How To Keep Weight Off After a Low Calorie DietWednesday, November 20, 2013
Low calorie diets (LCD: usually restricting intake to less than 1,000 calories per day with a formula diet) are highly effective in promoting weight loss and generally safe, when medically supervised.
However, as with all diets, the problem is not so much as how to lose weight – the real problem is keeping it off.
Now a paper by Kari Johansson and colleagues from the Karolinska Institute, Stockholm, Sweden, published in the American Journal of Clinical Nutrition, provides a systematic review and meta-analysis of randomised controlled trials on weight-loss maintenance post-LCDs.
The authors identified 20 studies with a total of 27 intervention arms in 3017 participants with the following treatment categories:
- anti-obesity drugs (3 arms; n = 658),
- meal replacements (4 arms; n = 322),
- high-protein diets (6 arms; n = 865),
- dietary supplements (6 arms; n = 261),
- other diets (3 arms; n = 564),
- exercise (5 arms; n = 347).
The low-calorie diet periods in these studies ranged with 3 and 16 weeks with an average weight loss of about 12 Kg.
Compared with controls, anti-obesity drugs and continued use of meal replacements improved weight-loss maintenance by about 3.5 kg.
Switching to a high-protein diet was only 1.5 kg better than control whereas, exercise (0.8 kg) and dietary supplements (0.0 kg) did not significantly improve weight-loss maintenance compared with control.
Thus, as one may have expected, adding anti-obesity drugs or continuing on (less restrictive) meal replacements were the most effective means of sustaining weight loss, whereas high-protein diets, exercise and dietary supplements were far less effective.
The message for both patients and clinicians here is clear: if you are going to go on a low-calorie diet – your best chances of actually keeping that weight of is if you go on anti-obesity medication or continue with the intermittent use of meal replacements.
All other strategies will likely result in rapid weight regain.
I’d certainly like to hear from my readers as to their experience with low-calorie diets and their success in keeping their weight off (or not).
Johansson K, Neovius M, & Hemmingsson E (2013). Effects of anti-obesity drugs, diet, and exercise on weight-loss maintenance after a very-low-calorie diet or low-calorie diet: a systematic review and meta-analysis of randomized controlled trials. The American journal of clinical nutrition PMID: 24172297