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


METHODS
Chart review of consecutively treated patients between 1995 and 2002 seen at three weight loss centers.


METHODS
One thousand five hundred and thirty one patients with severe obesity (>or=40 kg/m(2)) treated in three cities ('Study Group'). Of these, 1100 completed the 12-week core curriculum ('Completer Group'). Weight loss >or=100 lbs (>45 kg) was seen in 268 patients ('100-Pound Group').


METHODS
Charts were reviewed for baseline characteristics, weekly weights, follow-up weights and side effects.


RESULTS
In the Study Group, average weight loss+/-s.e. for 998 women was 23.9+/-0.6 kg (18.5% of initial body weight (IBW)) and for 533 men was 36.0+/-1.0 kg (22.5%) over 30 weeks. For Completers, average weight loss for women was 30.8+/-0.6 kg (23.9%) and for men was 42.6+/-1.1 kg (26.7%) over 39 weeks. In the 100-Pound Group, average weight loss for women was 58.2+/-1.2 kg (41.5%) in 65 weeks and for men was 65.7+/-1.5 kg (37.5%) in 51 weeks. Side effects, assessed in 100 patients losing >45 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.
Anderson
J W
JW
Department of Internal Medicine, College of Medicine, University of Kentucky and Health Management Resources Weight Management Program at the University of Kentucky, Lexington, KY 40536-0298, USA. janders@uky.edu
Grant
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Gotthelf
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Stifler
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LT
D000328:Adult; D001521:Behavior Therapy / Q000379:methods*; D031204:Caloric Restriction / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000178:diet therapy / Q000503:physiopathology / Q000628:therapy*; D012737:Sex Factors; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology*