Mixed
Combining a very-low-energy diet (VLED) with behavior therapy (BT) produces significantly greater 5-year weight maintenance than behavior therapy alone in morbidly obese patients, particularly men.
For morbid obesity, combining a short, strict very-low-energy diet (approx. 500 kcal) with behavioral therapy leads to significantly better long-term weight loss (5 years) than behavioral therapy alone. This is especially true for men. While dropout rates are higher with the diet, those who stick with it see much better results. You do not necessarily need a separate maintenance program if the initial behavioral training is robust.
Our data suggest that in the treatment of morbid obesity, VLED combined with BT may produce a better 5-year maintenance than BT alone, especially among men.
Why this rating
Randomized controlled trial with 5-year follow-up, but small sample size (n=59) and high dropout rate in the intervention group.
Source
Comparison of Behavior Therapy With and Without Very-Low-Energy Diet in the Treatment of Morbid Obesity
Tuula Pekkarinen · Archives of Internal Medicine · 1997
DOI 10.1001/archinte.1997.00440350089009
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