Background

We aimed to compare weight loss between one group of patients who underwent a standard weight-loss course (SWL) focusing on healthy lifestyle behaviors, and one group who underwent an intensified weight-loss course with greater emphasis on caloric restriction (CR).

Methods

Weight data from two different groups of patients attending a group-based interdisciplinary 6-month weight loss course (15 sessions) based on current guidelines for lifestyle intervention, was recorded at a pre-course visit and at the last visit. We introduced weight loss meal plans (1200 or 1500 kcal/day) at an earlier stage and with more emphasis on caloric restriction in the lifestyle course and compared weight loss in the CR group with the SWL group.

Results

Mean (SD) age was significantly higher in the CR group (n=63, 64 % women) compared with the SWL group (n=153, 73 % women), 48.9 (12.5) vs. 42.4 (12.2) years, p<0.001, while baseline weight was comparable between the CR and SWL groups, 116.2 (17.5) kg vs. 118.5 (22.0) kg, p=0.46. The age- and baseline weight- adjusted, mean (SD) weight loss was significantly higher in the CR group than in the SWL group, 7.5 (5.6) kg versus 4.5 (6.8) kg, p=0.008. Further, a significantly higher proportion of patients in the CR group achieved a weight loss of 5% or more, 57% versus 40%, p=0.02. There was no significant association between weight loss and age, employment status, vitamin D status or comorbidity. Patients who achieved weight loss after the pre-course visit and before the start of the lifestyle course had a greater age-and baseline weight-adjusted mean (SD) total weight loss than patients who did not achieve an initial weight loss, 10.4 (4.7) kg versus 3.6 (4.2) kg, p<0.001.

Conclusions

Compared with a traditional lifestyle course focusing on healthy lifestyle behaviors, the early introduction of a specific calorie restricted meal plan was associated with larger weight loss. An initial caloric restriction may improve the treatment efficacy.