A comparison of meal replacements and medication in weight maintenance after weight loss.
OBJECTIVE
To compare the use of meal replacements or medication during weight maintenance subsequent to weight loss using a very low-energy diet (VLED) in overweight or obese adults.


METHODS
Participants followed a liquid VLED of 2177 kJ for 12 weeks followed by 4 weeks of re-orientation to solid foods. Participants were randomized at week 16 to receive either meal replacements or Orlistat both combined with a structured meal plan containing an energy value calculated to maintain weight loss.


METHODS
Sixty-four women (age = 49.9 +/- 10 y, weight = 101.6 +/- 17.1 kg, height = 164.9 +/- 6.0 cm, BMI = 36.7 +/- 5.4 kg/m(2)) and 28 men (age = 53.7 +/- 9.6 y, weight = 121.8 +/- 16.0 kg, height = 178.7 +/- 5.6 cm, BMI = 37.8 +/- 4.9 kg/m(2)) completed a 1 year weight management program. Behavioral weight management clinics included topics on lifestyle, physical activity (PA), and nutrition. Participants met for 90 min weekly for 26 weeks, and then biweekly for the remaining 26 weeks.


RESULTS
Minutes of PA, fruits and vegetables (FV), and pedometer steps were recorded on a daily basis and reported at each group meeting. Body weight was obtained at each group meeting.


RESULTS
During VLED, the MR group decreased body weight by 22.8 +/- 6.1 kg and the Orlistat group decreased body weight by 22.3 +/- 6.1 kg. During weight maintenance, there was no significant group by time interaction for body weight, PA, FV consumption, or pedometer steps. At week 16, the meal replacement group had a body weight of 85.4 +/- 14.3 kg that increased to 88.1 +/- 16.5 kg at 52 weeks (p < 0.05). At week 16, the Orlistat group had a body weight of 85.7 +/- 17.9 kg that increased to 88.5 +/- 20.3 kg at 52 weeks (p < 0.05).


CONCLUSIONS
Subsequent to weight loss from a VLED, meal replacements and Orlistat treatments were both effective in maintaining weight significantly below baseline levels over a 52 week period of time. Meal replacements may be a viable alternative strategy to medications for weight maintenance.
LeCheminant
James D
JD
Center for Physical Activity and Weight Management, The University of Kansas, Lawrence, Kansas 66045, USA.
Jacobsen
Dennis J
DJ
Hall
Matthew A
MA
Donnelly
Joseph E
JE
D000328:Adult; D000368:Aged; D000886:Anthropometry; D019440:Anti-Obesity Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001823:Body Composition / Q000187:drug effects / Q000502:physiology; D003376:Counseling; D018592:Cross-Over Studies; D004038:Diet, Reducing; D015444:Exercise / Q000502:physiology; D005260:Female; D005526:Food, Formulated / Q000009:adverse effects; D006293:Health Promotion; D006801:Humans; D007783:Lactones / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000517:prevention & control* / Q000628:therapy*; D000077403:Orlistat; D016896:Treatment Outcome; D015430:Weight Gain; D015431:Weight Loss
D019440:Anti-Obesity Agents; D007783:Lactones; D000077403:Orlistat