Cabergoline inadequate for preventing weight regain
The dopamine agonist cabergoline does not provide clear benefits for maintaining weight loss in obese individuals who have shed >5 percent of body weight during a very low-calorie diet, according to the results of the 2-year Prevention of Weight Regain (POWER) study.
POWER randomized 221 obese patients (mean age 48 years; 94 percent female; mean body mass index [BMI], 37.4 kg/m2), who lost weight through an 800-kcal/day commercial meal replacement programme, to receive either cabergoline 0.5 mg (n=110) or placebo (n=111) taken orally once weekly.
At 24 months following randomization, the primary outcome measure of mean body weight did not significantly differ between the two treatment arms (mean difference, 0.6 kg; 95 percent CI, −1.5 to 2.6; p=0.58).
The mean baseline body weight of the cohort was 101.8 kg, with the 800-kcal/day diet producing a mean 7.1-kg reduction in weight. The mean weight regain at 24 months was 5.1 kg. BMI, percent weight loss, waist circumference, resting energy expenditure, blood pressure or metabolic parameters at 24 months were comparable between the cabergoline and placebo arms.
The findings do not support a major role for dopamine-mediated addiction-like mechanisms in curbing weight regain following acute weight loss, researchers said. The data also challenge the hypothesis that reduced central dopamine activity is a significant contributor to weight gain and obesity.
Dopamine is implicated in motivation and reward-driven eating, which strongly contributes to overeating, weight gain and obesity. The compound also factors in the regulation of inhibitory control, emotional status and other known biopsychosocial determinants of obesity. [Biol Psychiatry 2013;73:811-818; Annu Rev Nutr 2017;37:183-205]