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100 lb. Weight Loss in Intensive Behavioral Program Results in Reduction in Medical Risk Factors
L. Grant, L. Gotthelf
Obes 2008; 16 Suppl 1: s158
Objective: It is often believed that surgery is the only treatment for those needing to lose ≥100 lbs. An intensive behavioral program, however, can also be a successful option for both weight loss and medical risk factor reduction. The purpose of this study was to assess the outcomes of people who lost ≥ 100 lbs while participating in the HMR® Program for Weight Management™.
Methods & Subjects: 139 consecutive patients from 28 medical facilities who had ≥ 100 lbs. to lose and had completed an intial and a follow-up health risk appraisal (HRA).
Program: HMR offers a range of weight-loss treatment options, including medically supervised low and very low-calorie diets, moderately restricted diets and phone-based programs as well as long-term maintenance. The program is based on measurable, evidence-based variables allowing for specific goals to be set and compliance to be tracked. All options for weight loss and maintenance focus on the same lifestyle changes: increased physical activity (≥ 2000 kcal/wk); use of meal replacements (≥ 35/wk in weight loss and 14/wk in maintenance); increased vegetable and fruit intake (≥ 35/wk) is included in some weight-loss options and in maintenance.
Results:
| Measure |
Initial |
Follow-Up |
Changes
(Avg Time = 2.4 yrs) |
| Weight (lbs.) |
344 |
211 |
-133 lbs. (38.7%) |
| Total Cholesterol/HDL |
4.15 |
3.11 |
-25% |
| Triglycerides |
160 |
84 |
-47.5% |
| Systolic Blood Pressure |
134 |
121 |
-13 mmHg |
| Diastolic Blood Pressure |
80 |
73 |
-7 mmHg |
| Fasting Blood Glucose |
109 |
90 |
-17.4% |
Measure
|
% Off Medications |
Off Oral Diabetes
Medications |
65.5% |
| Off Insulin |
83.3% |
Off Cholesterol
Medications |
43.7% |
Off Blood Pressure
Medications |
50.0% |
- By the time of follow-up, these patients had made substantial lifestyle changes including a 256% increase in physical activity calories per week (average of 539 to 1918), decrease in dietary fat (average decrease from 40.5% to 25.5%), and increased intake of vegetables and fruits.
- The average total risk factor score on the HRA decreased from +39 (average American is +25 for men and +23 for women) to -1. The statistically computed cancer and cardiovascular risks both declined from high to moderate risk and from very high to moderate risk, respectively. The number of elevated risk factors declined from 8 at initial to 3 at follow-up HRA.
Conclusions: In conclusion, losing ≥ 100 lbs. in an intensive behavioral program resulted in a reduction in all measured medical risk factors, a reduction and/or elimination of medications and, therefore, can be seen an alternative to surgery for many patients.
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