title: Severe obesity: the use of very low energy diets or standard kilojoule restriction diets.
abstract: OBJECTIVE
  To determine the efficacy of two dietary therapies in both the short term (hospitalisation) and the longer term treatment of severe obesity.
  
  
  METHODS
  A descriptive study of two patient groups with obesity defined by a body mass index of greater than 30 kg/m2.
  
  
  METHODS
  A multidisciplinary weight control program in a tertiary care hospital.
  
  
  METHODS
  All admissions to hospital of patients on the weight control program for initiation of weight loss during a period of 48 months.
  
  
  METHODS
  A standard kilojoule reduction regimen or the use of complete, followed by partial, long term meal substitution with a very low energy liquid diet (VLED), coupled with an exercise and a behavioural modification program.
  
  
  METHODS
  Weight loss during and after hospitalisation was measured in both dietary regimen groups.
  
  
  RESULTS
  Both diets induced weight loss in hospital. Men prescribed VLED lost significantly more weight, 8.3 +/- 0.8 kg (mean +/- SEM) than women prescribed this diet (5.5 +/- 0.5 kg) or standard kilojoule restriction (5.1 +/- 0.8 kg).
  
  
  CONCLUSIONS
  VLED and standard kilojoule restriction are both effective for the treatment of severe obesity, particularly in a controlled environment (hospitalisation). In the longer term, VLED is an effective method of maintaining weight loss. Lack of continuing weight loss may reflect the patients who were initially placed on this regimen--small eaters with a presumed high metabolic efficiency.
authors.affiliation: Department of Endocrinology, Royal Prince Alfred Hospital, Camperdown, NSW.
authors.forename: R M
authors.initials: RM
authors.lastname: Richman
authors.forename: K S
authors.initials: KS
authors.lastname: Steinbeck
authors.forename: I D
authors.initials: ID
authors.lastname: Caterson
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D004038:Diet, Reducing / Q000379:methods*; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy*; D010045:Outpatients; D010351:Patient Discharge; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss