Table 2: Periodic health examination, 1999 update: 1. Detection, prevention and treatment of obesity [CMAJ

Periodic health examination, 1999 update:
1. Detection, prevention and treatment of obesity

Table 2: Studies of the effectiveness of dietary therapy for obesity

Study No. of patients (no. of women) Length of follow-up Patients lost to follow-up Intervention groups Mean baseline BMI or weight Mean weight loss/gain at follow-up, kg Comments

Randomized controlled trials

Hakala et al⁵¹ 60 (40) 5 yr 7 A: LCD + group counselling
B: LCD + individual counselling BMI 41.7–43.6 A: –2.1 to –3.0
B: –3.4 to –12.9 A: Regain: 86% of weight loss among women, 80% among men
B: Regain: 71% of weight loss among women, 50% among men

Miura et al⁵² 70 (46) 2 yr 0 A: VLCD
B: VLCD + BT
C: BT Weight 37%–65% above ideal A: –4.5
B: –1.3
C: No change –

Wadden et al⁵³ 76 (76) 5 yr 21 A: VLCD
B: VLCD + BT
C: BT BMI 39.4 A: +1.0
B: +2.7
C: +2.9 64% regained all weight loss, 18% maintained loss of 0.1–5.0 kg, 18% maintained loss of > 5 kg

Karvetti et al⁵⁴ 189 (147) 7 yr 110 A: LCD
B: LCD + counselling A: BMI 33.5
B: BMI 34.3 A: NA
B: –3.5 women; –8.7 men –

Skender et al⁵⁵ 127 (61) 2 yr 66 A: LCD
B: Exercise
C: LCD + Exercise A: 98.5 kg
B: 93.1 kg
C: 100.1 kg A: +0.9
B: –2.7
C: –2.2 –

Torgerson et al⁵⁶ 113 (74) 2 yr 26 A: VLCD + counselling
B: Counselling A: 116.2 kg
B: 116.6 kg A: –9.2
B: –6.3 A: 45% of women, 75% of men had weight loss > 5 kg
B: 50% of women, 40% of men had weight loss > 5 kg

Ryttig et al⁵⁷ 81 (44) 26 mo 39 A: VLCD + BT
B: VLCD + LCD
C: VLCD + VLCD A: 116.2 kg
B: 113.2 kg
C: 113.2 kg A: –5.5
B: –5.9
C: –5.7 –

King et al⁵⁸ 103 (0) 2 yr 30 A: LCD + counselling
B: LCD
C: Exercise + counselling
D: Exercise A: 85.7 kg
B: 83.4 kg
C: 91.0 kg
D: 86.2 kg A: –4.4
B: –3.3
C: –3.7
D: –1.6 –

Prospective cohort studies

Pekkarinen et al⁵⁹ 59 (34) 5 yr 8 A: VLCD + BT
B: BT A: 131.2 kg
B: 134.2 kg A: –16.9
B: –4.9 Mean weight gain among patients who did not complete treatment (A: +5.2 kg [n = 12],
B: +13.0 kg [n = 3])

Pekkarinen et al⁶⁰ 62 (57) 2 yr 5 VLCD 99.0 kg –5.8 19 patients did not regain weight, 24 regained 70% of lost weight, and 13 regained 100% of lost weight

Nunn et al⁶¹ 60 (44) 2.5 yr 3 VLCD + BT 104.3 kg –13.1 –

Anderson et al⁶² 80 (55) 2 yr 34 VLCD + BT + counselling BMI > 40 NA Mean regain 52% of lost weight

Anderson et al⁶³ 100 (71) 42 mo 42 VLCD + BT + counselling Women 93.7 kg;
Men 115.7 kg Women –7.3; men –7.2 Mean regain 61% of lost weight among women and 64% among men

Bjorvell et al⁶⁴ 68 (53) 10–12 yr 12 VLCD + BT + counselling + exercise BMI 41.0 –10.6 –

Note: LCD = low-calorie diet, VLCD = very-low-calorie diet, BT = behavioural therapy.

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