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  • Title: Comparison of behavior therapy with and without very-low-energy diet in the treatment of morbid obesity. A 5-year outcome.
    Author: Pekkarinen T, Mustajoki P.
    Journal: Arch Intern Med; 1997 Jul 28; 157(14):1581-5. PubMed ID: 9236560.
    Abstract:
    BACKGROUND: Very-low-energy diets (VLEDs) together with behavior therapy (BT) are widely used in the treatment of morbid obesity, but there is no evidence of their long-term effectiveness as compared with behavior therapy alone. METHODS: Fifty-nine morbidly obese patients (25 men and 34 women; mean weight, 132.8 +/- 20.7 kg; mean age, 43.1 +/- 9.2 years) were treated with combined therapy of VLED and BT or BT alone. No maintenance program was used. Eighty-seven percent of eligible patients were contacted 4.8 to 6.2 years after the program. RESULTS: During treatment, 56% of patients dropped out of the VLED + BT group and 28% from the BT group (P = .03). High scores on the Symptom Checklist-90R before treatment predicted dropout from the VLED+BT group, but not from BT. At the end of therapy, mean weight change was -22.9 kg in the VLED+BT group and -8.9 kg in the BT group (P < .001). The overall weight change from pretreatment to the 5-year follow-up was greater in the VLED+BT group than in the BT group (-16.9 kg vs -4.9 kg, respectively; P = .03). Men succeeded better in the VLED+BT group than in BT. Among the dropouts, the mean weight change from baseline was +5.2 kg in the VLED+BT group and +13.0 kg in the BT group. CONCLUSIONS: Our data suggest that in the treatment of morbid obesity, VLED combined with BT may produce a better 5-year maintenance than BT alone, especially among men. A satisfactory weight loss can be achieved without a maintenance program.
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