Long-term effects of a very low calorie diet (Nutrilett) in obesity treatment. A prospective, randomized, comparison between VLCD and a hypocaloric diet+behavior modification and their combination.

Author: Ryttig KR, Flaten H, Rossner S

Author affiliation: MEDDOC, Research Centre, Horsholm, Denmark.

Publication date & source: 1997.07, Int J Obes Relat Metab Disord., 21(7):574-9.

Publication type: Clinical Trial; Comparative Study ; Randomized Controlled Trial; Research Support, Non-U.S. Gov't

OBJECTIVES: To compare weight loss on a balanced hypocaloric diet to that of a Very Low Calorie Diet (VLCD) after two months of treatment and to further compare 26 months of weight maintenance and safety with or without VLCD assistance in obese patients. DESIGN: Prospective, randomized, controlled intervention trial, initially with two and later with three parallel groups. SETTING: Swedish University out-patient obesity clinic. SUBJECTS: Eighty-one obese patients of both gender with a BMI > or = 30 kg/m2 from the waiting list participated in a structured weight reduction + weight maintenance programme. INTERVENTION: Twenty-seven patients (group A) were randomized to a balanced diet of 6720 kJ/d (1600 kcal/d) during the whole treatment period. The other patients (n = 54) were randomized to VLCD (Nutrilett) 1764 kJ/d (420 kcal/d) diet during the first two months. The VLCD treated patients were rerandomized after the initial treatment to the well balanced hypocaloric diet (6720 kJ/d) with (group C) or without (group B) 1 MJ of VLCD to be taken during the evening. MAIN OUTCOME MEASURES: During the first two-month period, the mean body weight loss in the VLCD group was 18.9 +/- 7.1 kg compared to 7.2 +/- 4.8 kg in the diet treated group, with a similar relative fat loss assessed by bioimpedance of 68% and 76% respectively. The maintained weight loss in all groups after 28 months of treatment was 10.9 +/- 10.2 kg in the 52% who completed the programme. Weight losses and drop-out rates were similar in all three groups. CONCLUSIONS: Twenty-four months weight maintenance and drop out rates are independent of whether the initial treatment commences with VLCD or a hypocaloric diet. One MJ nutrition powder taken freely does not affect 24 months weight maintenance on a hypocaloric (6.7 MJ/d) diet.