THE EFFECT OF A HYPOCALORIC DIET ON THE SHORT AND LONG-TERM CONTROL OF MORBID-OBESITY

BACKGROUND: The ponderal evolution and biochemical parameters during t he in patient administration of a highly hypocaloric and high protein diet (VLCD) were evaluated. The efficacy at medium term of this treatm ent was determined and the possible determining factors of the pondera l evolution were analysed. METHODS: A VLCD was administered to 20 wome n with morbid obesity during 21 days. The modifications of the biochem ical parameters were determined during admission. The ponderal evoluti on was studied during hospitalization and during 9 months of out patie nt follow up. The prognostic factors of ponderal evolution analyzed we re: age, attempts to lose weight, familiar history of obesity, maximum weight attained, weight and index of body mass (IBM) at study initiat ion and admission, loss of weight during admission and the number of o ut patient controls. RESULTs: During hospitalization, a mean loss of 7 .0-1.9 kg, a significant decrease in glycemia, cholesterol, triglyceri des, lymphocytes and blood pressure were observed. It was found that p onderal loss at 3 and 6 months may be predicted by IBM upon initiation of the study. At 9 months weight was lower than at initiation of hosp italization but not than at discharge (p < 0.001). Weight upon initiat ion of the study and the maximum reached explain the weight at 9 month s in 82.5 % of the cases. CONCLUSIONS: Highly hypocaloric and high pro tein diets lead to a significant weight loss which is maintained at me dium term and an improvement in the factors of cardiovascular risk are observed. Of the factors evaluated, only the grade of obesity signifi cantly influences ponderal evolution.