COMPARISON OF BEHAVIOR-THERAPY WITH AND WITHOUT VERY-LOW-ENERGY DIET IN THE TREATMENT OF MORBID-OBESITY - A 5-YEAR OUTCOME

Background: Very-low-energy diets (VLEDs) together with behavior thera py (BT) are widely used in the treatment of morbid obesity, but there is no evidence of their long-term effectiveness as compared with behav ior therapy alone. Methods: Fifty-nine morbidly obese patients (25 men and 34 women; mean weight, 132.8+/-20.7 kg; mean age, 43.1+/-9.2 year s) were treated with combined therapy of VLED and BT or BT alone. No m aintenance program was used. Eighty-seven percent of eligible patients were contacted 4.8 to 6.2 years after the program.Results: During tre atment, 56% of patients dropped out of the VLED+BT group and 28% from the BT group (P=.03). High scores on the Symptom Checklist-90R before treatment predicted dropout from the VLED+BT group, but not from BT. A t the end of therapy, mean weight change was -22.9 kg in the VLED+BT g roup and -8.9 kg in the BT group (P<.001). The overall weight change f rom pretreatment to the 5-year follow-up was greater in the VLED+BT gr oup than in the BT group (-16.9 kg vs -4.9 kg, respectively; P=.03). M en succeeded better in the VLED+BT group than in BT. Among the dropout s, the mean weight change from baseline was +5.2 kg in the VLED+BT gro up and +13.0 kg in the BT group. Conclusions: Our data suggest that in the treatment of morbid obesity, VLED combined with BT may produce a better 5-year maintenance than BT alone, especially among men. A satis factory weight loss can be achieved without a maintenance program.