J K. Winkler et al, Germany and Switzerland
Obesity Facts (2013) 6, 469-480
The purpose of the study was to compare the effects of a one-year weight-loss programme in patients with type II obesity and significant/severe obesity type II (BMI <40) and extreme obesity type III (BMI>40), with regard to weight loss and improvement of cardiovascular risk factors.
311 patients with obesity (BMI > 30 kg/m2) between the ages of 20 and 65 with an average BMI of 41.8 kg/m2.
The weight-loss programme (Optifast52) was initiated with a weight-loss phase of 12 weeks (Low Calorie Diet 800 kcal, LCD), followed by an escalation phase and a weight-stabilisation phase, for 40 weeks.
Body weight, glucose and blood fats were monitored during the course of the study.
70% completed the study. After one year, weight loss was 17.9%, which gives a BMI of 34.3 kg/m2. The weight loss during 12 weeks of LCD was 15.6%. During the following weight-stabilisation phase, weight loss continued by a further 2.2%.
Men experienced a greater weight loss (-17.4%) than women (-14.7%).
There was no difference in weight loss when comparing the two BMI groups. However, during the maintenance phase, those with extreme obesity lost more weight in comparison with the group with obesity and serious obesity (-3.1 ±0.7% vs -1.2 ± 0.6%; p=0.04). Improvements in blood fats and glucose metabolism could be seen in all BMI groups.
This study is the first to clearly show that even patients with extreme obesity can have results from non-surgical weight-loss methods. This is an important finding, since low-calorie diets are more accepted and make for a much less intensive procedure than obesity surgery. Lasting results of such a weight-loss programme still present a challenge. Follow-up and counselling for several years after the weight-loss programme may conceivably improve the results in the long term, particularly in patients with extreme obesity.
A one-year weight-loss intervention improves body weight, as well as blood fats and glucose metabolism, in individuals with obesity and serious obesity and in individuals with extreme obesity.