Abstract
Background/objectives:
Weight loss in obesity can reduce morbidity and mortality and benefits persist as long as weight loss is maintained. Weight maintenance is difficult in the long term and new strategies need to be developed to achieve this goal. We aimed to evaluate the efficacy of substituting a low-calorie diet formula for a meal in a weight loss program during the maintenance phase.
Methods:
Randomized paralleled clinical trial including 62 adult patients with at least a 5% weight loss with diet alone for 6 months, randomized to two groups: daily replacement of one meal with a low-calorie diet formula, or dieting alone for another 6 months (weight maintenance phase).
Results:
Weight maintenance or further weight loss occurred in 83.9% of patients in the intervention group, whereas only in 58.1% in the control group (P=0.025). As a whole, patients in the intervention group lost a further 3.2±3.7% of initial weight compared with a 1.3±3.6% in the control group (P=0.030). Body fat mass diminished in both groups, with no differences between them (1.6±3.5 vs 1.0±9.3 kg, respectively, P=0.239), and the same happened with free fat mass (0.9±3.3 vs 0.4±6.7 kg, respectively, P=0.471). A multivariate logistic regression analysis (R2=0.114, P=0.023) retained only the intervention as a predictor of the achievement of weight maintenance with an odds ratio (95% confidence interval) of 3.756 (1.138–12.391).
Conclusions:
Substitution of a low-calorie diet formula for a meal is an effective measure for weight loss maintenance compared with dieting alone.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Rent or buy this article
Prices vary by article type
from$1.95
to$39.95
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Ashley JM, Herzog H, Clodfelter S, Bovee V, Schrage J, Pritsos C (2007). Nutrient adequacy during weight loss interventions: a randomized study in women comparing the dietary intake in a meal replacement group with a traditional food group. Nutr J 6, 12.
Ashley JM, St Jeor ST, Schrage JP, Perumean-Chaney SE, Gilbertson MC, McCall NL et al. (2001). Weight control in the physician's office. Arch Intern Med 161, 1599–1604.
Cheskin LJ, Mitchell AM, Jhaveri AD, Mitola AH, Davis LM, Lewis RA et al. (2008). Efficacy of meal replacements versus a standard food-based diet for weight loss in type 2 diabetes: a controlled clinical trial. Diabetes Educ 34, 118–127.
Dansinger ML, Tatsioni A, Wong JB, Chung M, Balk EM (2007). Meta-analysis: the effect of dietary counseling for weight loss. Ann Intern Med 147, 41–50.
DelParigi A, Chen K, Salbe AD, Hill JO, Wing RR, Reiman EM et al. (2004). Persistence of abnormal neural responses to a meal in postobese individuals. Int J Obes Relat Metab Disord 28, 370–377.
Early JL, Apovian CM, Aronne LJ, Fernstrom MH, Frank A, Greenway FL et al. (2007). Sibutramine plus meal replacement therapy for body weight loss and maintenance in obese patients. Obesity (Silver Spring) 15, 1464–1472.
Elfhag K, Rossner S (2005). Who succeeds in maintaining weight loss? A conceptual review of factors associated with weight loss maintenance and weight regain. Obes Rev 6, 67–85.
FAO food and nutrition technical report series 1. Human energy requirements. Report of a joint FAO/WHO/UNU expert consultation. Rome, 17–24 October 2001.
Flegal KM, Graubard BI, Williamson DF, Gail MH (2005). Excess deaths associated with underweight, overweight, and obesity. JAMA 293, 1861–1867.
Franz MJ, VanWormer JJ, Crain AL, Boucher JL, Histon T, Caplan W et al. (2007). Weight-loss outcomes: a systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up. J Am Diet Assoc 107, 1755–1767.
Gursoy A, Erdogan MF, Cin MO, Cesur M, Baskal N (2006). Comparison of orlistat and sibutramine in an obesity management program: Efficacy, compliance, and weight regain after noncompliance. Eat Weight Disord 11, e127–e132.
Hamman RF, Wing RR, Edelstein SL, Lachin JM, Bray GA, Delahanty L et al. (2006). Effect of weight loss with lifestyle intervention on risk of diabetes. Diabetes Care 29, 2102–2107.
Heymsfield SB, van Mierlo CA, van der Knaap HC, Heo M, Frier HI (2003). Weight management using a meal replacement strategy: meta and pooling analysis from six studies. Int J Obes Relat Metab Disord 27, 537–549.
Hill JO, Hauptman J, Anderson JW, Fujioka K, O’Neil PM, Smith DK et al. (1999). Orlistat, a lipase inhibitor, for weight maintenance after conventional dieting: a 1-y study. Am J Clin Nutr 69, 1108–1116.
Jakicic JM, Marcus BH, Lang W, Janney C (2008). Effect of exercise on 24-month weight loss maintenance in overweight women. Arch Intern Med 168, 1550–1559; discussion 1559–1560.
James WP, Astrup A, Finer N, Hilsted J, Kopelman P, Rossner S et al. (2000). Effect of sibutramine on weight maintenance after weight loss: a randomised trial. STORM Study Group. Sibutramine Trial of Obesity Reduction and Maintenance. Lancet 356, 2119–2125.
Jeffery RW, Drewnowski A, Epstein LH, Stunkard AJ, Wilson GT, Wing RR et al. (2000). Long-term maintenance of weight loss: current status. Health Psychol 19, 5–16.
Jung RT (1997). Obesity as a disease. Br Med Bull 53, 307–321.
Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA et al. (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 346, 393–403.
Konig D, Deibert P, Frey I, Landmann U, Berg A (2008). Effect of meal replacement on metabolic risk factors in overweight and obese subjects. Ann Nutr Metab 52, 74–78.
LeCheminant JD, Jacobsen DJ, Hall MA, Donnelly JE (2005). A comparison of meal replacements and medication in weight maintenance after weight loss. J Am Coll Nutr 24, 347–353.
Neter JE, Stam BE, Kok FJ, Grobbee DE, Geleijnse JM (2003). Influence of weight reduction on blood pressure: a meta-analysis of randomized controlled trials. Hypertension 42, 878–884.
Noakes M, Foster PR, Keogh JB, Clifton PM (2004). Meal replacements are as effective as structured weight-loss diets for treating obesity in adults with features of metabolic syndrome. J Nutr 134, 1894–1899.
Stevens VJ, Obarzanek E, Cook NR, Lee IM, Appel LJ, Smith West D et al. (2001). Long-term weight loss and changes in blood pressure: results of the Trials of Hypertension Prevention, phase II. Ann Intern Med 134, 1–11.
Svetkey LP, Stevens VJ, Brantley PJ, Appel LJ, Hollis JF, Loria CM et al. (2008). Comparison of strategies for sustaining weight loss: the weight loss maintenance randomized controlled trial. JAMA 299, 1139–1148.
Wadden TA, Crerand CE, Brock J (2005). Behavioral treatment of obesity. Psychiatr Clin North Am 28, 151–170, ix.
Wal JS, McBurney MI, Cho S, Dhurandhar NV (2007). Ready-to-eat cereal products as meal replacements for weight loss. Int J Food Sci Nutr 58, 331–340.
Weinsier RL, Nagy TR, Hunter GR, Darnell BE, Hensrud DD, Weiss HL (2000). Do adaptive changes in metabolic rate favor weight regain in weight-reduced individuals? An examination of the set-point theory. Am J Clin Nutr 72, 1088–1094.
Weiss EC, Galuska DA, Kettel Khan L, Gillespie C, Serdula MK (2007). Weight regain in U.S. adults who experienced substantial weight loss, 1999–2002. Am J Prev Med 33, 34–40.
Wing RR, Phelan S (2005). Long-term weight loss maintenance. Am J Clin Nutr 82, 222S–225S.
Wing RR, Tate DF, Gorin AA, Raynor HA, Fava JL (2006). A self-regulation program for maintenance of weight loss. N Engl J Med 355, 1563–1571.
Wood PD, Stefanick ML, Dreon DM, Frey-Hewitt B, Garay SC, Williams PT et al. (1988). Changes in plasma lipids and lipoproteins in overweight men during weight loss through dieting as compared with exercise. N Engl J Med 319, 1173–1179.
Acknowledgements
One of the Researchers, CM was supported by the Fundación para la Investigación Biomédica, Hospital Ramón y Cajal (FIBio-RyC), Madrid, Spain. Nestlé Healthcare Nutrition gave financial support and participated in the design of the study. These institutions had no role in the collection, analysis or interpretation of data, nor in the decision to submit for publication.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Vázquez, C., Montagna, C., Alcaraz, F. et al. Meal replacement with a low-calorie diet formula in weight loss maintenance after weight loss induction with diet alone. Eur J Clin Nutr 63, 1226–1232 (2009). https://doi.org/10.1038/ejcn.2009.48
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/ejcn.2009.48
Keywords
This article is cited by
-
A randomized controlled trial of two diets enriched with protein or fat in patients with type 2 diabetes treated with dapagliflozin
Scientific Reports (2021)
-
Mechanisms of weight regain after weight loss — the role of adipose tissue
Nature Reviews Endocrinology (2019)
-
Study Protocol for the Effects of Formula Diet with Dapagliflozin on Metabolic Improvement and Body Composition in Type 2 Diabetes Mellitus
Diabetes Therapy (2019)
-
Weight Management Using a Meal Replacement Strategy in Type 2 Diabetes
Current Diabetes Reports (2010)