Harper Claudia, Maher Judith, Hsu Michelle, Grunseit Anne, Seimon Radhika, Sainsbury Amanda
The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders Faculty of Medicine and Health Charles Perkins Centre The University of Sydney Camperdown New South Wales Australia.
School of Health and Behavioural Sciences University of the Sunshine Coast Sippy Downs Queensland Australia.
Obes Sci Pract. 2023 Jan 5;9(3):305-319. doi: 10.1002/osp4.654. eCollection 2023 Jun.
Very low energy diets (VLEDs) effectively induce substantial weight loss in people with obesity, yet they are rarely used as a first line treatment. There is a belief that such diets do not teach the lifestyle behavior changes needed for long-term weight maintenance. However, little is known about the lived experiences of people who have lost weight on a VLED in the long term.
This study aimed to explore the behaviors and experiences of postmenopausal women who had followed a 4-month VLED (using total meal replacement products [MRPs]), followed by a food-based, moderately energy-restricted diet for an additional 8 months, as part of the TEMPO Diet Trial. Qualitative in-depth semi-structured interviews were conducted with 15 participants at 12 or 24 months (i.e., at 8 or 20 months post diet completion). Transcribed interviews were analyzed thematically using an inductive approach.
Undertaking a VLED was reported by participants to confer advantages in weight maintenance that previous weight loss attempts had not been able to do for them. Firstly, the rapid and significant weight loss, in conjunction with ease of use, was motivational and helped instill confidence in the participants. Secondly, the cessation of a normal diet during the VLED was reported by participants to break weight gain-inducing habits, allowing them to abandon unhelpful habits and to introduce in their place more appropriate attitudes toward weight maintenance. Lastly, the new identity, helpful habits and increased self-efficacy around weight loss supported participants during weight maintenance. Additionally, participants reported that ongoing occasional use of MRPs provided a useful and easy new strategy for countering weight regain and supporting their weight maintenance regimen.
Among the participants in this qualitative study, most of whom had maintained a loss of over 10% of their baseline body weight at the time of interview, using a VLED in the context of a clinical weight loss trial conferred confidence, motivation and skills for weight maintenance. These findings indicate that VLEDs with clinical support could be successfully leveraged to set up behaviors that will support weight maintenance in the long term.
极低能量饮食（VLEDs）能有效促使肥胖人群大幅减重，但很少被用作一线治疗方法。人们认为这类饮食无法教会长期维持体重所需的生活方式行为改变。然而，对于长期通过极低能量饮食减重的人群的实际经历，我们知之甚少。
本研究旨在探索绝经后女性的行为和经历，她们参与了TEMPO饮食试验，先是进行了为期4个月的极低能量饮食（使用全代餐产品[MRPs]），随后又进行了为期8个月的以食物为基础、适度限制能量的饮食。在12个月或24个月（即饮食结束后8个月或20个月）时，对15名参与者进行了定性深入半结构化访谈。采用归纳法对转录后的访谈进行主题分析。
参与者报告称，进行极低能量饮食在维持体重方面具有优势，这是他们之前的减重尝试所未能实现的。首先，快速且显著的体重减轻，再加上使用方便，具有激励作用，并有助于增强参与者的信心。其次，参与者报告称，在极低能量饮食期间停止正常饮食打破了导致体重增加的习惯，使他们能够摒弃无益的习惯，并以更合适的态度对待体重维持。最后，在体重维持期间，围绕减重形成的新身份、有益习惯和增强的自我效能感对参与者起到了支持作用。此外，参与者报告称，持续偶尔使用代餐产品为应对体重反弹和支持他们的体重维持方案提供了一种有用且简便的新策略。
在这项定性研究的参与者中，大多数人在访谈时体重维持在比基线体重减轻超过10%的水平，在临床减重试验中采用极低能量饮食赋予了他们维持体重的信心、动力和技能。这些发现表明，在临床支持下，极低能量饮食可以成功地用于建立有助于长期维持体重的行为。
