Long-term follow-up of patients attending a combination very-low calorie diet and behaviour therapy weight loss programme.

We examined the effects of treatment with a very-low calorie diet (VLCD) combined with behaviour modification on weight loss and long-term maintenance of weight loss in 118 of 199 patients who completed eight weeks of VLCD. Those who began therapy in 1984 were surveyed by telephone an average of 3.3 years after ending the VLCD. Questionnaire data included reported weight, exercise, eating, work and sleep habits, emotional factors, and current use of behavioural techniques taught in the programme. Results showed that mean maximum weight loss during the time they attended the programme (average 51.6 weeks) was 31.3 kg, corresponding to a decrease in body mass index of 10.7 kg/m2. At follow-up a regain of 60.9% was reported yielding a net overall weight loss of 13.6 kg and decrease in body mass index of 4.4 kg/m2. Seventy-five per cent of subjects showed only a 37.5% regain of the weight they had lost. Those whose weight loss was better maintained at the time of follow-up reported exercising more, eating fewer high fat foods, and using more of the behavioural techniques taught in the programme. This study provides support for the conclusion that some patients treated with VLCD and behaviour modification can maintain significant weight losses over a relatively long period of time and that specific behaviours relate to this success.