Original Article

International Journal of Obesity (2007) 31, 488–493. doi:10.1038/sj.ijo.0803423; published online 4 July 2006

Weight loss and long-term follow-up of severely obese individuals treated with an intense behavioral program

J W Anderson1, L Grant2, L Gotthelf2 and L T P Stifler2

  1. 1Department of Internal Medicine, College of Medicine, University of Kentucky and Health Management Resources Weight Management Program at the University of Kentucky, Lexington, KY, USA
  2. 2Health Management Resources, Boston, MA, USA

Correspondence: Dr JW Anderson, Department of Internal Medicine, College of Medicine, University of Kentucky Medical Center, and Health Management Resources Weight Management Program at the University of Kentucky, Room 524, Lexington, KY 40536-0298, USA. E-mail: janders@uky.edu

Received 2 October 2005; Revised 1 May 2006; Accepted 14 May 2006; Published online 4 July 2006.

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Abstract

Objective:

 

To review weight loss and maintenance for severely obese individuals enrolled in intensive behavioral weight loss program using very-low or low-energy diets.

Design:

 

Chart review of consecutively treated patients between 1995 and 2002 seen at three weight loss centers.

Subjects:

 

One thousand five hundred and thirty one patients with severe obesity (greater than or equal to40 kg/m2) treated in three cities ('Study Group'). Of these, 1100 completed the 12-week core curriculum ('Completer Group'). Weight loss greater than or equal to100 lbs (>45 kg) was seen in 268 patients ('100-Pound Group').

Measurements:

 

Charts were reviewed for baseline characteristics, weekly weights, follow-up weights and side effects.

Results:

 

In the Study Group, average weight lossplusminuss.e. for 998 women was 23.9plusminus0.6 kg (18.5% of initial body weight (IBW)) and for 533 men was 36.0plusminus1.0 kg (22.5%) over 30 weeks. For Completers, average weight loss for women was 30.8plusminus0.6 kg (23.9%) and for men was 42.6plusminus1.1 kg (26.7%) over 39 weeks. In the 100-Pound Group, average weight loss for women was 58.2plusminus1.2 kg (41.5%) in 65 weeks and for men was 65.7plusminus1.5 kg (37.5%) in 51 weeks. Side effects, assessed in 100 patients losing >45 kg, were mild to moderate in severity. Severe adverse events unrelated to the diet were noted in 5% of patients and during weight loss 1% had elective cholecystectomies. Follow-up weights were available for 86% of Completers at an average of 72 weeks with average maintenance of 23 kg or 59% of weight loss; follow-up weights were available for 94% of the 100-Pound Group at an average of 95 weeks with average maintenance of 41 kg or 65% of weight loss maintained.

Conclusions:

 

Intensive behavioral treatment with meal replacements is a safe and effective weight-loss strategy for selected severely obese individuals.

Keywords:

intensive treatment, weight loss, weight maintenance, meal replacements

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