Understanding the Short-Term and Long-Term Results of Different Weight Loss Programs

Obesity continues to be a problem for more than two-thirds of the adults of the United States, and there seems to be new developments in dietary possibilities each year. While medical weight management, combined with exercise, behavioral and pharmacological support, is popular and often effective, there is little consensus on which dietary method is most effective. Dr. Christine Ren-Fielding from the NYU Langone Medical Center took part in a ground-breaking study to determine the effectiveness of an intensive medical intervention diet (IMI) with caloric restriction versus a conventional carbohydrate-restricted (CCR) diet. This study was the first of its kind, and offers solutions to those patients for whom bariatric surgery is not an option.

Dr. Christine Ren-Fielding’s Study Bridges the Gap for Patients in Need of Medical Solutions to Obesity

Although traditional methods of weight loss through caloric restriction remains popular and recommended to many people today, low-carbohydrate diets have recently generated substantial attention in the medical community as well as the general public. Bariatric, or weight loss, surgery, is a safe and effective insurance-covered intervention for obesity, yet this option is not for all individuals. Thus, the costs of community-based diet programs are left to patients themselves, and this can be prohibitive. Therefore, when choosing a diet program, individuals must choose carefully, and take into consideration the long-term effects, which this study has revealed.

Methods of Study

This observational study aimed to determine the effectiveness of a 6 month intensive medical intervention (IMI) with caloric restriction and high-protein meal replacements versus a conventional carbohydrate-restricted (CCR) diet. A total of 604 patients with obesity or overweight took part in the study. The mean age of this population was 48, and 78% were female. The mean body mass index (BMI) was 36.3, and 30% had hypertension. Individuals were given a choice of one of the two abovementioned weight-loss treatment programs. Patients in each group were given written and verbal dietary instructions, support, as well as email and phone interaction with physicians and dieticians on a regular basis. All individuals were instructed to engage in regular physical exercise, including at least 5 miles of walking and at least 240 minutes of overall exercise each week. After the 6-month treatment period, patients in both groups were placed on a conventional carbohydrate-restricted plan for weight loss maintenance, which was equivalent to the CCR group’s treatment plan. The exercise plan for all patients remained the same for the maintenance period.

Intensive Medical Intervention (IMI) Program

The patients who chose an IMI weight loss program had an initial visit with a weight loss physician (PI) and were then seen every two weeks for 6 months by a physician or a dietician. They were instructed to consume 1,110 calories per day, along with 30 grams of carbohydrates from nutritional supplements.

Conventional Carbohydrate Restriction (CCR) Program

The patients who opted for a CCR weight loss program were also seen by a weight loss physician, but monthly, and for 6 months. They were instructed in a carbohydrate-restricted diet consisting of protein at every meal and a snack. They were told to consume no more than 60 grams of carbohydrates total each day, and to avoid foods containing more than 30% of calories from fat.

Results

While patients in both groups experienced weight loss, the IMI group had an average of 5.7% greater mean body weight loss (BWL) than the CCR group. Overall, the IMI group was 1.79 more likely to have weight loss success than the control group (CCR group), and this success was attributable to patients’ success at 6 months. Although the IMI group experienced greater weight regain at 18 months, the differences were not significant at 12 months. Blood pressure improved with both groups, with no statistically significant differences between groups. After two years, both groups had similar weight loss.

Overall, this study demonstrates that an intensive medical intervention (IMI) with both caloric and carbohydrate restrictions results in preferable short-term weight loss over carbohydrate restriction alone. Programs described in this study are safe and effective for patients who may be resistant to the idea of weight loss, or for whom bariatric surgery or weight loss medications are not an option.

Determining the weight loss options that are right for you does not need to be a difficult and complicated decision when you consult experts like Dr. Christine Ren-Fielding and Dr. George Fielding. Visit the NYU Langone Weight Management Program here to learn about weight loss guidance and support, as well as the benefits of bariatric surgery.