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Weight loss and dropout during a commercial weight-loss program including a very-low-calorie diet, a low-calorie diet, or restricted normal food: observational cohort study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.ORCID iD: 0000-0003-2247-8454
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2012 (English)In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 96, no 5, 953-961 p.Article in journal (Refereed) Published
Abstract [en]

Background: The effectiveness of commercial weight-loss programs consisting of very-low-calorie diets (VLCDs) and low-calorie diets (LCDs) is unclear. Objective: The aim of the study was to quantify weight loss and dropout during a commercial weight-loss program in Sweden (Itrim; cost: $1300/(sic)1000; all participants paid their own fee). Design: This observational cohort study linked commercial weight-loss data with National Health Care Registers. Weight loss was induced with a 500-kcal liquid-formula VLCD [n = 3773; BMI (in kg/m(2)): 34 +/- 5 (mean +/- SD); 80% women; 45 +/- 12 y of age (mean +/- SD)], a 1200-1500-kcal formula and food-combination LCD (n = 4588; BMI: 30 +/- 4; 86% women; 50 +/- 11 y of age), and a 1500-1800-kcal/d restricted normal-food diet (n = 676; BMI: 29 +/- 5; 81% women; 51 +/- 12 y of age). Maintenance strategies included exercise and a calorie-restricted diet. Weight loss was analyzed by using an intention-to-treat analysis (baseline substitution). Results: After 1 y, mean (+/- SD) weight changes were -11.4 +/- 9.1 kg with the VLCD (18% dropout), -6.8 +/- 6.4 kg with the LCD (23% dropout), and -5.1 +/- 5.9 kg with the restricted normal-food diet (26% dropout). In an adjusted analysis, the VLCD group lost 2.8 kg (95% CI: 2.5, 3.2) and 3.8 kg (95% CI: 3.2, 4.5) more than did the LCD and restricted normal-food groups, respectively. A high baseline HMI and rapid initial weight loss were both independently associated with greater 1-y weight loss (P < 0.001). Younger age and low initial weight loss predicted an increased dropout rate (P < 0.001). Treatment of depression (OR: 1.4; 95% CI: 1.1, 1.9) and psychosis (OR: 2.6; 95% CI: 1.1, 6.3) were associated with an increased dropout rate in the VLCD group. Conclusion: A commercial weight-loss program, particularly one using a VLCD, was effective at reducing body weight in self-selected, self-paying adults.

Place, publisher, year, edition, pages
2012. Vol. 96, no 5, 953-961 p.
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Medical and Health Sciences
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URN: urn:nbn:se:uu:diva-185474DOI: 10.3945/ajcn.112.038265ISI: 000312949600003OAI: oai:DiVA.org:uu-185474DiVA: diva2:572295
Available from: 2012-11-27 Created: 2012-11-26 Last updated: 2017-12-07Bibliographically approved

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Sundström, Johan

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