title: Efficacy of water preloading before main meals as a strategy for weight loss in primary care patients with obesity: RCT.
abstract: OBJECTIVE
  To investigate the efficacy of water preloading before meals as a weight loss strategy for adults with obesity.
  
  
  METHODS
  A two-group randomized controlled trial was conducted in Birmingham, England. Eighty-four adults with obesity were recruited from general practices. All participants were given a face-to-face weight management consultation at baseline (30 min) and a follow-up telephone consultation at 2 weeks (10 min). At baseline, participants were randomized to either drinking 500 ml of water 30 min before their main meals or an attention control group where participants were asked to imagine their stomach was full before meals. The primary outcome was weight change at 12-week follow-up. Several measures of adherence were also used, including 24 h total urine collections.
  
  
  RESULTS
  41 participants were randomized to the intervention group and 43 to the comparator group. The water preloading group lost -1.3 kg (95% CI -2.4 to -0.1, P = 0.028) more than comparators at follow up. Adjusting for ethnicity, deprivation, age, and gender resulted in the intervention group losing -1.2 kg (95% CI -2.4 to 0.07, P = 0.063) more than the comparator.
  
  
  CONCLUSIONS
  There is preliminary evidence that water preloading before main meals leads to a moderate weight loss at follow up. ISRCTN33238158.
authors.affiliation: Primary Care Clinical Sciences, University of Birmingham, UK.
authors.forename: Helen M
authors.initials: HM
authors.lastname: Parretti
authors.affiliation: Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, University of Oxford, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Aveyard
authors.affiliation: School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Blannin
authors.affiliation: Primary Care Clinical Sciences, University of Birmingham, UK.
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Clifford
authors.affiliation: School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK.
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Coleman
authors.affiliation: Primary Care Clinical Sciences, University of Birmingham, UK.
authors.forename: Andrea
authors.initials: A
authors.lastname: Roalfe
authors.affiliation: Primary Care Clinical Sciences, University of Birmingham, UK.
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Daley
mesh_terms: D000328:Adult; D000368:Aged; D001069:Appetite Regulation / Q000502:physiology*; D004326:Drinking / Q000502:physiology*; D004739:England; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D062407:Meals; D008875:Middle Aged; D009765:Obesity / Q000517:prevention & control / Q000628:therapy*; D016896:Treatment Outcome; D014867:Water; D015431:Weight Loss
chemical_list: D014867:Water