title: Diminished weight loss and behavioral compliance during repeated diets in obese patients with type II diabetes.
abstract: Compared weight losses during first and second bouts of a very low calorie diet (VLCD) and examined whether decreased compliance might in part explain the decrease in weight loss during the second bout. Forty-five Type II diabetic patients participated in a year-long behavioral weight-reduction program that incorporated a VLCD (400 to 500 kcal/day) during Weeks 1 to 12 and 28 to 40. Weight losses decreased dramatically from the first to the second VLCD (15.54 vs. 1.42 kg, p less than .0001). There was also markedly diminished adherence as assessed by weeks ketonuric, attendance, and completeness of self-monitoring records. The percentage of weeks subjects were in ketosis dropped from 61% during VLCD 1 to 13% during VLCD 2 (p less than .0001). Similarly, subjects attended significantly fewer treatment meetings during VLCD 2 and self-monitored less during VLCD 2 than during VLCD 1. Weeks ketonuric and initial weight accounted for 63% of the variance in weight loss during VLCD 1 (p less than .0001); weeks ketonuric and attendance predicted weight loss during VLCD 2 (p less than .0001), accounting for 54% of the variance. These results suggest the importance of behavioral factors in explaining poorer performance on a repeated diet.
authors.affiliation: Department of Psychiatry, University of Pittsburg School of Medicine.
authors.forename: D E
authors.initials: DE
authors.lastname: Smith
authors.forename: R R
authors.initials: RR
authors.lastname: Wing
mesh_terms: D000328:Adult; D000368:Aged; D003920:Diabetes Mellitus / Q000178:diet therapy* / Q000523:psychology*; D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy* / Q000523:psychology*; D004038:Diet, Reducing / Q000523:psychology*; D002149:Energy Intake; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity; D010349:Patient Compliance / Q000523:psychology*; D015431:Weight Loss