Risk factor reductions with 100-pound weight losses: results for 75 medically treated morbidly obese individuals.

Objective: Obesity is an independent risk factor for coronary heart disease (CHD) and weight loss decreases many different risk factors. Limited data are available on CHD risk factors changes with weight loss of > 100 pounds (#) without gastrointestinal surgery.

Method: We reviewed weight loss patterns and changes in risk factors for 75 morbidly obese individuals who have lost > 100# over the past 6 yrs. in our medically supervised, intensive behavioral weight-loss program. Average age (39 men, 36 women) was 43 yrs. and average BMI was 53 kg/m². Most were treated with a low-energy diet (LED) of 800–1000 kcal/day from 5 shakes or 3 shakes plus two entrees. Most lost the majority of their weight in the weight-loss classes but some lost substantial weight in maintenance classes. Some achieved their weight loss in a less intensive program including five meal replacements and five servings of vegetables or fruits daily. All patients attended weekly 90 min. classes and were encouraged to exceed 2000 kcal/week in physical activity.

Results: Maximum weight loss averaged 136 ± 48#(SD) or 39% of initial weight over 36 weeks with 7 losing > 200# and 1 > 300#. Patients lost 100# (28.5% of initial weight) in an average of 23 wks. For all patients average fasting values had the following significant changes (*=P<0.05): plasma glucose values, -11.4%*; cholesterol, -14.4%*; triglycerides, -29.8*; and HDL cholesterol, +9%*. Nondiabetic patients had glucose changes of -7.2%*; normocholesterolemic patients had cholesterol changes of -11.6%*. Antihypertensive medications were stopped in 62% of treated hypertensives but systolic and diastolic blood pressure decreased 9.5%* and 13%* for all subjects. CHD risks were also reduced by the increased physical activity, lower animal fat intake, and higher intakes of vegetables and fruits sustained in weight maintenance. These weight losses were well tolerated with minimal side effects.

Conclusion: This review indicates that morbidly obese patients can successfully lose large amounts of weight with a medically supervised behavioral program using LED. Weight losses of >100# significantly improve all measured CHD risk factors.