Abstract
BACKGROUND: Low-income patients are disproportionately affected by obesity. Routine care is available to this population at the Venice Family Clinic (VFC) in Los Angeles. The current study examined the effectiveness of nutrition clinic utilizing meal replacements (Slim-Fast, Slim-Fast Foods Co., FL, USA) in low-income patients over a 6-month period compared with the routine care by their primary care physician (PMD) prior to enrolling in the nutrition clinic at similar time intervals
METHODS: In total, 63 patients (51 F; 49±0.8 yo) who had been followed at the VFC by their PMD for at least 6 months were enrolled in this study. Patients had a body mass index (BMI) of 40±1.1 kg/m2, were 72% Hispanic, 25% Caucasian, and 3% African American. They had the following co-morbidities: hypertension (HTN) 45%, diabetes mellitus II (DM II) 50%, gastroesophageal reflux disease (GERD) 34%, osteoarthritis 51%, and hypercholesterolemia 48%. All patients were provided with meal replacements to be taken twice a day and were instructed to consume one complete low calorie meal per day. Weights at the first visit to the nutrition clinic, 1, 3, and 6 months after enrollment in nutrition clinic were compared to their weights at the same time intervals during routine visits to their PMD prior to enrollment in the nutrition clinic.
RESULTS: There was no significant weight change during the 6 months prior to enrollment in the nutrition program despite receiving care by a PMD. At 6 months after participating in the nutrition program, there was a mean decrease of 7% body weight with a reduction in BMI from 40–37 kg/m2 (P≤0.05).
CONCLUSION: Implementation of nutrition clinic utilizing meal replacements in this low-income patient population was effective in achieving a significant reduction in weight over 6 months of treatment.
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References
National Heart, Lung, Blood Institute. Clinical guidelines on the identification, evaluation and treatment of overweight and obesity in adults: the evidence report. National Heart, Lung and Blood Institute: Washington, DC; 1998.
National Center for Health Statistics, Center for Disease Control. National Health and Nutrition Examination Survey. NHANES 1999–2000 2000.
Mokdad AH, Ford ES, Bowman BA, Dietz WH, Vinicor F, Bales VS, Marks JS . Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA 2003; 289: 76–79.
Drewnowski A, Specter SE . Poverty and obesity: the role of energy density and energy costs. Am J Clin Nutr 2004; 79: 6–16.
Heber D, Ashley JM, Wang HJ, Elashoff RM . Clinical evaluation of a minimal intervention meal replacement regimen for weight reduction. J Am Coll Nutr 1994; 13: 608–614.
Heymsfield SB, van Mierlo CA, van der Knaap HC, Heo M, Frier HI . Weight management using a meal replacement strategy: meta and pooling analysis from six studies. Int J Obes Relat Metab Disord 2003; 27: 537–549.
Quinn RD . Five-year self-management of weight using meal replacements: comparison with matched controls in rural Wisconsin. Nutrition 2000; 16: 344–348.
Rothacker DQ, Staniszewski BA, Ellis PK . Liquid meal replacement vs traditional food: a potential model for women who cannot maintain eating habit change. J Am Diet Assoc 2001; 101: 345–347.
Yip I, Go VL, DeShields S, Saltsman P, Bellman M, Thames G, Murray S, Wang HJ, Elashoff R, Heber D . Liquid meal replacements and glycemic control in obese type 2 diabetes patients. Obes Res 2001; 9 (Suppl 4): 341S–347S.
Bowerman S, Bellman M, Saltsman P, Garvey D, Pimstone K, Skootsky S, Wang HJ, Elashoff R, Heber D . Implementation of a primary care physician network obesity management program. Obes Res 2001; 9 (Suppl 4): 321S–325S.
Huerta S, Heber D, Sawicki MP, Liu CD, Arthur D, Alexander P, Yip I, Li ZP, Livingston EH . Reduced length of stay by implementation of a clinical pathway for bariatric surgery in an academic health care center. Am Surg 2001; 67: 1128–1135.
Huerta S, Li ZP, Bowerman S, Heber D . Office-based obesity management program in an indigent population. Proc UCLA Health Care 2002; 6: 36–39.
Huang J, Marin E, Yu H, Carden D, Arnold C, Davis T, Banks D . Prevalence of overweight, obesity, and associated diseases among outpatients in a public hospital. South Med J 2003; 96: 558–562.
Raghuwanshi M, Kirschner M, Xenachis C, Ediale K, Amir J . Treatment of morbid obesity in inner-city women. Obes Res 2001; 9: 342–347.
Van Itallie TB . ‘Morbid’ obesity: a hazardous disorder that resists conservative treatment. Am J Clin Nutr 1980; 33: 358–363.
Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM . Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002; 346: 393–403.
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Huerta, S., Li, Z., Li, H. et al. Feasibility of a partial meal replacement plan for weight loss in low-income patients. Int J Obes 28, 1575–1579 (2004). https://doi.org/10.1038/sj.ijo.0802792
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DOI: https://doi.org/10.1038/sj.ijo.0802792