Obesity is a major public health challenge not only for developed but developing countries as well. The World Health Organization recommends the immediate use of effective, efficient and widely accessible weight loss interventions. Telephone based weight loss intervention could provide a cheaper and wider reach of obese participants. Previous systematic reviews on telephone based weight loss interventions either excluded studies that had obese participants with co-morbidities or were silent on their inclusion. Obese/overweight individuals with co-morbidities constitute an important population in any weight loss intervention study due to the strong association of obesity with major chronic health conditions. This paper, reviews the efficacy of telephone based weight loss intervention solely in overweight/obese individuals with obesity related diseases and discusses its relevance for developing countries.

Background and Aim. There is a need to investigate the long-term impact of successful weight loss maintenance on blood lipids and glucose concentrations in populations within Africa, where obesity and cardiovascular disease (CVD) rates are increasingly becoming a public health threat. The aim of this study was to compare the serum lipid and glucose concentrations of successful and unsuccessful weight loss maintainers who previously participated in the Nutriline Weight Loss Programme (NWLP) in Accra, Ghana. Methods. 112 participants were randomly selected to participate in this cross-sectional study. Baseline and end of weight loss programme anthropometric and programmatic data were accessed via the NWLP archival database. On follow-up, anthropometric data, physical activity, dietary behaviour, serum lipid, and glucose indices were taken. Successful weight loss maintainers (SWLM) were defined as those achieving at least 5% weight loss below the baseline weight at follow-up, otherwise unsuccessful (UWLM). Results. The adjusted serum total cholesterol (TC) concentration was significantly lower for SWLM (5.17 ± 0.99 mmol/L) compared to UWLM (5.59 ± 1.06 mmol/L). Serum low-density lipoprotein (LDL), high-density lipoprotein (HDL), fasting blood glucose (FBG), and glycosylated haemoglobin (HbA1c) concentrations for SWLM versus UWLM did not differ significantly and were as follows: 3.58 ± 0.92 mmol/L versus 3.87 ± 0.99 mmol/L, 1.22 ± 0.38 mmol/L versus 1.17 ± 0.32 mmol/L, 4.48 ± 0.72 mmol/L versus 4.73 ± 1.00 mmol/L, and 5.52 ± 0.39% versus 5.59 ± 0.59%, respectively. Triglyceride (TG) concentration was significantly (P<0.001) lower for SWLM (0.79 ± 0.28 mmol/L) compared to UWLM (1.17 ± 0.51 mmol/L). After adjusting for covariates, it was no longer significant. Additionally, there was no significant association between weight loss maintenance success and having a normal status for selected lipids and glucose parameters. Conclusion. SWLM had a significantly lower serum TC compared to UWLM. In addition, a greater proportion of SWLM had normal values for TC, TG, HbA1c, and LDL out of the six parameters measured although not statistically significant.

Overweight and obesity are major risk factors for a number of non-communicable diseases such as type 2 diabetes, hypertension, stroke, heart attack and others. Intentional weight loss has been widely documented as an effective way of reducing the risk of such chronic diseases. As a result of the positive health consequences of weight reduction, many people all over the world are attempting weight loss to reap these health benefits. Common methods being used to achieve weight loss include self-help measures and structured programmes such as commercial weight loss programmes. Although commercial weight loss programmes are increasingly being patronised, little is known about the long-term outcomes of such programmes. The purpose of this study was to ascertain the prevalence of weight loss maintenance success in previous participants of a commercial weight loss programme in Accra, Ghana, who had been out of the weight loss programme for a median period of 4.75 years. A cross-section of 230 participants were randomly selected for this study. Baseline and end-line anthropometric data, length of stay in the programme and post treatment time were extracted from the programme's database. Weight measurements taken at follow up were used in calculating the percent weight loss at follow up. Successful weight loss maintenance was defined as achieving at least five percent weight loss below baseline weight at follow up otherwise unsuccessful. Comparisons of successful weight loss maintainers (SWLM) and unsuccessful weight loss maintainers (UWLM) were conducted using Analysis of covariance (ANCOVA) for continuous variables and Pearson chi-square for categorical variables. The mean baseline weight, height, Body Mass Index (BMI) and age for the cohort were 96.5±16.3kg, 1.65±0.08m, 35.4±5.4kg/m 2 , and 39.7±9.2yrs, respectively. The prevalence of weight loss maintenance success was 23.9%. More than half (52.2%) of the study cohort either returned to baseline weight or further regained some weight beyond baseline weight at follow up. Seventeen percent of the study cohort retained at least 95% of losses previously attained during the weight loss programme. Long-term maintenance of lost weight is achievable in a substantial proportion of weight losers and must be actively promoted by health professionals. The results can be generalised to majority of those who enter this commercial weight loss programme and not only the successful ones.