Raghuwanshi M, Kirschner M, Xenachis C, Ediale K, Amir J
Division of Endocrinology, New Jersey Medical School, Newark, New Jersey 07103, USA.
Obes Res. 2001 Jun;9(6):342-7. doi: 10.1038/oby.2001.44.
To explore the use of the very-low-calorie formula diet (VLCD) in the indigent population of Newark, NJ, with the goal of achieving 10% weight loss within a relatively short period of 10 weeks.
We accepted 131 morbidly obese indigent women into our study program. The study was limited to women only and the average starting weight was 292.3 +/- 5.9 lbs (+/- SE; 50.3 +/- 0.9 body mass index [kg/m(2)]). We used three treatment paradigms: total cost-free program for 10 weeks; cost-free, but compliance requirements; and a weekly charge of $25. The results obtained were compared with two control populations: women enrolled during the same recruitment period in a comparable suburban VLCD program and a historical control population of suburban women treated from 1985 through 1995.
In group A (total cost-free), 79% of patients completed the 10-week program, but only 18% of patients achieved the goal of 10% weight loss. In group B when attendance and weight loss requirements were imposed, the dropout rate accelerated such that only 37% of patients completed the 10-week course, and 16% of the women were successful with their weight loss. In group C, imposing $25/wk financial outlay also accelerated dropouts but had little effect on weight loss success, which was 10% of the starting group. By comparison, the suburban patients and the historical control group exhibited 67% and 76% attendance rates after 10 weeks, and 33% and 55% success rates, respectively, in achieving the weight loss goal.
We conclude that inner-city patients exhibit great interest in weight loss when financial barriers are removed. Successful weight loss was achieved in 10% to 18% of patients using the VLCD approach, approximately one-half of that obtained in affluent suburban women. Imposing financial or compliance restrictions to the inner-city patients served only to enhance dropouts.
探索极低热量配方饮食（VLCD）在新泽西州纽瓦克市贫困人群中的应用，目标是在相对较短的10周内实现体重减轻10%。
我们将131名病态肥胖的贫困女性纳入研究项目。该研究仅限于女性，平均起始体重为292.3±5.9磅（±标准误；体重指数[kg/m²]为50.3±0.9）。我们采用了三种治疗模式：为期10周的完全免费项目；免费但有依从性要求；以及每周收费25美元。将所得结果与两个对照组进行比较：在同一招募期参加类似郊区VLCD项目的女性，以及1985年至1995年接受治疗的郊区女性历史对照组。
A组（完全免费）中，79%的患者完成了10周项目，但只有18%的患者实现了体重减轻10%的目标。B组施加出勤和体重减轻要求后，辍学率加快，只有37%的患者完成了10周疗程，16%的女性成功减重。C组每周收取25美元费用也加速了辍学，但对减重成功率影响不大，成功率为起始组的10%。相比之下，郊区患者和历史对照组在10周后的出勤率分别为67%和76%，实现减重目标的成功率分别为33%和55%。
我们得出结论，当消除经济障碍时，市中心患者对减重表现出极大兴趣。使用VLCD方法，10%至18%的患者成功减重，约为富裕郊区女性的一半。对市中心患者施加经济或依从性限制只会增加辍学率。
