Five-Year Self-management of Weight Using Meal Replacements: Comparison With Matched Controls in Rural Wisconsin

Rothacker DQ. Nutrition. 2000; 16:344-348. Editorial Opinions by George Bray MD and James Hill Ph.D.

Objective

To compare 5-year weight changes of subjects after a self-managed, meal-replacement, weight control program with that of a cohort of weight- and age-matched control subjects.

Methods

Residents in a rural Wisconsin town volunteered to enter a weight loss program utilizing meal replacements (MR, Slim·Fast) with subsequent follow-up for 5 years. After the 12-week weight loss phase, subjects in the MR group were weighed biannually. Body weight data from a post hoc cohort group (control) matched for age, sex, and initial body weight was acquired from the surrounding communities to compare the treated group with secular trends in weight change. For each of the treatment subjects, 2.7 controls were analyzed. Control body weights were verified from physicians' medical records between 1992 and 1997.

Results

After 5 years, 141 of the original 158 volunteers remained in the program and were compared with 389 controls. The female MR participants lost an average of -4.2 ± 6.9 kg and the males -5.8 ± 5.4 kg from baseline over the 5-year period. Those in the control group experienced weight gains of + 6.7 ± 10.2 kg and + 6.5 ± 10.7, respectively.

Conclusion

Federally funded community-based health programs have shown limited success. By contrast, this program demonstrated that a meal replacement strategy can promote sustained weight loss for 5 years.

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