Weight Management Results

High risk patients with multiple co-morbidities reduce medical risk factors and medications after participating in weight management program.

Obes 2012:S170.

112 patients with ≥ 10 elevated medical risk factors were maintaining an average 55 lb weight loss after an average of 3.2 years. Patients substantially lowered the number of elevated risk factors (11 to 3) and made substantial lifestyle changes. Average reductions in all measured risk factors included: 14.5% total cholesterol/HDL, 29.2% triglycerides, and 12% fasting blood glucose. 28.7% of cholesterol, blood pressure or diabetes medications (oral or insulin) had been eliminated (not including reductions in medication dosages).

Substantial weight loss can help prevent co-morbid conditions and the need for medications.

Obes 2011;19 suppl 1:S99.

1250 patients who were maintaining a weight loss of > 10% of initial weight an average of 2.6 years later were assessed. 94% of patients with pre-hypertension were not taking any hypertensive medications at follow-up. 97% of patients with pre-diabetes were not taking any diabetes medications at follow-up. Patients with borderline risk factors should be encouraged to lose weight to prevent the progression of co-morbid conditions.

Weight management is health management: lifestyle changes improve health risks.

Obes 2011;19 suppl 1:S99.

1751 patients in 50 programs participated in an annual health management project. The average weight loss being maintained was 40.0 lbs over an average of 3.3 years. All changes in measured risk factors were significant including total cholesterol/HDL, triglycerides, fasting blood glucose, and blood pressure. 97% of those with pre-diabetes remained medication-free at follow-up. Focusing on medical risk factor changes reinforces reasons to maintain healthy lifestyle changes.

Improvements in medical risk factors for maintenance patients in an ongoing medical weight management treatment program

J Am Diet Assoc 2010;110 suppl 2:A-45
The average weight loss maintenance of 1246 patients from 42 different clinics was 39 lbs. over an average of 3.8 years. Improvements in all measured medical risk factors were statistically significant. 25.5% discontinued cholesterol, blood pressure, or diabetes medications (not including those who decreased their dosage). Participants also made substantial changes in lifestyle behaviors including a 144% increase in physical activity calories per week.

Greater Weight Loss Leads to Greater Changes in Medication Use in an Ongoing Treatment Program

Obes 2010;18 suppl 2:S85.

There was a dose-response relationship between weight loss and medication elimination in 1246 patients from 42 different clinics. Those losing the most weight (≥ 75 lbs) had the greatest changes in medication use with 52.5% of medications eliminated (cholesterol, blood pressure, insulin and oral diabetes medications). This is in comparison to those losing 50-74 lbs, 25-49 lbs and < 25 lbs who eliminated 32.8%, 21.2% and 12.7% of medications, respectively. These data do not include changes in medication dosages.

Risk factor changes in participants with BMI> 40 in an ongoing treatment program.

Obes 2010;18 suppl 2:S86.

When analyzed by weight change group (> 75, 50-74, < 50 lbs), a dose-response relationship was found in the risk factor summary score of a health risk appraisal (including lifestyle and medical risk factors and personal health history). Those losing > 75 lbs (average of 114 lbs, 34.7% of initial weight) decreased total risk factor scores by an average of 36 points vs. 33 and 25 points, respectively, for the other weight loss categories.

Changes in medical risk factors and medication use with participation in an ongoing treatment program.

Obes 2010;18 suppl 2:S86.

The average weight loss for individuals with a BMI ≥ 40 kg/m² (n=456) was 60 lbs (20.3% of initial weight) over an average of 3.2 years. When analyzed by weight change category (> 75, 50-74, < 50 lbs), there was a dose-response relationship between groups in all measured medical risk factors (total cholesterol/HDL, triglycerides, fasting glucose, systolic and diastolic blood pressure) as well as in percent of medications eliminated (reduction in dose was not included).

Assessment of weight maintenance at five years after behavioral weight loss intervention

Obes 2009;17 suppl 2:S87

Weight change over 5 years was assessed in participants who lost an average of 65.6 lbs. When analyzed by quartiles, it was found that 52% of patients were keeping off > 5% of initial weight at 5 years, 31% were keeping off > 10%, 24% > 15% and 15% > 20% of initial weight. One-quarter of the patients were highly successful in maintaining 97% of the weight loss.

Obese patients who decrease BMI to overweight range have significant changes in lifestyle and medical risk factors

Obes 2009;17 suppl 2:S279

Obese patients who lost an average of 52 lbs and moved from the obese to overweight BMI category experienced substantial health changes. 35.7% who were initially on cholesterol, blood pressure, or diabetes medications eliminated these medications (data on dosage decreases were not available). 55% of those on diabetes medications discontinued those medications.

Improvement in Medical Risk Factors for 1,000 Patients in Ongoing Treatment Program

Obes 2009; 17 suppl 2:S279

Health risk appraisal data from 1,000 consecutive participants in 26 HMR programs found the average weight loss to be 41 lbs (16.7% of initial body weight) over an average of 2.8 years. Overall 72.6% of patients were keeping off an average of 21.4% of initial weight. There were also significant decreases in total cholesterol/HDL (12.1%), triglycerides (24.2%), fasting blood glucose (7.7%) and systolic (6 mmHg) and diastolic (4 mmHg) blood pressure.

Weight maintenance, behaviors and barriers among previous participants of a university-based weight control program

Int J Obes 2008;32:519-526

76.5% of previous program participants (n=179) had successfully maintained a weight loss of > 5% below baseline for 14 months. Successful maintainers reported that they ate five or more fruits and vegetables per day, continued to use meal replacements, and exercised more, kept exercise records and planned for exercise significantly more often than unsuccessful maintainers.

Four-year efficacy and safety of sibutramine for weight maintenance: a multicenter, double-blind, randomized, placebo-controlled study

Obes 2008;16 suppl 1:S64

Severely obese patients who lost 26.3% of initial body weight (66.2 lbs) in nonpharmacological weight loss programs maintained weight losses of 37.8% (25.1 lbs) over follow-up of 6 years. Sibutramine significantly enhanced weight maintenance for the first 24 months but weight changes did not differ significantly between placebo and medication after that time.

One Hundred-pound Weight Losses with an Intensive Behavioral Program: Changes in Risk Factors in 118 Patients with Long-term Follow-up.

Am J Clin Nutr 2007;86:301-307

These 118 patients weighed an average of 352 lbs on entering the HMR Program and lost an average of 134 lbs. in 44 weeks. Medication doses were reduced in all patients who entered the program on medications. Medications were discontinued in 66% of all patients, including 100% of patients with dyslipidemia, 67% with hypertension, 73% with diabetes and 83% with degenerative joint disease.

Weight loss and long-term follow-up of severely obese individuals treated with an intense behavioral program.

Int J Obes 2007;31:488-493.

Results for 1100 people with BMIs > 40 kg/m² who completed the 12-week program showed an average weight loss of 77.6 lbs. Twenty-five percent (25%) of this group lost 100 lbs. or more – for an average weight loss of 137.4 lbs. Those who lost > 100 lbs. were maintaining an average of 90.4 lbs. approximately 2 years later while participating in a maintenance program.

Comparison of a low carbohydrate and low fat diet for weight maintenance in overweight or obese adults enrolled in a clinical weight management program

Nutr J 2007;6:36

After losing 18-19% of initial body weight on an HMR very-low-calorie diet, a low fat and a low carbohydrate diet group, combined with a clinical weight management program, were similar and effective in preventing weight regain over 6 months.

100 lb. Weight Loss in Intensive Behavioral Program Results in Reduction in Medical Risk Factors

Obes 2008; 16 Suppl 1: s158

Data from 139 consecutive patients from 28 medical facilities who lost > 100 lbs. were analyzed using an initial and a follow-up health risk appraisal (HRA). The average weight change was 133 lbs. or 38.7% of initial body weight over an average of 2.4 years. At follow-up, a large percent of patients were off their medications: 65.5% off oral diabetes medications, 83.3% off insulin, 43.7% off cholesterol medications, and 50.0% off blood pressure medications.

 

Impact of Weight Loss on Patients with High TC/HDL Ratios

Obes 2008; 16 suppl: s308

Patients (n=331) who entered the HMR Program with TC/HDL > 5.0 and were not on medications were included in the analysis. From initial to follow-up health risk appraisal, patients lost an average of 49 lbs. (18.5%) and made substantial lifestyle changes. TC/HDL ratio decreased an average of 25.9% and  triglycerides decreased 36.7%. The average number of elevated risk factors decreased from 8 to 3.

Patients Completing 12 Weeks in Structured Maintenance Program Continue Lifestyle Changes and Prevent Weight Regain

J Am Diet Assoc 2008; 108 suppl 3: A39

Data from 124 consecutive patients found that patients continued to practice lifestyle behaviors over the 12 weeks of maintenance (average of 2319 kcals of physical activity, 45 servings of vegetables and fruits, and 29.6 meal replacements per week). During this time, patients lost an additional 4.5 lbs, on average, for a total weight loss of 33.6 lbs.

Three Behaviors Which Prevented Weight Regain in Maintenance

Obes 2008;16 suppl 1:S157

Data were analyzed from 165 consecutive patients who completed 6 months of maintenance. On average, patients were doing 2,695 kcals of physical activity per week, 48.5 servings of vegetables and fruits per week, and 29.6 meal replacements per week and were experiencing virtually no weight regain at 6 months (-0.14 lbs). When each patient’s data was analyzed for each week in maintenance, however, it was found that most patients seem to require different levels of these behaviors at different times in order to manage their weight.

Using a Greater Number of Meal Replacement Entrees Helps Prevent Weight Regain in Maintenance

Obes 2008; 16 suppl 1: s158

Data were analyzed from 142 consecutive maintenance patients who had participated in Healthy Solutions^® for weight loss. The average weight loss was 31 lbs. in an average of 17 weeks. Those who used > 12 entrees per week lost an average of 7.8 lbs. in maintenance while those who used < 12 entrees per week gained an average of .08 lbs.

 

Patients with Hypertension Who Lose Substantial Amounts of Weight Can Positively Impact Risk Factors and Need for Medications Obes 2007;15 suppl:A98.
Patients with high blood pressure but not on medications at the time of program entry were followed in maintenance. Patients who lost substantial amounts of weight (average of 54 lbs) and made lifestyle changes (along with decreases in medical risk factors) were able, on average, to avoid the need for hypertensive medications.

Prehypertensive Patients Substantially Improve Risk Factors in a Weight Management Program. Obes 2006;14 suppl:A101.
Initial risk factor data from patients who were prehypertensive when they entered the HMR^® Program for Weight Management^TM were compared with data an average of 2.7 years later.  Patients had significant decreases in all measured medical risk factors.  94.3% of patients remained free of blood pressure medications and 84.6% discontinued diabetes medications.

Weight Maintenance with Five Clinic-Based and Phone-Based Treatment Options. Obes 2006;14 suppl:A101.
603 medically supervised patients were maintaining an average of 71.1% of their weight loss (average weight loss was 62.8 lbs.) over a total of 63.9 weeks of treatment.  Healthy Solutions patients (n = 259) were maintaining an average of 66% of their weight loss (average weight loss was 41.6 lbs.) over a total of 65.4 weeks of treatment.

Losing Greater Amounts of Weight Leads to Greater Changes in Medical Risk Factors. Obes 2006;14 suppl:A103
Data from 2564 patients in 65 HMR clinics were analyzed by percent of initial body weight kept off.  All measured medical risk factors decreased significantly more in those losing the most weight as compared to all other groups.  Patients reporting the greatest changes in lifestyle behaviors lost more weight, indicating a dose-response relationship.

Long-term follow-up of 1,000 patients shows substantial lifestyle and medical changes. Obes Res 2005;13 suppl:A203.
1,000 maintenance patients were maintaining an average weight loss of 44 pounds (18% of initial body weight) over an average of 2½ years. Participants had made substantial lifestyle changes and had highly significant decreases in all measured medical parameters, such as fasting blood glucose, blood pressure, total cholesterol/HDL ratio, and triglycerides.

A comparison of meal replacements and medication in weight maintenance after weight loss. J Am Coll Nutr 2005;24:347–353.
After an average weight loss of 50.3 lbs. with a very low-calorie diet, using 2 HMR^® meal replacement entrees a day was effective in maintaining weight loss within 6 lbs. over one year.

Intensive behavioral program is a successful treatment option for severely obese patients with BMI > 40. Obes Res 2005;13 suppl:A203.
1,136 participants who completed at least 12 weeks in weight loss treatment lost an average of 78.1 lbs. over an average of 37.2 weeks. Nearly ¼ of these participants lost > 100 lbs. and those who entered a maintenance program were keeping off an average of 69% of this weight loss (94.5 lbs.) over an average of 2.7 years.

Response of men and women with BMI > 40 to intensive treatment program for weight management. Obes Res 2005;13 suppl:A144.
This study analyzed data from 1,136 men and women who entered the HMR Program with a BMI > 40 kg/m² and completed at least 12 weeks of weight loss. Men in this sample tended to sustain more of their weight loss. However, men and women who had lost > 100 lbs. were both maintaining an average weight loss of 27% of initial body weight after 2½ to nearly 3 years while participating in the program.

Improved long-term maintenance of weight loss with ongoing involvement in weight management program. Obes Res 2004;12 suppl:A41.
Fifty-four participants who lost > 100 lbs. (average weight loss was 140 lbs.) were maintaining 70% of this weight loss (average of 100 lbs.) at an average of over three years.

Long-term weight-loss maintenance: a meta-analysis of US studies. Am J Clin Nutr 2001;74:579–584.
Individuals who lost greater amounts of weight in shorter amounts of time (e.g., very low-calorie diet) lost significantly more weight overall and kept off more of the weight loss than those following less intensive diets. Additionally, those who exercised more had significantly greater success with weight-loss maintenance than those who exercised less.

Success in behavioral weight management program depends on treatment variables chosen. Obes Res 2001;9 suppl 3:181S.
Behavioral and weight change data from a total of 248 maintenance patients who were active in either 1995 or in 2000 were compared. Due to recent changes in the HMR Program, those who were enrolled in 2000 gained less weight in the maintenance program and participated in more lifestyle behaviors, such as physical activity, meal replacements, and vegetable/fruit intake.

Accountability (attendance and phone calls) is critical for patient success in a weight management program.
Obes Res 2000;8 suppl 1:69S.
Data from 666 maintenance program participants were analyzed to determine the impact of attendance and phone calls on success. Those who attended the program most often and made a greater number of structured phone calls were more successful with weight management and lifestyle behaviors than those who attended less often.

Greater improvement in medical risk factors with greater weight loss/maintenance compared to recommended 5–10%. Obes Res 2000;8 suppl 1:69S.
The average weight loss maintenance for a sample of 1,219 participants from the maintenance program was 43.1 lbs. (17% of initial body weight) over 2 years. Compared to the standard of a 5-10% loss of initial body weight, those maintaining greater amounts of weight demonstrated significant improvements in medical risk factors.

Use of meal replacements associated with greater success in weight maintenance treatment program. J Am Diet Assoc 2000;100 suppl:A-75.
In a sample of 666 participants, those who used > 14 meal replacements per week did better with weight maintenance and participated in more lifestyle behaviors (physical activity, vegetable/fruit intake, attended the program, and kept records) than those who used < 14 meal replacements per week.

Long-term weight maintenance after an intensive weight-loss program. J Am Coll Nutr 1999;18:620–627.
This prospective study documented an average weight loss of 65 lbs. for patients in a medically supervised HMR very low-calorie diet program and reported follow-up data of up to seven years.

Weight loss and 2-year follow-up for 80 morbidly obese patients treated with intensive very-low-calorie diet and an education program. Am J Clin Nutr 1992;56:244–246S.
This follow-up study found that obese individuals in a medically supervised HMR program lost a substantial amount of weight, reduced risk factors, and were maintaining 48% of their weight loss two years after treatment.

Benefits and risks of an intensive very-low-calorie diet program for severe obesity. Am J Gastroenterol 1992;87:6–15.
This article reviewed the use of very low-calorie diets and reported data for three samples of patients enrolled in an HMR program. Patients were maintaining approximately 56% of their initial weight loss two years after treatment.

Safety and effectiveness of a multidisciplinary very-low-calorie diet program for selected obese individuals. J Am Diet Assoc 1991;91:1582–1584.
This study reported the results for the first 100 patients consecutively enrolled in an HMR very low-calorie diet program (up to 42 month follow-up).