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Abstract
purpose: To evaluate a year-long behavioral weight control program, used with and without
an intermittent very-low-calorie diet (VLCD) in the treatment of type II diabetes
mellitus.
patients and methods: Subjects (n = 93) were randomly assigned to 50-week treatment programs that used
either a balanced low-calorie diet (LCD) of 1,000 to 1,200 kilocalories (kcal) per
day throughout or included 2 12-week periods of a VLCD of 400 to 500 kcal per day
alternating with the balanced LCD. Weight, glycemic control, blood pressure, and lipids
were assessed at baseline, at the end of the year-long treatment, and at 2-year follow-up.
results: Subjects in the VLCD program lost significantly more weight than did LCD subjects
at the end of the 50-week program (14.2 kg versus 10.5 kg; P = 0.057) and remained off diabetes medication longer (P <0.05). These benefits of the VLCD were due primarily to the first 12 weeks of the
diet; the second diet maintained, but did not increase, these effects. Subjects in
both groups experienced marked improvements in glycemic control and cardiovascular
risk factors over the year-long program, but attendance declined in the latter weeks
of treatment and weight was regained. There was also marked recidivism in both groups
in the year following treatment.
conclusions: The intermittent VLCD improved weight loss and glycemic control, but these effects
were quite modest and do not appear to justify the clinical use of an intermittent
VLCD. Moreover, lengthening treatment to a full year did not prevent relapse. Thus,
further research is needed to develop a successful approach to long-term weight control.
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References
- Memorandum on federal government ability to oversee $33 billion diet business.House of Representatives, Committee on Small Business, Subcommittee on Regulation, Washington DC1990 (March)
- A multicenter evaluation of a proprietary weight reduction program for the treatment of marked obesity.Arch Intern Med. 1992; 152: 961-966
- An eight-year experience with a very-low-calorie formula diet for control of major obesity.Int J Obesity. 1988; 12: 60-80
- Long-term weight loss maintenance: assessment of a behavioral and supplemented fasting regimen.Am J Public Health. 1988; 78: 663-666
- Supplemented fasting as a large scale outpatient program.JAMA. 1977; 238: 2152-2153
- The long term effectiveness of combined therapy by behavior modification and very low calorie diet: 2 years follow-up.Int J Obesity. 1989; 13: 73-77
- Controlled trial of very low calorie diet, behavior therapy, and their combination in the treatment of obesity.J Consult Clin Psychol. 1986; 54: 482-488
- Effects of a very-low-calorie diet on long-term glycemic control in obese type 2 diabetic subjects.Arch Intern Med. 1991; 151: 1334-1340
- Long-term effects of dieting on resting metabolic rate in obese outpatients.JAMA. 1990; 264: 707-711
- One-year behavioral treatment of obesity: comparison of moderate and severe caloric restriction and the effects of weight maintenance therapy.J Consult Clin Psychol. 1994; 62: 165-171
- Very low calorie diets: their efficacy, safety, and future.Ann Intern Med. 1983; 99: 675-684
- Very low-calorie diets.JAMA. 1993; 270: 967-974
- Behavioral treatment of severe obesity.Am J Clin Nutr. 1992; 55: 545S-551S
- Treatment of obesity by moderate and severe caloric restriction: results of clinical research trials.Ann Intern Med. 1993; 119: 688-693
- Evidence for success of behavior modification in weight loss and control.Ann Intern Med. 1993; 119: 694-697
- Effect of length of treatment on weight loss.J Consult Clin Psychol. 1989; 57: 450-452
- Long-term effects of modest weight loss in type II diabetic patients.Arch Intern Med. 1987; 147: 1749-1753
- Effects of caloric restriction and weight loss on glycemia control, insulin release and resistance, and atherosclerotic risk in obese patients with type II diabetes mellitus.Am J Med. 1984; 77: 7-17
- A hypocaloric high-protein diet as primary therapy for adults with obesity-related diabetes: effective long-term use in a community hospital.Diabetes Care. 1983; 6: 328-333
- Glycemic effects of intensive caloric restriction and isocaloric refeeding in noninsulin-dependent diabetes mellitus.J Clin Endocrinol Metab. 1985; 61: 917-925
- Metropolitan height and weight tables.Stat Bull Metropol Life Insur Co. 1983; 64: 2-9
- Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance.Diabetes. 1979; 28: 1039-1057
- Nutritional management of the person with diabetes.in: Rifkin H Porte Jr, D Diabetes Mellitus. Elsevier, New York1990: 464-496
- Nutritional recommendations and principles for individuals with diabetes mellitus.Diabetes Care. 1990; 13: 18-25
- A comparison of two very-low-calorie diets: protein-sparing-modified fast versus protein-formula-liquid diet.Am J Clin Nutr. 1985; 41: 533-539
- Factors affecting glycosylated hemoglobin values in children with insulin-dependent diabetes.J Pediatr. 1981; 99: 847-853
- Coated charcoal immunoassay of insulin.J Clin Endocrinol Metab. 1965; 25: 1375-1384
- Enzymatic determination of total serum cholesterol.Clin Chem. 1974; 20: 470-475
- Quantitive determination of serum triglycerides by the use of enzymes.Clin Chem. 1973; 19: 476-482
- Multi-laboratory comparison of three heparin-Mn 2+ precipitation procedures for estimating cholesterol in high-density lipoproteins.Clin Chem. 1978; 24: 853-856
- Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge.Clin Chem. 1972; 18: 499-502
- Diminished weight loss and behavioral compliance during repeated diets.Health Psychol. 1991; 10: 378-383
- A controlled comparison of three very-low-calorie diets: effects on weight, body composition, and symptoms.Am J Clin Nutr. 1991; 55: 811-817
- Strengthening behavioral interventions for weight loss: a randomized trial of food provision and monetary incentives.J Consult Clin Psychol. 1993; 61: 1038-1045
- Improving long-term weight loss: pushing the limits of treatment.Behav Ther. 1987; 18: 353-374
Article Info
Publication History
Accepted:
February 4,
1994
Received:
November 23,
1993
Footnotes
☆This research was supported by a grant from the National Institutes of Health (DK 29757).
Identification
Copyright
© 1994 Published by Elsevier Inc.
