WEIGHT MAINTENANCE AFTER A VERY-LOW-CALORIE DIET (VLCD) WEIGHT-REDUCTION PERIOD AND THE EFFECTS OF VLCD SUPPLEMENTATION - A PROSPECTIVE, RANDOMIZED, COMPARATIVE, CONTROLLED LONG-TERM TRIAL

Objectives, To evaluate the efficacy of a structured very low calorie diet (VLCD) weight reduction/weight maintenance behaviour programme on weight maintenance in obese patients (BMI greater than or equal to 30 kg/m(2)). Design, Prospective, randomized, controlled intervention tr ial. Setting, University out-patient obesity clinic. Subjects. A total of 114 obese patients from the waiting list were invited to participa te in the structured weight reduction/weight maintenance programme las ting for 64 weeks, Sixty patients agreed to participate. Intervention, All 60 patients were placed on a Cambridge 330 kcal day(-1) diet duri ng the first 12 weeks, Fifty-two were subsequently randomized to eithe r a well balanced hypocaloric diet(1600 kcal day(-1)), of which 220 kc al were provided by two sachets of Cambridge diet (group 1), or the sa me energy provided by the same principal diet (group 2) during the fol lowing 52-week weight maintenance period. Main outcome measures, Durin g the VLCD period, the mean body weight decreased significantly from 1 12.4 +/- 19.8 to 91.6 +/- 17.7 kg (P < 0.0001), Seventy-one per cent o f the weight loss was fat. During the weight maintenance period the av erage body weight increased significantly in group 1: 8.0 +/- 8.2 vs, 12.3 +/- 9.7 kg in group 2 (P < 0.0001). After the 64-week treatment p eriod the mean body weight in group 1 was 93.7 +/- 18.1 kg and signifi cantly lower compared to 109.9 +/- 23.8 kg in group 2 (P = 0.008), Com pliance was high: 87% completed the VLCD period and 75% completed the whole 64-week treatment programme. Conclusion, Very low calorie diet a s part of the dietary allowance during the weight maintenance programm e partly prevents weight regain. This finding can be translated into p ractical treatment recommendations.