Study population and design
obesity, Weight loss, weight loss
OBESITY
The OPTICARE XL CR (OPTImal CArdiac REhabilitation XL CR) study is an open-label, randomized controlled trial [The experimental group participated in OPTICARE XL CR, and the controls received standard CR as recommended by the guidelines [In order to enter cardiac rehabilitation, patients are exposed to a symptom-limited exercise test (on a bike in a controlled setting, with a safety protocol). Based on the achievements on this exercise test, patients started standard cardiac rehabilitation on a certain intensity level (low, moderate, or high intensity), or when randomized to OPTICARE XL CR started OPTICARE XL CR. The cycle ergometer, the rowing ergometer and fitness equipment were used for strength training. The training modalities for patients in the standard CR group consisted mainly of activities such as walking, jogging and group sports. During cardiac rehabilitation the patient is monitored every week and the training schedule is revised upon consultation with the multidisciplinary treatment team. Standard CR programs terminate once the patients’ physical and psychosocial recovery is sufficient. In most cases this goal is reached between 6 and 12 weeks, whereas the performance of the patient is evaluated in consultation with the multidisciplinary team. The OPTICARE XL CR program lasted for 12 weeks, since it was assumed that patients with obesity need at least 12 weeks of care in order to facilitate in behavioral changes. Furthermore, a behavioural after-care program was organized with 6 meetings (one hour each) between weeks 13–52 for the OPTICARE XL CR patients. This was done in small groups with a maximum of 8 participants instead of the standard CR groups with a maximum of 25 participants.Weight loss was defined as any decrease in weight and measured with a calibrated weight scale. Clinically significant weight loss was defined as a loss of 5% of body weight at baseline [