title: The impact of a weight reduction program with and without meal-replacement on health related quality of life in middle-aged obese females.
abstract: BACKGROUND
  In addition to an increased risk for chronic illnesses, obese individuals suffer from social stigmatization and discrimination, and severely obese people may experience greater risk of impaired psychosocial and physical functioning. Lower health-related quality of life (HRQOL) has been reported among obese persons seeking intensive treatment for their disease. To aid in the treatment of obesity, meal replacements have been recommended as an effective therapeutic strategy for weight loss, particularly when consumed in the beginning of an intervention. Hence, the objective of this study was to assess the impact of two 12-month weight reduction interventions (one arm including a meal replacement) on changes in HRQOL among obese females.
  
  
  METHODS
  This controlled trial compared two versions of a standardized 12-month weight reduction intervention: the weight-reduction lifestyle program without a meal replacement (LS) versus the same lifestyle program with the addition of a soy-based meal replacement product (LSMR). 380 women (LS: n = 190, LSMR: n = 190) were matched by age, gender, and weight (51.4 ± 7.0 yrs., 35.5 ± 3.03 kg/m2). This sample of women all completed the 12-month lifestyle intervention that was part of a larger study. The lifestyle intervention included instruction on exercise/sport, psychology, nutrition, and medicine in 18 theoretical and 40 practical units. Led by a sport physiologist, participants engaged in group-based exercise sessions once or twice a week. To evaluate HRQOL, all participants completed the SF-36 questionnaire pre- and post-intervention. Anthropometric, clinical, physical performance (ergometric stress tests), and self-reported leisure time physical activity (hours/day) data were collected.
  
  
  RESULTS
  The LSMR sample showed lower baseline HRQOL scores compared to the LS sample in six of eight HRQOL dimensions, most significant in vitality and health perception (p < 0.01). After the intervention, body weight was reduced in both lifestyle intervention groups (LS: -6.6±6.6 vs. LSMR -7.6±7.9 kg), however, weight loss and HRQOL improvements were more pronounced in the LSMR sample (LSMR: seven of eight, LS: four of eight dimensions).
  
  
  CONCLUSIONS
  Our results show that HRQOL may improve among middle-aged obese females during a standardized lifestyle weight reduction program and may be enhanced by consuming a soy-based meal replacement product.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT00356785.
authors.forename: Sadaf
authors.initials: S
authors.lastname: Koohkan
authors.forename: Denise
authors.initials: D
authors.lastname: Schaffner
authors.forename: Brandy J
authors.initials: BJ
authors.lastname: Milliron
authors.forename: Ingrid
authors.initials: I
authors.lastname: Frey
authors.forename: Daniel
authors.initials: D
authors.lastname: König
authors.forename: Peter
authors.initials: P
authors.lastname: Deibert
authors.forename: Mara
authors.initials: M
authors.lastname: Vitolins
authors.affiliation: Department of Nutrition, Institut für Sport und Sportwissenschaft der Universität Freiburg, Schwarzwaldstrasse 175, Freiburg D-79117, Germany. aloys.berg@klinikum.uni-freiburg.de.
authors.forename: Aloys
authors.initials: A
authors.lastname: Berg
mesh_terms: D000328:Adult; D004032:Diet; D015444:Exercise; D005260:Female; D006304:Health Status; D006801:Humans; D062407:Meals; D008875:Middle Aged; D009765:Obesity / Q000628:therapy*; D010353:Patient Education as Topic; D011788:Quality of Life; D013025:Glycine max; D011795:Surveys and Questionnaires; D015431:Weight Loss; D061217:Weight Reduction Programs / Q000379:methods*