Long-term effects of a very low calorie diet (Nutrilett^®) in obesity treatment. A prospective, randomized, comparison between VLCD and a hypocaloric diet+behavior modification and their combination

Abstract

OBJECTIVES. To compare weight loss on a balanced hypocaloric diet to that of a Very Low Calorie Diet (VLCD) after two months of treatment and to further compare 26 months of weight maintenance and safety with or without VLCD assistance in obese patients. DESIGN. Prospective, randomized, controlled intervention trial, initially with two and later with three parallel groups. SETTING. Swedish University out-patient obesity clinic. SUBJECTS. Eighty-one obese patients of both gender with a BMI≥30 kg/m² from the waiting list participated in a structured weight reduction+weight maintenance programme. INTERVENTION. Twenty-seven patients (group A) were randomized to a balanced diet of 6720 kJ/d (1600 kcal/d) during the whole treatment period. The other patients (n=54) were randomized to VLCD (Nutrilett^®) 1764 kJ/d (420 kcal/d) diet during the first two months. The VLCD treated patients were rerandomized after the initial treatment to the well balanced hypocaloric diet (6720 kJ/d) with (group C) or without (group B) 1 MJ of VLCD to be taken during the evening. MAIN OUTCOME MEASURES. During the first two-month period, the mean body weight loss in the VLCD group was 18.9±7.1 kg compared to 7.2±4.8 kg in the diet treated group, with a similar relative fat loss assessed by bioimpedance of 68% and 76% respectively. The maintained weight loss in all groups after 28 months of treatment was 10.9±10.2 kg in the 52% who completed the programme. Weight losses and drop-out rates were similar in all three groups. CONCLUSIONS. Twenty-four months weight maintenance and drop out rates are independent of whether the initial treatment commences with VLCD or a hypocaloric diet. One MJ nutrition powder taken freely does not affect 24 months weight maintenance on a hypocaloric (6.7 MJ/d) diet.