Feasibility and indicative results from a 12-month low-energy liquid diet treatment and maintenance programme for severe obesity
Feasibility and indicative results from a 12-month low-energy liquid diet treatment and maintenance programme for severe obesity
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DOI：
10.3399/bjgp13x663073
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发表时间：
2013-02-01
影响因子：
5.9
通讯作者：
Morrison, David
中科院分区：
文献类型：
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作者：
Lean, Michael;Brosnahan, Naomi;Morrison, David
背景对于体重指数（BMI）>40 kg/m2的严重肥胖人群数量的迅速增加，目前还没有建立起初级保健解决方案。目的该计划旨在在12个月内减轻体重≥ 15 kg，在常规的初级保健中。设计和设置初级保健的可行性研究。方法BMI >= 40 kg/m2的患者开始一个富含微量营养素的810- 833千卡/天低能量流质饮食（LELD），在初级保健中提供，计划12周或20 kg体重减轻（以较早发生者为准），重新引入结构性食物，然后维持减肥，可选奥利司他至12个月。（74名女性）（基准线：体重131 kg，BMI 48 kg/m2，年龄46岁），58/91（64%）完成LELD分期，平均持续时间为14.4周（标准差[SD] = 6.0周），平均体重减轻16.9 kg（SD = 6.0 kg）。4例患者开始减肥维持省略食物再引入阶段。在其余54名受试者中，37名（68%）在开始长期低脂饮食减肥维持计划之前，在平均9.3周（SD = 5.7周）的时间内开始并完成了食物重新引入，平均体重进一步减轻2.1 kg（SD = 3.7 kg）。共有44/91（48%）在某个阶段接受奥利司他。在12个月时，记录了68/91例（75%）患者的体重，平均减轻12.4 kg（SD = 11.4 kg）。其中，30名（所有91名开始该计划的患者中的33%）在12个月时记录了体重减轻≥ 15 kg，6名（7%）体重减轻10-15 kg，11名（12%）体重减轻5-10 kg。为更广泛的实施提供这一整个计划的指示性成本将是861磅每病人进入，或2611磅每记录15公斤loss achieved.ConclusionA护理包在常规初级保健严重肥胖，包括LELD，食物再引入，和减肥维护，被广泛接受，并实现了12个月的维持体重减轻>= 15公斤的三分之一的所有患者进入该计划。
BackgroundThere is no established primary care solution for the rapidly increasing numbers of severely obese people with body mass index (BMI) >40 kg/m(2).AimThis programme aimed to generate weight losses of >= 15 kg at 12 months, within routine primary care.Design and settingFeasibility study in primary care.MethodPatients with a BMI >= 40 kg/m(2) commenced a micronutrient-replete 810-833 kcal/day low-energy liquid diet (LELD), delivered in primary care, for a planned 12 weeks or 20 kg weight loss (whichever was the sooner), with structured food reintroduction and then weight-loss maintenance, with optional orlistat to 12 months.ResultsOf 91 patients (74 females) entering the programme (baseline: weight 131 kg, BMI 48 kg/m(2), age 46 years), 58/91(64%) completed the LELD stage, with a mean duration of 14.4 weeks (standard deviation [SD] = 6.0 weeks), and a mean weight loss of 16.9 kg (SD = 6.0 kg). Four patients commenced weight-loss maintenance omitting the food-reintroduction stage. Of the remaining 54, 37(68%) started and completed food reintroduction over a mean duration of 9.3 weeks (SD = 5.7 weeks), with a further mean weight loss of 2.1 kg (SD = 3.7 kg), before starting a long-term low-fat-diet weight-loss maintenance plan. A total of 44/91 (48%) received orlistat at some stage. At 12 months, weight was recorded for 68/91 (75%) patients, with a mean loss of 12.4 kg (SD = 11.4 kg). Of these, 30 (33% of all 91 patients starting the programme) had a documented maintained weight loss of >= 15 kg at 12 months, six (7%) had a 10-15 kg loss, and 11 (12%) had a 5-10 kg loss. The indicative cost of providing this entire programme for wider implementation would be 861 pound per patient entered, or 2611 pound per documented 15 kg loss achieved.ConclusionA care package within routine primary care for severe obesity, including LELD, food reintroduction, and weight-loss maintenance, was well accepted and achieved a 12-month-maintained weight loss of >= 15 kg for one-third of all patients entering the programme.