Long-term weight-loss maintenance of a meal replacement based weight management program in primary care

Objectives: Structured obesity treatment programs at primary care level are becoming increasingly important. However, evidence from current treatment approaches in the long term is lacking. In view of this fact we evaluated a standardized, meal replacement based weight loss program (myLINE, AENGUS, Austria) according to the currently applicable guidelines.

Methods: Data of overweight and obese individuals (n = 70), who participated at least 36 months in the program, were analyzed. Data were collected at baseline (T0), after 1, 3, 6, 12, 24, and 36 (T1-T36) months. Body composition was measured by conventional anthropometry and bioelectrical impedance analysis (AKERN BIA 101, BIACORPUS RX 4000, Software Bodycomp Version 8.4).

Results: Female individuals covered 81% of the population with a mean age of 54 ± 14 years. Compared to T0, a maximum weight-, BMI-, fat mass-, absolute body cell mass (BCM) reduction and an increase of relative BCM could be seen at T6 (Table 1). At T12, 61% of all participants achieved a minimal weight loss of 5%, 36% of minimal 10% and 19% lost more than 15% of their initial weight. Subsequently the findings reveal a significant reduction of body weight, body fat and a satisfying development of body cell mass during the observation period of 36 months (Table 1). The initial BMI influenced weight loss over the observation period (β=-0.501; p < 0.001). No influence of age, sex or initial BCM on weight loss could be detected.

Tab. 1: Body composition data from T0 to T36

	n	T0		T6		T0-T6	T12		T0-T12	T24		T0-T24	T36		T0-T36
		mean	SD	mean	SD	p	mean	SD	p	mean	SD	p	mean	SD	p
Weight [kg]	70	92.8	18.3	82.3	16.3	< 0.001	82.2	16.1	< 0.001	82.9	16.8	< 0.001	84.3	16.1	< 0.001
BMI []		33.9	5.7	30.0	4.9	< 0.001	29.9	4.6	< 0.001	30.2	4.9	< 0.001	30.8	4.9	< 0.001
Weight loss [kg]		-	-	10.5	6.2	< 0.001	10.5	7.7	< 0.001	9.9	9.1	< 0.001	8.4	9.4	< 0.001
Weight loss [%]		-	-	11.1	5.9	< 0.001	11.0	7.0	< 0.001	10.3	8.3	< 0.001	8.6	8.4	< 0.001
FM [kg]		35.5	11.5	28.1	10.2	< 0.001	28.1	9.6	< 0.001	28.9	9.9	< 0.001	29.9	9.8	0.001
FN [%]		37.8	7.4	33.5	7.8	< 0.001	33.6	7.2	< 0.001	34.3	7.3	0.01	35.0	7.3	0.01
BCM [kg]		28.2	6.1	26.8	5.8	< 0.001	26.8	5.9	< 0.001	26.8	6.2	0.002	26.8	6.1	0.001
BCM [%]		30.8	5.3	33.0	5.7	< 0.001	32.9	5.4	< 0.001	32.7	5.6	0.001	32.1	5.3	n.s.

Conclusion: The evaluated program complies with national and international guidelines [1 – 5] for the therapy of obesity in adults and is efficient and meaningful for a long-term therapeutic use in primary care.

References:

[1] Yumuk V, et al. Obesity facts. 2015;8:402 – 24.

[2] Hauner H, et al. Akt Ernaehr Med. 2000;25:163 – 5.

[3] Thomas P, editor. Washington: National Academic Press; 1995.

[4] Wing R, et al. Annu Rev Nutr. 2001;21:323 – 41.

[5] Stevens J, et al. Int J Obes. 2006;30:391 – 9.