Effects of prescribing 1,000 versus 1,500 kilocalories per day in the behavioral treatment of obesity: A randomized trial

Abstract

Objective Controversy exists regarding the optimal energy prescription to promote successful long-term behavioral management of obesity. Prescribing intake of 1,000 (vs. 1,500) kcal/day may produce larger initial weight reduction, but long-term advantage remains unclear. The effects of prescribing 1,000 versus 1,500 kcal/day on 6- and 12-month weight changes within behavioral treatment of obesity were examined. Design and Methods Participants were 125 obese women (mean ± SD; BMI ¼ 37.84 ± 3.94 kg/m2) randomly assigned goals of 1,000 or 1,500 kcal/day. Results From months 0 to 6, participants prescribed 1,000 kcal/day lost more weight than those prescribed 1,500 kcal/day (mean ± SE = −10.03 ± 0.92g vs. −6.23 ± 0.94 kg, P = 0.045); however, from months 7 through 12, only the 1,000 kcal/day condition experienced a significant weight regain (1.51 ± 0.77 kg, P ¼ 0.025). Baseline caloric consumption moderated the effect of treatment on regain; participants with baseline intakes ≥2,000 kcal/day who were assigned 1,000 kcal/day were significantly more susceptible to weight regain than those assigned 1,500 kcal/day (P = 0.049). At month 12, a significantly greater percentage of 1,000 kcal/day participants achieved weight reductions of 5% or more than those prescribed 1,500 kcal/day. Conclusion Encouraging obese individuals in behavioral treatment to adhere to a 1,000 kcal/day intake may increase their likelihood of achieving clinically meaningful weight losses.

Group dynamics are associated with weight loss in the behavioral treatment of obesity

“…Exclusion criteria included the presence of a major psychiatric disorder, excessive alcohol intake, weight loss of ≥4.5 kg during the preceding 6 months, inability to read English at a sixth‐grade level, participation in another randomized trial, previous participation in a behavioral weight loss program, and lack of availability or willingness to attend sessions, self‐monitor dietary intake, adhere to the prescribed caloric goal, or provide informed consent. Additional information on eligibility criteria, recruitment, and screening has been described previously . All procedures followed ethical standards and informed consent was obtained from all participants prior to enrollment.…”

“…This study includes secondary analyses from a 12‐month behavioral weight loss trial . All eligible participants were randomly assigned in a 2 × 2 factorial design to a group of either approximately 10 or 30 individuals and intake goals of either 1,000 or 1,500 kcal/day.…”

“…The participants were asked to continue recording dietary intake and physical activity at least three times per week. Additional study design information has been described previously .…”

Das Behandlungsprogramm bei Adipositas mit den Schwerpunkten Essverhalten und Lebensstiländerung (BASEL) ist effektiv, aber nicht kostendeckend

“…Von 445 Teilnehmenden erreichten 197 eine Reduktion von ≥ 5 %. Dies entspricht dem Mittelfeld anderer Programme, die darüber [9,19,22,36,37] oder darunter lagen [23,24]. Einerseits könnte der hohe Ausgangs-BMI ein beeinflussender Faktor in dieser Evaluation sein und somit ein Grund für eine bescheidenere, mittlere Gewichtsreduktion, verglichen mit anderen Studien.…”

“…Die große Teilnehmeranzahl von 454 Personen und das Erheben der Daten über einen Zeitraum von 18 Jahren zählen zu den Stärken der Auswertung. Die Drop-out-Rate von 8,3 % ist verglichen mit anderen Programmen gering [20,22,23,36].…”