−4.48; −5.10] (p < 0.01), with a corresponding reduction in waist circumference by 4 cm ([0; 9], p < 0.01). The median weight loss was 4.4 kg [0.5; 9.4] in those who used remote consultations, and 1.4 kg [0.8; 5.7] in the no remote consultation group (p < 0.01). In this large prospective cohort, we ob...
Le programme RNPC ® ,u ne thérapeutique non-médicamenteusep our la prise en charge des patients a... more Le programme RNPC ® ,u ne thérapeutique non-médicamenteusep our la prise en charge des patients atteints de surcharge pondérale The RNPC ® program, an on-medicinal therapy for the managemento fo verweightp atients
Bariatric surgery is the most effective treatment for obesity. However, less than 1% of eligible ... more Bariatric surgery is the most effective treatment for obesity. However, less than 1% of eligible patients undergo bariatric surgery annually. Here we evaluated the weight loss effectiveness of an intensive non-surgical weight loss program in patients that would qualify for bariatric surgery. Methods: Patients eligible for bariatric surgery (n = 1460) (BMI≥40 or BMI≥35 kg/m 2 plus comorbidities) who were enrolled in a dietary weight loss intervention, the RNPC® program, were compared to a cohort of bariatric surgery patients in terms of weight loss outcome. Results: The 663 patients completing the RNPC® program (35% dropout and 20% ongoing) lost 20.2 ± 11.8 kg corresponding to a reduction of 47% of the excess weight and a percentage weight loss from the initial weight of 18% after a mean period of 18.6 ± 9.1 months. Weight loss 18 months after bariatric surgery (n = 61) was 42.5 ± 15.8 kg corresponding to a reduction of 74% of excess weight and a percentage weight loss from the initial weight of 32%. Conclusion: Although bariatric surgery results in a more pronounced weight loss, a clinically important weight loss can be obtained in patients that would qualify for bariatric surgery following an intensive non-surgical weight loss program. This retrospective analysis calls for randomized trials that compare the long-term costeffectiveness between the RNPC® program and bariatric surgery.
Bodyweight loss is essential to lower risk factors for type 2 diabetes and cardiovascular disease... more Bodyweight loss is essential to lower risk factors for type 2 diabetes and cardiovascular disease in overweight patients. Therefore, we examined the effectiveness of the RNPC® program for short and long term bodyweight reduction. Methods: The RNPC® program is a novel weight loss and maintenance program achieving weight loss by an energy-restricted 800-1000 kcal/day high-protein low-glycemic diet (weight loss phase), followed by an intensive follow-up with a step-wise increase in energy intake to reach energy balance (weight stabilization phases). The analysis included 12,179 overweight or obese patients treated in 54 RNPC® weight loss clinics in France. Results: A total of 10,809 (89%) patients completed the initial weight loss phase and 2,996 (25%) completed the full program. Median weight loss percentage was 10.7 % (Interquartile range [IQR]: 5.8;16.5) after a median of 105 days (IQR: 56;175) during the weight loss phase, and a median of 17.5 % (IQR: 12.7;24.2) after a median of 251 days (IQR: 187; 350) at program completion. Conclusion: The RNPC® program is cost-effective and well tolerated for short-term body weight loss as well as effective in the long term among the patients completing the program. The program might be particularly effective among patient with elevated fasting glucose.
Obstructive sleep apnea (OSA) is one of the most frequent chronic diseases, and comorbid obesity ... more Obstructive sleep apnea (OSA) is one of the most frequent chronic diseases, and comorbid obesity occurs in more than 60% of cases. Variations in body weight influence both OSA severity and OSA-related symptoms. We prospectively assessed the impact of a weight-loss program using the Berlin score to reflect OSA risk, and we also used the Epworth Sleepiness Scale (ESS) to assess daytime sleepiness. DietSleep was a prospective multicentric cohort study investigating OSA risk and daytime sleepiness before and after weight-loss intervention. One hundred and twenty-seven patients were included (initial OSA risk 36%), most of whom were women (85.8%) with a median body mass index (BMI) of 29.7 kg/m2, and the interquartile range was (27.6; 34). The diet-based weight-loss program induced a median decrease in BMI of 3.7 kg/m2 (−5; −2.9) (body weight~12.1% (−16.0; −8.8)) over a period of 171 days (114; 269). Changes in anthropometric values were similar regarding OSA risk after adjusting for ini...
Background: Dietary intervention is a cornerstone of weight loss therapies. In obesity, a dysbiot... more Background: Dietary intervention is a cornerstone of weight loss therapies. In obesity, a dysbiotic gut microbiota (GM) is characterized by high levels of Bacteroides lineages and low diversity. We examined the GM composition changes, including the Bacteroides 2 enterotype (Bact2), in a real-world weight loss study in subjects following a high-protein hypocaloric diet with or without a live microorganisms (LMP) supplement. Method: 263 volunteers were part of this real-world weight loss program. The first phase was a high-protein low-carbohydrate calorie restriction diet with or without LMP supplements. Fecal samples were obtained at baseline and after 10% weight loss for 163 subjects. Metagenomic profiling was obtained by shotgun sequencing. Results: At baseline, the Bact2 enterotype was more prevalent in subjects with aggravated obesity and metabolic alterations. After weight loss, diversity increased and Bact2 prevalence decreased in subjects with lower GM diversity at baseline, n...
The aim of this study was to assess the impact of the nationwide total lockdown (LD) in France on... more The aim of this study was to assess the impact of the nationwide total lockdown (LD) in France on weight loss and body composition modifications in subjects participating in a weight loss program and to evaluate the impact of remote consultations on participants’ adherence to the weight loss program. The CO-RNPC study was a prospective multicentre cohort study including participants undergoing a two to six months program. The rate of weight loss in kg/week was computed before (15 days), during (99 days) and after LD (15 days). In the 1550 completing participants, body weight decreased from 87.1 kg [IQR 77.0; 100.2] to 82.3 kg [72.1; 94.3] resulting in a difference of −4.79 kg [−4.48; −5.10] (p < 0.01), with a corresponding reduction in waist circumference by 4 cm ([0; 9], p < 0.01). The median weight loss was 4.4 kg [0.5; 9.4] in those who used remote consultations, and 1.4 kg [0.8; 5.7] in the no remote consultation group (p < 0.01). In this large prospective cohort, we ob...
Le programme RNPC ® ,u ne thérapeutique non-médicamenteusep our la prise en charge des patients a... more Le programme RNPC ® ,u ne thérapeutique non-médicamenteusep our la prise en charge des patients atteints de surcharge pondérale The RNPC ® program, an on-medicinal therapy for the managemento fo verweightp atients
Bariatric surgery is the most effective treatment for obesity. However, less than 1% of eligible ... more Bariatric surgery is the most effective treatment for obesity. However, less than 1% of eligible patients undergo bariatric surgery annually. Here we evaluated the weight loss effectiveness of an intensive non-surgical weight loss program in patients that would qualify for bariatric surgery. Methods: Patients eligible for bariatric surgery (n = 1460) (BMI≥40 or BMI≥35 kg/m 2 plus comorbidities) who were enrolled in a dietary weight loss intervention, the RNPC® program, were compared to a cohort of bariatric surgery patients in terms of weight loss outcome. Results: The 663 patients completing the RNPC® program (35% dropout and 20% ongoing) lost 20.2 ± 11.8 kg corresponding to a reduction of 47% of the excess weight and a percentage weight loss from the initial weight of 18% after a mean period of 18.6 ± 9.1 months. Weight loss 18 months after bariatric surgery (n = 61) was 42.5 ± 15.8 kg corresponding to a reduction of 74% of excess weight and a percentage weight loss from the initial weight of 32%. Conclusion: Although bariatric surgery results in a more pronounced weight loss, a clinically important weight loss can be obtained in patients that would qualify for bariatric surgery following an intensive non-surgical weight loss program. This retrospective analysis calls for randomized trials that compare the long-term costeffectiveness between the RNPC® program and bariatric surgery.
Bodyweight loss is essential to lower risk factors for type 2 diabetes and cardiovascular disease... more Bodyweight loss is essential to lower risk factors for type 2 diabetes and cardiovascular disease in overweight patients. Therefore, we examined the effectiveness of the RNPC® program for short and long term bodyweight reduction. Methods: The RNPC® program is a novel weight loss and maintenance program achieving weight loss by an energy-restricted 800-1000 kcal/day high-protein low-glycemic diet (weight loss phase), followed by an intensive follow-up with a step-wise increase in energy intake to reach energy balance (weight stabilization phases). The analysis included 12,179 overweight or obese patients treated in 54 RNPC® weight loss clinics in France. Results: A total of 10,809 (89%) patients completed the initial weight loss phase and 2,996 (25%) completed the full program. Median weight loss percentage was 10.7 % (Interquartile range [IQR]: 5.8;16.5) after a median of 105 days (IQR: 56;175) during the weight loss phase, and a median of 17.5 % (IQR: 12.7;24.2) after a median of 251 days (IQR: 187; 350) at program completion. Conclusion: The RNPC® program is cost-effective and well tolerated for short-term body weight loss as well as effective in the long term among the patients completing the program. The program might be particularly effective among patient with elevated fasting glucose.
Uploads
Papers by Rémy Legrand