Intensive Weight Loss Intervention Versus Usual Care for Adults With Obesity

NCT ID: NCT06321432

Last Updated: 2025-05-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

400 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-06-05

Study Completion Date

2048-12-31

Brief Summary

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In this trial, the aim is to assess the clinical benefits and harms, as well as cost-effectiveness of an intensive weight loss (IWL) intervention that includes total dietary replacements, behavioural support and weight-loss medication compared with existing weight management programmes within primary care for people with obesity class I or uncomplicated obesity class II or higher.

Detailed Description

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In the LightCARE trial, an intensive weight loss (IWL) intervention will compared with usual care. The IWL lasts two years, and includes total dietary replacements, behavioural support, and weight loss medication in three phases:

* Induction' phase (week 0-12 after randomisation): total dietary replacement (TDR) programme and behavioural support with weight loss medication (WLM) if rate of weight loss is insufficient.
* Weight loss continuation' phase (week 13-32 after randomisation): progression of dietary programme including reduction in use of TDR products, reintroduction of healthy foods, with behavioural support, introduction of physical activity, WLM (as required).
* Maintenance' phase (week 33-104 after randomisation): Continued healthy diet and physical activity with WLM (if required), with return to induction phase if weight regain occurs induction, weight loss continuation, maintenance.

Usual care will differ between the two countries (Denmark and the United Kingdom).

In Denmark, participants will receive a pamphlet on current obesity management guidelines from the Danish National Board of Health, and will be advised to contact their GP for potential referral to local municipality-based obesity management programmes. Furthermore, a notification will be sent to the participant's GP, informing that the participant has been enrolled in the trial and is randomised to usual care. The availability and structure of current obesity programmes varies between municipalities.

In the United Kingdom, participants will be offered to discuss weight management programmes available in their area with their GP practice; the programmes available referral routes vary slightly from place to place. Tier 2 weight management services are mostly commissioned by local authority, and therefore differ slightly across the 333 local authorities in England. These local community-based weight management services provide diet, nutrition, behavioural advice.

Conditions

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Obesity

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Investigators Outcome Assessors
Due to the nature of the interventions, it will not be possible to blind the participants or the healthcare providers administering the interventions. In all other aspects of the trial, blinding will be employed. Outcome assessors will be blinded to group allocation. Participants will also be requested not to disclose their allocation when outcomes are assessed.

Statisticians and investigators drawing conclusions will be fully blinded. The statistical analyses will be conducted with the intervention groups coded as e.g., 'A' and 'B'. The Steering Committee ill write two abstracts while the blinding is intact; one assuming the experimental intervention group is 'A' and the control intervention group is 'B', and one assuming the opposite. After these two abstracts have both obtained consensus, the code will be broken by the data manager.

Study Groups

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Intensive weight loss intervention

The intensive weight loss intervention (IWL) includes total dietary replacements, behavioural support, and weight loss medication. The intervention consists of three phases: induction, weight loss continuation, maintenance, and it will lasts two years in total.

Group Type EXPERIMENTAL

Intensive weight loss intervention

Intervention Type BEHAVIORAL

Intensive weight loss intervention, incl. total meal replacements, behavioural support, and weight loss medication.

Usual care

Denmark: usual care offered by the GP or local municipality. The UK: usual care in primary care, Tier 2 weight management services.

Group Type ACTIVE_COMPARATOR

Usual care

Intervention Type BEHAVIORAL

Usual care

Interventions

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Intensive weight loss intervention

Intensive weight loss intervention, incl. total meal replacements, behavioural support, and weight loss medication.

Intervention Type BEHAVIORAL

Usual care

Usual care

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

1. Age ≥18 years and ≤60 years old at screening.
2. BMI ≥30 kg/m2 or ≥27.5 kg/m2 in people with South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean family backgrounds (as reported by the participants).
3. Informed consent.

Exclusion Criteria

1. Has severe and complex obesity, i.e., obesity class II (BMI≥35 if white or 32.5 if non-white) with one or more of these specific adiposity-related comorbidities: cardiovascular disease, type 2 diabetes, hypertension, non-alcoholic steatosis, or sleep apnoea (Appendix 1).
2. Intending to become pregnant in the next two years, or pregnant, or breastfeeding.
3. Use of WLM or GLP-1 agonist treatment within the last 3 months.
4. Currently being treated for cancer other than oestrogen antagonist therapy or non-melanoma skin cancer.
5. Prior bariatric surgery, not including laparoscopic gastric banding, intragastric balloons or duodenal-jejunal bypass sleeve (Endobarrier™ or similar) if the device has been removed \>1 year before screening.
6. Diagnosis or treatment for eating disorder within the last 6 months.
7. Any other disease that markedly compromises the participant's ability to adhere to the treatment programme or follow-up or is likely to mean that weight loss will not improve the person's length or quality of life, such as conditions limiting life expectancy.
8. Conditions that contraindicate or complicate total diet replacement (including type 1 diabetes or other diabetes requiring any insulin therapy, phenylketonuria, or other conditions requiring special diets).
9. Taking part in other research involving multidisciplinary obesity treatment that would compromise participation in this trial.
10. Conditions that contraindicate or complicate GLP-1 or GIP agonist treatment (including history of pancreatitis)
11. Another member of the household enrolled in the trial.
Minimum Eligible Age

18 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Copenhagen

OTHER

Sponsor Role collaborator

University of Southern Denmark

OTHER

Sponsor Role collaborator

University of Oxford

OTHER

Sponsor Role collaborator

Copenhagen Trial Unit, Center for Clinical Intervention Research

OTHER

Sponsor Role collaborator

Carsten Dirksen

OTHER

Sponsor Role lead

Responsible Party

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Carsten Dirksen

Associate Professor

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Carsten Dirksen, Ass. Prof.

Role: STUDY_CHAIR

Department of Medicine, Copenhagen University Hospital - Amager and Hvidovre

Locations

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The Department of Medicine and the Gastro Unit, Copenhagen University Hospital - Amager and Hvidovre

Copenhagen, , Denmark

Site Status RECRUITING

Frederiksberg kommune: Social-, Sundheds- og Arbejdsmarkedsområdet

Frederiksberg, , Denmark

Site Status RECRUITING

The Parker Institute, Copenhagen University Hospital - Bispebjerg and Frederiksberg

Frederiksberg, , Denmark

Site Status RECRUITING

Hvidovre kommune: Center for Sundhed og Ældre, Hvidovre Sundhedscenter, Sundhed og Forebyggelse

Hvidovre, , Denmark

Site Status RECRUITING

Gladsaxe kommune: Social- og Sundhedsforvaltningen, Sundhed og Rehabilitering

Søborg, , Denmark

Site Status RECRUITING

East of England RRDN

Ipswich, , United Kingdom

Site Status RECRUITING

Yorkshire and Humber RRDN (Leeds, Sheffield and Hull)

Leeds, , United Kingdom

Site Status RECRUITING

North West RRDN

Manchester, , United Kingdom

Site Status RECRUITING

West Midlands RRDN

Wolverhampton, , United Kingdom

Site Status RECRUITING

Countries

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Denmark United Kingdom

Central Contacts

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Frans B Waldorff, Professor

Role: CONTACT

+4535327129

Susan Jebb, Professor

Role: CONTACT

Facility Contacts

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Carsten Dirksen

Role: primary

Addie J Frederiksen

Role: primary

Sofus C Larsen

Role: primary

Maria Bleiback Clausen

Role: primary

Julie Borgen Braget

Role: primary

Susan Jebb

Role: primary

Susan Jebb

Role: primary

Susan Jebb

Role: primary

Susan Jebb

Role: primary

References

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Larsen SC, Heitmann BL, Wane S, Wielsoe S, Lindschou J, Jakobsen JC, Engstrom J, Specht IO, Christiansen AL, Jensen AKG, Nyvold Bojsen-Moller K, Bandholm T, Overbeck G, Kousgaard MB, Albury C, Reventlow S, Olsen KR, Kongstad LP, Madsbad S, Jebb SA, Dirksen C, Aveyard P, Waldorff FB; LightCOM team. Intensive weight loss intervention versus usual care in adults with obesity: a protocol for the LightCARE randomised clinical trial. BMJ Open. 2025 Oct 15;15(10):e107155. doi: 10.1136/bmjopen-2025-107155.

Reference Type DERIVED
PMID: 41093354 (View on PubMed)

Related Links

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Other Identifiers

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LightCARE

Identifier Type: -

Identifier Source: org_study_id

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