title: Improving maintenance of lost weight following a commercial liquid meal replacement program: a preliminary study.
abstract: Clinic-based liquid meal replacement (800kcals/day) programs produce substantial weight loss. Nevertheless, long-term maintenance remains a challenge. A limitation of maintenance programs is that they continue to promote large behavior changes that are initially required to induce weight loss which may be unsustainable long-term. The study aims were to conduct a preliminary assessment of the feasibility, acceptability, and effectiveness of a small changes maintenance intervention (SCM) for 30 patients who completed liquid meal replacement program (LMR). The 20-session SCM delivered over 52 weeks offered no preset goals for maintenance behaviors and all changes in behavior were self-selected. Participants had a median BMI of 40.9 kg/m(2) and weight of 111 kg at the start of LMR. At LMR completion, they lost 18% (21 kg) of body weight. The SCM was completed by 22 patients (73%); 19 completers (86%) attended ≥ 17 of 20 sessions with a median satisfaction rating of 9 (on a scale of 1 to 9). Completers were asked to record self-selected maintenance behaviors daily (median 351 days recorded). The most commonly reported daily behaviors were self-weighing, use of meal replacements and step counting. Median percent regain at week 52 was 14% (2.8 kg) of lost weight (range, -42 to 74%), significantly less than a median of 56% (11 kg) percent regain of lost weight (range, -78 to 110%) in a demographically similar historical control group with no maintenance intervention after LMR completion (P<0.001). Thus, SCM holds promise for improving weight maintenance. Future research should compare SCM to standard maintenance programs that promote large program-directed changes.
authors.affiliation: Obesity Medicine, Division of General Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA. Electronic address: ames.gretchen@mayo.edu.
authors.forename: Gretchen E
authors.initials: GE
authors.lastname: Ames
authors.affiliation: Obesity Medicine, Division of General Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA.
authors.forename: Roshni H
authors.initials: RH
authors.lastname: Patel
authors.affiliation: Obesity Medicine, Division of General Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA.
authors.forename: Jillian S
authors.initials: JS
authors.lastname: McMullen
authors.affiliation: Divison of Biomedical Statistics and Informatics, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA.
authors.forename: Colleen S
authors.initials: CS
authors.lastname: Thomas
authors.affiliation: Divison of Biomedical Statistics and Informatics, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA.
authors.forename: Julia E
authors.initials: JE
authors.lastname: Crook
authors.affiliation: Obesity Medicine, Division of General Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA.
authors.forename: Scott A
authors.initials: SA
authors.lastname: Lynch
authors.affiliation: Department of Psychology, East Carolina University, 1001 E 5th St., Greenville, NC 27858, USA.
authors.forename: Lesley D
authors.initials: LD
authors.lastname: Lutes
mesh_terms: D000328:Adult; D000368:Aged; D004038:Diet, Reducing; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D005526:Food, Formulated; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy / Q000517:prevention & control*; D015397:Program Evaluation; D016896:Treatment Outcome; D015431:Weight Loss; D061217:Weight Reduction Programs / Q000379:methods*; D055815:Young Adult
keywords: Obesity; Small Changes Maintenance; Weight loss