LeCheminant James D, Jacobsen Dennis J, Hall Matthew A, Donnelly Joseph E
Center for Physical Activity and Weight Management, The University of Kansas, Lawrence, Kansas 66045, USA.
J Am Coll Nutr. 2005 Oct;24(5):347-53. doi: 10.1080/07315724.2005.10719484.
To compare the use of meal replacements or medication during weight maintenance subsequent to weight loss using a very low-energy diet (VLED) in overweight or obese adults.
Participants followed a liquid VLED of 2177 kJ for 12 weeks followed by 4 weeks of re-orientation to solid foods. Participants were randomized at week 16 to receive either meal replacements or Orlistat both combined with a structured meal plan containing an energy value calculated to maintain weight loss.
Sixty-four women (age = 49.9 +/- 10 y, weight = 101.6 +/- 17.1 kg, height = 164.9 +/- 6.0 cm, BMI = 36.7 +/- 5.4 kg/m(2)) and 28 men (age = 53.7 +/- 9.6 y, weight = 121.8 +/- 16.0 kg, height = 178.7 +/- 5.6 cm, BMI = 37.8 +/- 4.9 kg/m(2)) completed a 1 year weight management program. Behavioral weight management clinics included topics on lifestyle, physical activity (PA), and nutrition. Participants met for 90 min weekly for 26 weeks, and then biweekly for the remaining 26 weeks.
Minutes of PA, fruits and vegetables (FV), and pedometer steps were recorded on a daily basis and reported at each group meeting. Body weight was obtained at each group meeting.
During VLED, the MR group decreased body weight by 22.8 +/- 6.1 kg and the Orlistat group decreased body weight by 22.3 +/- 6.1 kg. During weight maintenance, there was no significant group by time interaction for body weight, PA, FV consumption, or pedometer steps. At week 16, the meal replacement group had a body weight of 85.4 +/- 14.3 kg that increased to 88.1 +/- 16.5 kg at 52 weeks (p < 0.05). At week 16, the Orlistat group had a body weight of 85.7 +/- 17.9 kg that increased to 88.5 +/- 20.3 kg at 52 weeks (p < 0.05).
Subsequent to weight loss from a VLED, meal replacements and Orlistat treatments were both effective in maintaining weight significantly below baseline levels over a 52 week period of time. Meal replacements may be a viable alternative strategy to medications for weight maintenance.
比较超重或肥胖成年人在采用极低能量饮食（VLED）减肥后进行体重维持期间使用代餐或药物的情况。
参与者先遵循能量为2177千焦的流质VLED饮食12周，随后进行4周的固体食物适应期。在第16周时，参与者被随机分为两组，一组接受代餐，另一组接受奥利司他，两组均结合一份经计算能维持减肥效果的结构化饮食计划。
64名女性（年龄=49.9±10岁，体重=101.6±17.1千克，身高=164.9±6.0厘米，体重指数=36.7±5.4千克/平方米）和28名男性（年龄=53.7±9.6岁，体重=121.8±16.0千克，身高=178.7±5.6厘米，体重指数=37.8±4.9千克/平方米）完成了一项为期1年的体重管理计划。行为体重管理诊所涉及生活方式、身体活动（PA）和营养等主题。参与者每周会面90分钟，共26周，之后每两周会面一次，持续余下的26周。
在VLED期间，代餐组体重下降了22.8±6.1千克，奥利司他组体重下降了22.3±6.1千克。在体重维持期间，体重、PA、水果和蔬菜（FV）摄入量或计步器步数在组间与时间上均无显著交互作用。在第16周时，代餐组体重为85.4±14.3千克，到第52周时增至88.1±16.5千克（p<0.05）。在第16周时，奥利司他组体重为85.7±17.9千克，到第52周时增至88.5±20.3千克（p<0.05）。
在通过VLED减肥后，代餐和奥利司他治疗在52周的时间内均能有效将体重维持在显著低于基线水平。代餐可能是一种可行的替代药物的体重维持策略。
