These 63 men and 55 women were among 656 morbidly obese people who enrolled in a University of Kentucky weight loss program over a nine-year period. When they started, the men averaged 383 pounds and the women averaged 317 pounds.
The diet plan called for intensive coaching, meal replacement with shakes and prepared entrées, low-calorie diets, weekly classes, keeping careful records of all foods eaten, and moderate exercise. To keep weight off, the dieters avoided fats, continued using meal-replacement shakes, continued to attend coaching sessions, and ate at least five daily servings of fruits and vegetables.
Men's average maximum weight loss was 146 pounds -- 38% of their initial weight -- over 43 weeks. Women's average maximum weight loss was 122 pounds -- a little more than 38% of their initial weight -- over 46 weeks.
What happened next? As is usual, people tend to gain back weight over time. But five years after reaching their maximum weight loss, both men and women kept about half the weight off.
- 20% lower 'bad' LDL cholesterol
- 36% lower blood-fat levels
- 17% lower blood-sugar levels
- Significantly lower blood pressure
Maintaining these risk reductions probably reduced the dieters' risk of heart disease by 50%, estimate James W. Anderson, MD, director of the University of Kentucky's Metabolic Research Group, and colleagues.
Losing weight is great. But what really helps is keeping weight off, Anderson and colleagues suggest.
"Procedures that enhance maintenance of weight loss are regular physical activity, low fat intake, generous consumption of vegetables and fruit, regular use of meal replacements, self-monitoring, and ongoing treatment or coaching," Anderson and colleagues note.
The researchers report their findings in the Aug. 1 issue of the American Journal of Clinical Nutrition.