WEIGHT-REDUCTION PROGRAMS AT A REHABILITATION CENTER AND A HEALTH-CENTER BASED ON GROUP-COUNSELING AND INDIVIDUAL SUPPORT - SHORT-TERM AND LONG-TERM FOLLOW-UP-STUDY

The objective of this study was to evaluate the effects of two weight reduction programmes on moderately and severely obese subjects over a period of five years. The subjects were randomly divided into a rehabi litation centre group (RC group) and a health centre group (HC group). Treatment in the RC group consisted of a three-week in-patient weight reduction programme at a rehabilitation centre and in the HC group of a ten-week out-patient weight reduction course at a health centre. Tr eatment in both groups continued for up to 24 months with an individua l follow-up at 1-2-month intervals by a general practitioner (GP) at t he health centre. The subjects were 42 women and 10 men. The mean weig ht of women at the onset of the study was 104 kg and the mean BMI 39.5 kg/m(2) and the respective means of men 121 kg and 40.1 kg/m(2). The mean age of both sexes was 40 years. In the RC group the mean weight l oss at 6, 12 and 24 months was 11.5, 9.1 and 5.9 kg in women, and 19.0 , 18.3 and 11.2 kg in men, respectively. In the HC group the respectiv e values were 5.5, 4.8 and 3.2 kg in women and 12.2, 6.7 and 2.8 kg in men. At the five-year follow-up the mean weight change from baseline was -6.8 kg in the men and +0.3 kg in the women of the RC group. In th e HC group the mean weight returned to baseline level in both sexes. T he drop-out rate was 28% at 24 months and 10% at five years. A conside rable weight loss during the first 6 and 24 months predicted a good re sult at the five-year follow-up. Only a minority (35%) of the Gps of h ealth centres were motivated enough to follow and support the weight r eduction efforts of these obese patients. The in-patient weight reduct ion programme resulted in better short- and long-term weight loss resu lts than the out-patient weight reduction course. To improve the maint enance of weight reduction results follow-up methods should be develop ed further.