Background

To determine the effectiveness of an updated structured multidisciplinary non-surgical obesity therapy program on the basis of a temporary liquid low-calorie-diet for 12 weeks, and additional intervention modules to enhance nutritional education, to increase physical activity and to modify eating behavior. The intervention program was updated 2011: elongation of switch-phase between initial liquid low-calorie-diet and normal food, reworked token-concept to control energy intake, introduction of a dedicated weight-loss maintenance training in the second half of the program etc. Results of the earlier program version until 2010 were already published (doi:10.1038/ijo.2011.107).

Methods

Observational study in obese individuals undergoing a medically supervised outpatient-based 52-week treatment in Germany. A total of 311 participants with a body mass index (BMI) of 44.5 kg/m2 included within 7.0 years (2012-2019). Main outcome measures were body weight loss, dropout-rate and reduction in cardiovascular risk factors.

Results

In females, initial body weight was reduced after the 1-year-intervention from 121.7 kg (95% confidence intervals 118.6 – 124.7 kg) to 97.3 kg (95% confidence intervals 93.7 – 100.9 kg) and in males from 147.1 kg (95% confidence intervals 142.6 – 151.6 kg) to 109.7 kg (95% confidence intervals 105.9 – 113.5 kg) according to per protocol analysis. Dropout-rate was 20.9 %. There was an improvement in nearly all cardiovascular risk factors (blood pressure, lipids, glucose etc.). Compared to the earlier version of the program, participants were heavier, the proportion of male participants was higher, the dropout-rate was much lower and weight loss was higher with the updated program version.

Conclusions

The updated non-surgical intervention program is a highly effective initial treatment of obesity grades I–III and obesity related diseases. The changes in program structure resulted in several outcome improvements. Most notably the dropout-rate decreased from 42 % to 20.9 %.