One-year behavioral treatment of obesity: Comparison of moderate and severe caloric restriction and the effects of weight maintenance therapy.

Wadden, Thomas A.; Foster, Gary D.; Letizia, Kathleen A.

doi:10.1037/0022-006x.62.1.165

Cited by 295 publications

(252 citation statements)

References 24 publications

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“…Although different measurement scales are used in different studies, our results are consistent with the ®ndings of others. 18,19 However, contrary to a previous study of Wadden et al, 7 no reduction was observed in the Beck Depression Inventory scores.…”

Section: Discussioncontrasting

confidence: 55%

A multidisciplinary approach to the treatment of obesity

Vansant

Hulens

Borght³

et al. 1999

Int J Obes

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OBJECTIVE: The aim of this paper is: (1) To describe a long-term multidisciplinary group approach to the treatment of morbidly obese persons; and (2) to present, in a preliminary report, results at three months in 30 obese women. DESIGN: Prospective study with evaluation at the start of therapy and after three months of therapy. SUBJECTS: Thirty obese women, initial mean BMI 35.3 kgam 2 , age 28 ± 67 y. RESULTS: Body weight decreased signi®cantly ( 7 6 kg) with 74% of weight loss as fat mass. This moderate decrease in body weight resulted in a signi®cant improvement of VO 2 maxakg body weight. Resting metabolic rate and metabolic parameters remained unchanged. Among psychological variables, participating in the therapy resulted in a more pronounced restrained eating behaviour, an improvement of body image and a higher expression of positive feelings and actions. CONCLUSION: Preliminary results of the program are encouraging. However, continuous evaluation and improvement of the program in the long-term (at least several years) are extremely important.

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Section: Discussioncontrasting

confidence: 55%

A multidisciplinary approach to the treatment of obesity

Vansant

Hulens

Borght³

et al. 1999

Int J Obes

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“…1,3 In a majority of trials with longer treatment and follow up-periods, VLCD-strategies have not been superior to programs combining hypocaloric diets and behaviour modi®ca-tion. 5,13,14 One exception is a study by Miura et al, 15 showing a greater weight loss at two years follow-up in a VLCD-group, than in a group treated with behaviour modi®cation and hypocaloric diet. In the present randomised study, we found no signi®cant bene®t of 12 initial VLCD weeks included in a dietary and behavioural support program, compared to the same supportive strategy alone after two years of active treatment.…”

Section: Discussionmentioning

confidence: 96%

VLCD plus dietary and behavioural support versus support alone in the treatment of severe obesity. A randomised two-year clinical trial

et al. 1997

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OBJECTIVES: To determine whether 12 initial weeks on a Very Low Calorie Diet (VLCD) included in a two-year support program is associated with better long term weight loss maintenance than a dietary and behavioural support program alone. Additionally, to identify characteristics associated with successful treatment or attrition, which can be used in selecting individuals likely to respond to VLCD-programs. DESIGN: Randomised clinical trial. SETTING: Two Swedish out-patient clinics. SUBJECTS: 113 obese men and women aged 37±58 y, body mass index (BMI) b 32.0 kg/m 2 , participating in the Swedish Obese Subjects-(SOS) study. INTERVENTIONS: One group received VLCD for 12 initial weeks plus regular dietary and behavioural support over two years while the other group received two years of the same supportive program only. MAIN OUTCOME MEASURE: Weight loss after two years treatment. RESULTS: Both treatment groups maintained highly signi®cant weight losses at two years but the initial VLCDtreatment appeared to have given no signi®cant long term bene®t compared to the supportive program. Examination of selected demographic, psychosocial and dietary characteristics showed that the VLCD-approach was more effective than the supportive strategy alone in men and possibly in individuals sharing household with only one person. High initial hunger-score was associated with attrition, irrespective of treatment. CONCLUSION: A VLCD-program including long term dietary and behavioural support is a successful treatment for some severely obese subjects, especially men. Further research should be directed towards matching treatments to individuals in order to improve the high recidivism rates generally following weight loss attempts.

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“…On the other hand, to be able to further lose weight, one strategy could be to adopt a very low calorie diet. However, this type of diet has been associated with weight regain in a 1-year period upon return to a low calorie diet, 31 thus again suggesting that adaptive thermogenesis could limit the efficiency of weight reduction programs and also complicate weight loss maintenance.…”

Section: Case Studymentioning

confidence: 99%

Clinical significance of adaptive thermogenesis

et al. 2007

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The epidemic of obesity is developing faster than the scientific understanding of an efficient way to overcome it, as reflected by the low success rate of short-and long-term weight loss interventions. From a clinical standpoint, this suggests that the body tends to defend a set point of possible genetic origin in the context of a weight-reducing program. As described in this paper, this limited therapeutic success may depend on adaptive thermogenesis, which represents in this case the decrease in energy expenditure (EE) beyond what could be predicted from the changes in fat mass or fat-free mass under conditions of standardized physical activity in response to a decrease in energy intake. This issue has been documented in recent studies that have shown in obese individuals adhering to a weight reduction program a greater than predicted decrease in EE, which in some cases was quantitatively sufficient to overcome the prescribed energy restriction, suggesting a role for adaptive thermogenesis in unsuccessful weight loss interventions and reduced body weight maintenance. As also discussed in this paper, this 'adaptive thermogenesis' can be influenced by environmental factors, which have not been frequently considered up to now. This is potentially the case for plasma organochlorine concentration and oxygen desaturation in obstructive sleep apnea syndrome. It is concluded that health professionals should be aware that in some vulnerable individuals, adaptive thermogenesis can be multicausal, and has the capacity to compensate, at least partly, for the prescribed energy deficit, possibly going beyond any good compliance of some patients.

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One-year behavioral treatment of obesity: Comparison of moderate and severe caloric restriction and the effects of weight maintenance therapy.

Cited by 295 publications

References 24 publications

A multidisciplinary approach to the treatment of obesity

A multidisciplinary approach to the treatment of obesity

VLCD plus dietary and behavioural support versus support alone in the treatment of severe obesity. A randomised two-year clinical trial

Clinical significance of adaptive thermogenesis

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