Weight Control in the Physician's Office

Ashley JM, et al. Arch Intern Med. 2001;161:1599-1604.

Objective

To measure the efficacy of a meal replacement strategy in a dietitian-led group setting and a physician office setting.

Methods

One hundred thirteen overweight premenopausal women were randomly assigned to 3 treatment modalities and followed for 1 year. Subjects in Group A participated in a 1-hour group session led by a registered dietitian (RD), which included behavioral modification, exercise recommendations, and a reduced-calorie diet. Group B subjects received the same treatment but were instructed to replace 2 of their daily meals with meal replacements (MR, Slim·Fast). Group C subjects saw a physician for a 10-minute visit every other week and were provided with the same instructional materials as the RD-led group, but were also instructed to replace 2 meals per day with MR.

Results

At the end of 1 year, body weight for all groups was significantly lower than their baseline values. However, Group B (9.1 ± 8.9%) had twice the percentage weight loss seen in Group A (4.1 ± 6.4%) and Group C (4.3 ± 6.5%).

A secondary variable analysis was completed to evaluate improvements in risk factors based on the level of weight loss attained. A loss in initial body weight of more than 5% was associated with significant decreases in plasma insulin, total cholesterol, and LDL-C (P=0.01). In addition, subjects with weight loss >10% had significantly lower triacylglycerol levels and significant decreases in systolic and diastolic blood pressures (P=0.05).

Conclusion

Weight management using lifestyle counseling that incorporated meal replacements was an effective form of long-term weight loss and chronic disease risk reduction in a dietitian-led group as well as in a physician's office setting.

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