title: Long-term weight loss maintenance and management following a VLCD: a 3-year outcome.
abstract: BACKGROUND
  Effective weight loss treatment is important as obesity has severe health and socioeconomic repercussions. Emerging evidence suggests that rapid initial weight loss results in better long-term weight loss maintenance. This remains controversial and contradicts current recommendations for slower weight loss.
  
  
  OBJECTIVE
  To determine the effect of a very low calorie diet (VLCD) with group-based behaviour therapy on weight loss and long-term weight management by means of a retrospective database analysis.
  
  
  METHODS
  Data for this retrospective analysis included participants who embarked on the LighterLife Total VLCD programme between 2007 and 2010, and whose weights at baseline and at least 12 months were available (n = 5965).
  
  
  RESULTS
  Data were available for 5965 individuals at 1 year, 2044 at 2 years and 580 at 3 years. At baseline, the majority of individuals were Caucasian (n = 5155), female (n = 5419), ≥ 40 years old (n = 4272), 49% were within the body mass index (BMI) range of 30-35 kg/m(2) while 51% had a BMI > 35 kg/m(2) . The average initial weight of the whole cohort was 99.1 kg (SD 16.6). Initial weight and BMI at entry onto programme, as well as numbers of weeks of weight loss were all significantly associated with weight loss achieved on the first weight loss attempt. Weight lost during the initial weight loss phase was the only factor, which was significantly associated with percentage weight loss maintenance for years 1, 2, and 3.
  
  
  CONCLUSIONS
  The findings of this retrospective analysis suggest that provided a longer term weight loss management programme is adhered to, large amounts of initial weight loss can result in important longer term weight loss maintenance in motivated individuals.
authors.affiliation: Centre for Obesity Research and Epidemiology, Robert Gordon University, Aberdeen, UK.
authors.forename: C
authors.initials: C
authors.lastname: Rolland
authors.forename: K L
authors.initials: KL
authors.lastname: Johnston
authors.forename: S
authors.initials: S
authors.lastname: Lula
authors.forename: I
authors.initials: I
authors.lastname: Macdonald
authors.forename: J
authors.initials: J
authors.lastname: Broom
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001521:Behavior Therapy / Q000379:methods; D015992:Body Mass Index; D031204:Caloric Restriction / Q000379:methods*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy*; D011615:Psychotherapy, Group / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology*; D055815:Young Adult