Objective: To investigate changes in weight, Three Factor Eating Questionnaire and Binge eating scores during a two-year period from the start of a VLCD (Nutrilett) and behavioural modification therapy for obesity.
Design: Prospective study of a 17-weeks weight loss programme with one- and two-year follow-up visits.
Subjects: 62 healthy, overweight subjects without previous eating disorders. The mean (+/- SD) age 41 +/- 8 years and BMI 36.4 +/- 2.6 kg/m2.
Main outcome measures: Weight loss, Binge eating scale, Bulimic Investigatory Test and Three Factor Eating Questionnaire before and after therapy and at 1 and 2 year control visits.
Results: The mean weight loss (+/- SD) at the end of the treatment was 14.9 +/- 4.6 kg (n = 59) and at the two-year control 5.8 +/- 7.6 kg (n = 57). After two years 20 (32%) patients had a weight loss of more than 10% (good result), 24 patients a weight loss of 0-10% of their initial weight (partial result) and 13 patients weighed more than before therapy (poor result). The mean binge eating, disinhibition and hunger scores decreased in all patients by the end of the therapy. At the end of two years these improvements in the scores were maintained in patients with a good result but the scores returned to the pretreatment levels in the patients with partial or poor result. The mean restraint scores increased in all patients after treatment and were maintained in those with a good or partial result.
Conclusions: VLCD combined with behaviour modification is a useful mode of therapy for obesity with low drop-out rate and majority (71%) of patients below pretreatment weight at the two-year control. One third of the patients succeeded to maintain positive changes in the scores measuring eating behaviour which was associated with sustained weight loss.