Long-term follow-up of 1,000 patients shows substantial lifestyle and medical changes.

Objective: Recent research indicates that only a minority of people attempting weight loss make the appropriate lifestyle changes necessary for long-term weight maintenance. Successful weight-loss maintenance includes both increased physical activity and dietary changes such as decreased fat and increased vegetable/fruit/fiber intake.

Method: This study assessed the lifestyle changes and medical outcomes from 1,000 maintenance patients in 28 Health Management Resources™ (HMR®) Programs for Weight Management. HMR is an ongoing, structured treatment program focusing on lifestyle changes: > 2,000 kcals/wk of physical activity, > 35 cup servings/wk of vegetables/fruits, and the use of meal replacements.

Results: This sample included all patients who had completed a pre-treatment health risk appraisal (HRA) and a follow-up HRA between 6/03–8/04. The average time between surveys was 129 weeks (2.5 yrs). The average weight-loss maintenance was 44 lbs. (18% of initial). Patients had made substantial lifestyle changes with average physical activity increasing from 948 to 2558 kcals/wk and average dietary fat intake decreasing from 38% to 28% of energy. These lifestyle changes were associated with highly significant decreases (p<.001) in all measured medical parameters: total cholesterol/HDL ratio -13%, triglycerides -23%, fasting blood glucose -10%, systolic -8 mm/Hg and diastolic blood pressure -7 mm/Hg. These medical changes occurred in addition to substantial decreases and/or elimination of medications. Overall, 74% of patients were maintaining a loss of >10% of initial weight (average of 23% or 58 lbs.) and 19% were maintaining a loss of < 10% of initial weight (average of 6% or 14 lbs.). Only 7% of patients had gained weight at follow-up. The average number of measured risk factors dropped from 7 to 3.

Conclusion: Patients in an ongoing treatment setting can lose substantial amounts of weight and practice the lifestyle changes necessary for weight loss and risk factor reduction. As evidenced by the public’s lack of compliance with nutrition recommendations, many people need structure and accountability to make lifestyle changes not supported in our current cultural environment.