Weight loss and long-term follow-up of severely obese individuals treated with an intense behavioral program

Abstract

Objective: To review weight loss and maintenance for severely obese individuals enrolled in intensive behavioral weight loss program using very-low or low-energy diets. Design: Chart review of consecutively treated patients between 1995 and 2002 seen at three weight loss centers. Subjects: One thousand five hundred and thirty one patients with severe obesity (X40 kg/m 2) treated in three cities ('Study Group'). Of these, 1100 completed the 12-week core curriculum ('Completer Group'). Weight loss X100 lbs (445 kg) was seen in 268 patients ('100-Pound Group'). Measurements: Charts were reviewed for baseline characteristics, weekly weights, follow-up weights and side effects. Results: In the Study Group, average weight loss7s.e. for 998 women was 23.970.6 kg (18.5% of initial body weight (IBW)) and for 533 men was 36.071.0 kg (22.5%) over 30 weeks. For Completers, average weight loss for women was 30.870.6 kg (23.9%) and for men was 42.671.1 kg (26.7%) over 39 weeks. In the 100-Pound Group, average weight loss for women was 58.271.2 kg (41.5%) in 65 weeks and for men was 65.771.5 kg (37.5%) in 51 weeks. Side effects, assessed in 100 patients losing 445 kg, were mild to moderate in severity. Severe adverse events unrelated to the diet were noted in 5% of patients and during weight loss 1% had elective cholecystectomies. Follow-up weights were available for 86% of Completers at an average of 72 weeks with average maintenance of 23 kg or 59% of weight loss; follow-up weights were available for 94% of the 100-Pound Group at an average of 95 weeks with average maintenance of 41 kg or 65% of weight loss maintained. Conclusions: Intensive behavioral treatment with meal replacements is a safe and effective weight-loss strategy for selected severely obese individuals.

Initial weight loss on an 800-kcal diet as a predictor of weight loss success after 8 weeks: the Diogenes study

“…In addition, this study assessed predictors of weight loss separately in women and men, and confirms that men lose weight more rapidly in the initial stage of a slimming program than women (12.67 ± 0.22 vs 9.86 ± 0.13, P ¼ 0.0001). This has been shown previously (Sartorio et al, 2005;Anderson et al, 2007). The reason is most likely the gender difference in body composition, and the consequent differences in total energy expenditure, appetite control and reproductive hormone signals, resulting in gender-specific responsiveness to weight loss programs (Dye and Blundell, 1997;Sartorio et al, 2005;Anderson et al, 2007).…”

Treatment of Obesity in Primary Care Practice in the United States: A Systematic Review

“…45,46 Intensive behavioral treatments provided in academic medical centers, such as in the Diabetes Prevention Program, 4 can help patients achieve a weight loss of 7-10%. 47 Medically supervised programs (OPTIFAST, Health Management Resources) may induce losses of 15-25% of initial weight using meal replacements, [48][49][50][51][52] although patients have difficulty sustaining losses of this size, even when provided weight maintenance therapy. 48,51,53 Pharmacotherapy (e.g., orlistat, sibutramine), when prescribed alone, produces modest losses of 4 to 5% of initial weight.…”

Circadian rhythms of GIP and GLP1 in glucose-tolerant and in type 2 diabetic patients after biliopancreatic diversion

“…Lifestyle intervention programmes and pharmacotherapy fail to maintain long-term weight loss, particularly in severe obesity [8], whereas bariatric surgery is effective and associated with a significant reduction in mortality [9]. Relatively few data are available concerning the effect of bariatric surgery on incretin secretion [10][11][12][13][14][15] and, at least to our knowledge, no data exist regarding the response of incretin to multiple meals.…”