Abstract
About half of Australian women have a body mass index in the overweight or obese range at the start of pregnancy, with serious consequences including preterm birth, gestational hypertension and diabetes, caesarean section, stillbirth, and childhood obesity. Trials to limit weight gain during pregnancy have had limited success and reducing weight before pregnancy has greater potential to improve outcomes. The PreBabe Pilot study was a randomised controlled pilot trial to assess the feasibility, acceptability and potential weight loss achieved using a commercial online partial meal replacement program, (MR) vs. telephone-based conventional dietary advice, (DA) for pre-conception weight-loss over a 10-week period. Women 18–40 years of age with a BMI ≥ 25 kg/m2 planning pregnancy within the next 6 to 12 months were included in the study. All participants had three clinic visits with a dietitian and one obstetric consultation. In total, 50 women were enrolled in the study between June 2018 and October 2019–26 in MR and 24 in DA. Study retention at the end of 10 week intervention 81% in the MR arm and 75% in the DA arm. In the-intention-to-treat analysis, women using meal replacements lost on average 5.4 ± 3.1% body weight compared to 2.3 ± 4.2% for women receiving conventional advice (p = 0.029). Over 80% of women in the MR arm rated the support received as excellent, compared to 39% in the DA arm (p < 0.001). Women assigned to the MR intervention were more likely to achieve pregnancy within 12 months of the 10 week intervention (57% (12 of 21) women assigned to MR intervention vs. 22% (4 of 18) assigned to the DA group (p = 0.049) became pregnant). The findings suggest that a weight loss intervention using meal replacements in the preconception period was acceptable and may result in greater weight loss than conventional dietary advice alone.
Highlights
Australia is one of the most overweight developed nations, with two-thirds of adults and a quarter of children having overweight or obesity [1]
This government-sponsored service is a freely. This government-sponsored service is a freely availavailable one-on-one weight loss program with telephone support delivered by a health able one-on-one weight loss program with telephone support delivered by a health coach
The findings will inform a larger pragmatic trial designed to assess the effect of weight loss preconception on clinical, maternal and newborn outcomes
Summary
Replacement Preconception Weight Loss Program for Women with Overweight and Obesity. Roslyn Muirhead 1 , Nathalie Kizirian 2 , Ravin Lal 2 , Kirsten Black 3,4 , Ann Prys-Davies 4 , Natasha Nassar 5 , Louise Baur 5 , Amanda Sainsbury 6 , Arianne Sweeting 7,8,9 , Tania Markovic 7,8,9 , Michael Skilton 7,8,9 , Jon Hyett 10 , Bradley de Vries , William Tarnow-Mordi , Jennie Brand-Miller 1 and Adrienne Gordon 3,12,13,14, *,† on behalf of the PreBabe Investigator Team. Preconception Weight Loss Program for Women with Overweight and Obesity. Charles Perkins Centre, Boden Initiative, The University of Sydney, NSW 2006, Australia. Sydney Medical School, Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia. Sydney Institute for Women, Children and their Families, Sydney Local Health District, Sydney, NSW 2000, Australia.
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