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

Torgerson, JS:son; Lissner, Lauren; Lindroos, Anna‐Karin; Kruijer, H; Sjöström, Lars

doi:10.1038/sj.ijo.0800507

Cited by 64 publications

(75 citation statements)

References 14 publications

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“…during food limitation), weight reduction was associated with higher hunger scores (e.g. Lowe et al and Torgerson et al 32,33 ), higher restraint and lower disinhibition scores, 34 and absence of negative alimentary alliesthesia, 21,35 in comparison to lean subjects. Indirect arguments may also be put forward: a decrease in fasting leptin concentration with higher hunger ratings was observed in obese women during caloric restriction 36,37 and a rise in ghrelin concentration in obese subjects was noted during slimming.…”

Section: Discussionmentioning

confidence: 99%

Sensory-specific satiety with simple foods in humans: no influence of BMI?

Brondel

Romer²,

Wymelbeke

et al. 2006

Int J Obes

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Objective: Olfacto-gustatory sensory-specific satiety plays an important role in the termination of food ingestion. A defect in this mechanism, by increasing food intake, could be a factor in development of overweight. The present study was conducted to explore whether sensory-specific satiety in the overweight may be different from that in normal-weight subjects. Subjects: 144 subjects (half men, half women; age range: 17-62 years; BMI range: 17-39 kg m À2 ). Measurements: Olfactory pleasure (OP) and flavor pleasure (FP) were evaluated before and after ingestion of a single chosen food. Six foods from three classes were offered: cucumber and tomato, pineapple and banana, and peanut and pistachio. According to the subjects' preference for one of them, subjects were classified into six groups (24 subjects each with equal sex ratio). The experimental sequence was (1) evaluation of the six foods (OP), (2) ad libitum intake of the preferred food (FP) and (3) second evaluation of the six foods (OP). Results: Food intake was limited by sensory-specific satiety (that is, a decline in FP for the ingested food) in overweight subjects just as it was in the leanest. There was no significant correlation between BMI and hedonic parameters (OP and FP) Conclusion: After intake of a single food, olfacto-gustatory sensory-specific satiety correlated with the ingested food's weight and volume and with the duration of ingestion, but not with bodyweight. This suggests that overweight and lean subjects have similar hedonic control of food intake with simple foods.

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Section: Discussionmentioning

confidence: 99%

Sensory-specific satiety with simple foods in humans: no influence of BMI?

Brondel

Romer²,

Wymelbeke

et al. 2006

Int J Obes

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“…Nine studies had high proportion (31-64%) of subjects lost to follow-up. This may affect clinical applicability of findings because in all but two studies, 50,77 outcomes were reported based on a 'study-completers' analysis, which may overestimate weight loss because study completers may have greater weight loss than noncompleters. Long-term efficacy of weight loss methods JD Douketis et al Long-term efficacy of weight loss methods Six studies had a 'usual care' control group.…”

Section: Dietary/lifestyle Therapymentioning

confidence: 99%

Systematic review of long-term weight loss studies in obese adults: clinical significance and applicability to clinical practice

et al. 2005

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BACKGROUND: Obesity is a common health problem that requires a long-term care approach. We systematically reviewed long-term (Z2 y) studies investigating dietary/lifestyle, pharmacologic, and surgical weight loss methods to assess (1) weight loss efficacy, defined by absolute weight loss and the proportion of subjects with Z5% weight loss, (2) effects of weight loss on cardiovascular risk factors, and (3) applicability of findings from studies to everyday clinical practice. METHODS: The MEDLINE, HealthSTAR, and the Cochrane Controlled Trials databases were searched for studies investigating the long-term efficacy of weight loss methods in overweight and obese adults. Data were extracted for (i) weight loss after 1 y (pharmacologic studies only), 2 y, 3 y, and 4 y, (ii) proportion of subjects with Z5% weight loss at the end of follow-up, and (iii) changes (end-of follow-up minus baseline values) in blood lipids, fasting blood glucose, and systolic and diastolic blood pressure. RESULTS: Dietary/lifestyle therapy provides o5 kg weight loss after 2-4 y, pharmacologic therapy provides 5-10 kg weight loss after 1-2 y, and surgical therapy provides 25-75 kg weight loss after 2-4 y. Weight loss of Z5% baseline weight is not consistently associated with improvements in cardiovascular risk factors and these benefits appear to be intervention specific and occur mainly in people with concomitant cardiovascular risk factors. Weight loss studies have methodologic limitations that restrict the applicability of findings to unselected obese people assessed in everyday clinical practice. These limitations include an inadequate study duration, large proportions of subjects lost to follow-up, a lack of an appropriate usual care group, and a lack of reporting of outcomes in high-risk subgroups. CONCLUSIONS: Dietary/lifestyle and pharmacologic weight loss interventions provide modest weight loss, and may improve markers of cardiovascular risk factors although these benefits occur mainly in patients with cardiovascular risks. Studies investigating weight loss have methodologic limitations that restrict the applicability of findings to obese patients assessed in clinical practice.

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“…Numerous randomized trials have shown that very-lowcalorie diets (VLCDs), providing 400 -800 kilocalories per day (kcal/day), produce short-term weight losses nearly double those resulting from a standard 1,200 -1,500 kcal/day diet of conventional foods (used in traditional behavioral programs). VLCDs, however, are associated with rapid weight regain, such that 1 year after treatment there are not statistically significant differences in weight loss between the two dietary approaches (Ryttig, Flaten, & Rossner, 1997;Torgerson, Lissner, Lindross, Kruijer, & Sjöstrom, 1997;Wadden, Foster, & Letizia, 1994;Wing, Blair, Marcus, Epstein, & Harvey, 1994). This has led investigators to use less calorically restricted diets but to retain the use of portioncontrolled servings, a prominent feature of liquid VLCDs .…”

Section: Group Behavioral Treatmentmentioning

confidence: 99%

Obesity: Responding to the global epidemic.

Wadden¹,

Brownell²,

Foster³

2002

Journal of Consulting and Clinical Psychology

438

328

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Obesity has reached epidemic proportions in the United States and other developed nations. In the United States, 27% of adults are obese and an additional 34% are overweight. Research in the past decade has shown that genetic influences clearly predispose some individuals to obesity. The marked increase in prevalence, however, appears to be attributable to a toxic environment that implicitly discourages physical activity while explicitly encouraging the consumption of supersized portions of high-fat, high-sugar foods. Management of the obesity epidemic will require a two-pronged approach. First, better treatments, including behavioral, pharmacologic, and surgical interventions, are needed for individuals who are already obese. The second and potentially more promising approach is to prevent the development of obesity by tackling the toxic environment. This will require bold public policy initiatives such as regulating food advertising directed at children. The authors call not for the adoption of a specific policy initiative, but instead propose that policy research, based on viewing obesity as a public health problem, become a central focus of research.Research on obesity has increased exponentially during the past decade and has yielded remarkable discoveries in the regulation of body weight. This same period, however, has witnessed an unparalleled increase in the prevalence of obesity, making it one of our nation's most pressing health problems. This article reviews the epidemiology and complications of obesity and the factors that have contributed to its sharp increase. Consistent with previous reviews, we examine advances in treatment including behavioral, pharmacologic, and surgical interventions (Brownell, 1982;Brownell & Wadden, 1992). Advances in treatment, however, must be complemented in the next decade by innovative public policy designed to prevent the development of obesity. Epidemiology and Complications of ObesityObesity refers to an excess of body fat, which normally accounts for about 25% of weight in women and 18% in men (Bray, 1998). Body fat can be measured by a number of methods but is now usually estimated by the body mass index (BMI), which is calculated as weight in kilograms divided by height in meters squared (i.e., kg/m 2 ; Bray, 1998). (Figure 1 provides for this calculation using pounds and inches.) The BMI is highly correlated with measures of body fat and has replaced the more traditional measure of percentage over ideal weight (VanItallie & Lew, 1992).The World Health Organization (WHO; 1998) has defined obesity as a BMI Ն 30 kg/m 2 , as has the National Institutes of Health/National Heart, Lung, and Blood Institute (NIH/NHLBI; 1998). By this criterion, in 1994 (the last period for which most complete analyses are available), 25% of U. S. women and 20% of men were obese (Flegal, Carroll, Kuczmarski, & Johnson, 1998). An additional 25% and 39%, respectively, were considered overweight, defined as a BMI of 25.0 to 29.9 kg/m 2 . Thus, 55% of adult Americans were either overweight or...

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

Cited by 64 publications

References 14 publications

Sensory-specific satiety with simple foods in humans: no influence of BMI?

Sensory-specific satiety with simple foods in humans: no influence of BMI?

Systematic review of long-term weight loss studies in obese adults: clinical significance and applicability to clinical practice

Obesity: Responding to the global epidemic.

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