Improving maintenance of lost weight following a commercial liquid meal replacement program: A preliminary study

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Clinic-based liquid meal replacement (800kcals/day) programs produce substantial weight loss. Nevertheless, long-term maintenance remains a challenge. A limitation of maintenance programs is that they continue to promote large behavior changes that are initially required to induce weight loss which may be unsustainable long-term. The study aims were to conduct a preliminary assessment of the feasibility, acceptability, and effectiveness of a small changes maintenance intervention (SCM) for 30 patients who completed liquid meal replacement program (LMR). The 20-session SCM delivered over 52weeks offered no preset goals for maintenance behaviors and all changes in behavior were self-selected. Participants had a median BMI of 40.9kg/m2 and weight of 111kg at the start of LMR. At LMR completion, they lost 18% (21kg) of body weight. The SCM was completed by 22 patients (73%); 19 completers (86%) attended≥17 of 20 sessions with a median satisfaction rating of 9 (on a scale of 1 to 9). Completers were asked to record self-selected maintenance behaviors daily (median 351days recorded). The most commonly reported daily behaviors were self-weighing, use of meal replacements and step counting. Median percent regain at week 52 was 14% (2.8kg) of lost weight (range, −42 to 74%), significantly less than a median of 56% (11kg) percent regain of lost weight (range, −78 to 110%) in a demographically similar historical control group with no maintenance intervention after LMR completion (P<0.001). Thus, SCM holds promise for improving weight maintenance. Future research should compare SCM to standard maintenance programs that promote large program-directed changes.