title: Meal replacement with a low-calorie diet formula in weight loss maintenance after weight loss induction with diet alone.
abstract: OBJECTIVE
  Weight loss in obesity can reduce morbidity and mortality and benefits persist as long as weight loss is maintained. Weight maintenance is difficult in the long term and new strategies need to be developed to achieve this goal. We aimed to evaluate the efficacy of substituting a low-calorie diet formula for a meal in a weight loss program during the maintenance phase.
  
  
  METHODS
  Randomized paralleled clinical trial including 62 adult patients with at least a 5% weight loss with diet alone for 6 months, randomized to two groups: daily replacement of one meal with a low-calorie diet formula, or dieting alone for another 6 months (weight maintenance phase).
  
  
  RESULTS
  Weight maintenance or further weight loss occurred in 83.9% of patients in the intervention group, whereas only in 58.1% in the control group (P=0.025). As a whole, patients in the intervention group lost a further 3.2+/-3.7% of initial weight compared with a 1.3+/-3.6% in the control group (P=0.030). Body fat mass diminished in both groups, with no differences between them (1.6+/-3.5 vs 1.0+/-9.3 kg, respectively, P=0.239), and the same happened with free fat mass (0.9+/-3.3 vs 0.4+/-6.7 kg, respectively, P=0.471). A multivariate logistic regression analysis (R (2)=0.114, P=0.023) retained only the intervention as a predictor of the achievement of weight maintenance with an odds ratio (95% confidence interval) of 3.756 (1.138-12.391).
  
  
  CONCLUSIONS
  Substitution of a low-calorie diet formula for a meal is an effective measure for weight loss maintenance compared with dieting alone.
authors.affiliation: Unit of Clinical Nutrition and Dietetics, Department of Endocrinology and Nutrition, Madrid, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Vázquez
authors.forename: C
authors.initials: C
authors.lastname: Montagna
authors.forename: F
authors.initials: F
authors.lastname: Alcaraz
authors.forename: J A
authors.initials: JA
authors.lastname: Balsa
authors.forename: I
authors.initials: I
authors.lastname: Zamarrón
authors.forename: F
authors.initials: F
authors.lastname: Arrieta
authors.forename: J I
authors.initials: JI
authors.lastname: Botella-Carretero
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism; D001823:Body Composition / Q000502:physiology; D004038:Diet, Reducing; D005260:Female; D005526:Food, Formulated; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy*; D010349:Patient Compliance; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology*