Long term treatment of severe obesity: four year follow up of results of combined behavioural modification programme.

A four year programme of treatment for severe obesity combining standard techniques such as behavioural modification, exercise, nutritional advice, and, in addition, readmission of patients who relapse has been developed. One hundred and seven subjects of both sexes were treated. Thirty nine had their jaws fixed from the start. After four years 104 out of 107 subjects were traced; 33 (31%) had left the programme. The mean loss of weight in the remaining 74 subjects was 11.7 kg (range -20 to 55.5): 14 had lost more than 20 kg, 35 had lost 5-20 kg, 17 had lost 0-5 kg, and eight were above their weight before treatment. The rate of dropping out in this study was lower than that generally reported. Our data suggest that combined behavioural modification used as a programme for reducing weight may result in a substantial loss of weight for several years even for severely obese subjects.