Thirty-month evaluation of a popular very-low-calorie diet program.

OBJECTIVE

To analyze weight maintenance, cost, and predictors of weight maintenance in a formula-based very-low-calorie diet program.

DESIGN AND SETTING

Consecutive sample of patients evaluated at 30 months after program entry at a community hospital in Orange Park, Fla.

PATIENTS

Consecutive sample of 306 patients who entered a very-low-calorie diet program. Of these, 255 met inclusion criteria.

INTERVENTION

Patients entered a 26-week very-low-calorie diet program. At 30 months after program entry, questionnaires were mailed. Data were collected via telephone interview, as needed.

MAIN OUTCOME MEASURES

Initial and maintained weight loss, and association of weight loss to the following factors: insurance coverage, continued exercising, weeks attended, exit weight in relation to ideal weight, and cost per kilogram of weight loss.

RESULTS

Medically significant weight loss of 10% was initially achieved by 90% of patients and maintained by 33%. The average initial weight loss was 21.4 kg and the maintained weight loss was 6.5 kg for all patients. For those who remained in the program 19 weeks (61%), the initial weight loss was 25.6 kg and the maintained weight loss was 9.2 kg. Exercisers maintained more than twice as much weight loss as nonexercisers. Men lost a larger percentage of weight (22% vs 19%) and maintained more of that loss (29.5% vs 8.3%). Maintenance was not associated with insurance coverage and at how close patients came to achieving ideal weight. The cost was $396 per kilogram of weight loss maintained. An improved sense of well-being was expressed by 71% of patients.

CONCLUSIONS

Very-low-calorie diet programs can be effective in maintaining a medically significant weight loss in some patients at 30 months after program entry. Longer attendance and regular exercise help weight maintenance. The high costs and rate of weight regain indicate the need to find a more affordable and effective strategy for weight loss and maintenance.