国际标准期刊号: 2165-7904

肥胖与减肥治疗杂志

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The Effectiveness of a Partial Meal Replacement Program in Extremely Obese Individuals: A Systematic Retrospective Chart Review of Medifast Weight Control Centers

Jessica R. Kiel, Christopher D. Coleman, Andrea H. Mitola, Janice S. Langford, Kevin N. Davis, Linda M. Arterburn

Background: Extreme obesity is associated with elevated risks of morbidities and mortality, and the prevalence of this condition has been rising. Lifestyle interventions are the cornerstone of all treatment options, yet relatively few studies have assessed the effectiveness of commercial programs for attaining clinically meaningful weight loss (≥ 5%) in this population. The purpose of this study was to evaluate the effectiveness of the Medifast 5 & 2 & 2 Plan™ administered along with counseling in obese adults, a majority of whom were extremely obese. Methods: We conducted a systematic retrospective chart review of 62 obese clients from 17 Medifast Weight Control Centers® (MWCCs). Weight, body composition and cardiometabolic risk factor data were abstracted through 24 weeks. Data were recorded electronically, and key data points were independently verified. The primary endpoint was change from baseline body weight at 12 weeks, assessed using Wilcoxon signed rank tests. Results: The population consisted of 57% men, and 82% had a body mass index of ≥ 40 kg/m2. Mean body weight among completers was reduced by 12.9±7.1 kg (-8.6%, n=37) at the 12-week primary endpoint and by 19.3 ± 11.4 kg (12.5%, n=17) at 24 weeks (p<0.0001). At 12 and 24 weeks, 76% and 88% of those remaining on the plan, respectively, had lost ≥ 5% of their baseline body weight. Fat mass accounted for a majority (68-80%) of the weight lost, resulting in improvements in body composition. Significant improvements in blood pressure and central adiposity were also observed. Program adherence was >80%, and the meal plan was well-tolerated. Conclusions: The 5 & 2 & 2 Plan used at MWCCs was effective for achieving clinically meaningful weight loss and improving cardiometabolic risk factors in a population of extremely obese individuals. This lifestyle program represents a viable first line approach for meeting treatment goals in extremely obese adults. #NCT0215083.