Abstract
Severely energy-restricted diets (SERDs) are an effective treatment for obesity, however, adherence to such diets is often perceived as poor by healthcare professionals. This investigation evaluated adherence to a 12-week SERD in participants with class II and III obesity. Reported food consumption was compared against individualised SERD prescriptions. Body weight measures were obtained at baseline, 12 and 52 weeks. The data were analysed in three groups (i) the entire cohort (n = 26), (ii) completers (n = 13) and (iii) non-completers (n = 13). SERD prescription elements included (i) the number of meal replacement products; (ii) total protein; (iii) total energy intake; (iv) level of dietary energy restriction; (v) vegetable serves; (vi) water serves, and (vii) how much physical activity was performed. A generalised repeated-measures mixed-effects model was used to investigate if adherence to the program elements individually, or collectively, influenced weight loss. Completers had an average (± SD) of 4549 ± 748 kJ energy intake per day, resulting in a mean energy restriction of 62% compared to the 69% prescribed, indicating a degree of non-adherence. The percent weight changes for completers and non-completers were −7.8 ± 4.7% and −1.6 ± 2.6% at 12 weeks, and −12.2 ± 12.1% and −1.8 ± 3.2% at 52 weeks, respectively. Complete dietary adherence to a SERD may not be necessary to achieve a clinically relevant weight loss of 12% at 52 weeks, if energy is restricted by at least 62% (~4600 kJ per day) relative to requirements.
Highlights
Obesity is an epidemic that affects 2.1 billion people worldwide [1]
While participants deemed completers were not adherent to all seven severely energy-restricted diet” (SERD) program elements, we have demonstrated that the greater the adherence to the prescribed SERD
Guidelines from Australia, the United States of America and other countries recommend that a 10% reduction in body weight is an appropriate weight loss target for people with class III obesity, as this is associated with decreased health risk and improved metabolic health [43,44,45,46]
Summary
Obesity is a disease that is associated with other chronic health conditions, such as cardiovascular disease [5,6], type 2 diabetes [7,8], gall bladder disease [9], kidney disease [10], obstructive sleep apnea [11], cancer [12], depression [13], infertility [14] and osteoarthritis [15]. Intentional weight loss dose-dependently reduces the risk factors associated with the development and progression of all obesity-related chronic health conditions [16,17,18,19,20]. Effective weight loss treatments that induce energy restriction are necessary to curb the burden of the disease
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
