According to a study, a total diet replacement (TDR) program results in higher weight loss in people with obesity than care from a practice nurse, and the benefit lasts at least three years.
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| Photo: Dietician with Obese Patient | InStyleHealth |
The TDR regimen lasted 8 weeks, after which food was
reintroduced over a 4-week period. Behavioral support was also offered weekly
for the first eight weeks, bi-weekly for the next four weeks, and then monthly
for three months. The usual care (UC) group, on the other hand, received up to
three months of dietary and behavioral assistance from a practicing nurse.
The study comprised 272 participants who were eligible
for follow-up, with 179 (66%) having available data on their follow-up outcomes
(96 [72 percent] from the TDR group and 83 [62 percent] from the UC group).
At the start of the study, the average body mass index
was 36.8 kg/m2, with 20% of patients having type 2 diabetes and 25% having
hypertension. The majority of those who took part were in their forties and
fifties, with 55% of them being female and 90% of them being white British.
At three years, TDR patients lost 6.2 kg, while UC
patients lost 2.7 kg (adjusted mean difference, 3.3 kg, 95 percent confidence
interval [CI], 5.2 to 1.5; p0.0001). TDR also had a higher weight loss from the
conclusion of the program at 6 months to 3 years (8.9 kg vs 1.2 kg with UC;
adjusted mean difference, 6.9 kg, 95 percent CI, 4.2–9.5; p0.001).
TDR also resulted in lower diastolic blood pressure
(mean difference 3.3 mm Hg (95 percent CI, 6.2 to 0.4; p=0.024) and systolic
blood pressure (mean differences 3.7 mm Hg (95 percent CI, 7.4 to 0.1; p=0.057)
than UC after 3 years.
HbA1c (1.9 mmol/mol, 95 percent CI, 0.7 to 4.5;
p=0.15), low-density lipoprotein cholesterol concentrations (0.2 mmol/L, 95
percent CI, 0.3 to 0.7; p=0.39), and cardiovascular risk score (QRISK2; 0.37,
95 percent CI, 0.96 to 0.22; p=0.22) were not significantly different between
groups.
Source: Int J Obesity 2021;45:2432-2438