Clinical Weight Management Program Research Articles

The Use of Electronic Health Record Data to Identify Variation in Referral, Consent, and Engagement in a Pediatric Intervention for Overweight and Obesity: A Cross-Sectional Study.

Clinical weight management programs face low participation. The authors assessed whether using electronic health record (EHR) data can identify variation in referral, consent, and engagement in a pediatric overweight and obesity (OW/OB) intervention. Using Epic EHR data collected between August 2020 and April 2021, sociodemographic and clinical diagnostic data (ie, International Classification of Disease [ICD] codes from visit and problem list [PL]) were analyzed to determine their association with referral, consent, and engagement in an OW/OB intervention. Bivariate analyses and multivariable logistic regression modeling were performed, with Bayesian inclusion criterion score used for model selection. Compared with the 581 eligible patients, referred patients were more likely to be boys (60% vs. 54%, respectively; P = 0.04) and have a higher %BMIp95 (119% vs. 112%, respectively; P < 0.01); consented patients were more likely to have a higher %BMIp95 (120% vs. 112%, respectively; P < 0.01) and speak Spanish (71% vs. 59%, respectively; P = 0.02); and engaged patients were more likely to have a higher %BMIp95 (117% vs. 112%, respectively; P = 0.03) and speak Spanish (78% vs. 59%, respectively; P < 0.01). The regression model without either ICD codes or PL diagnoses was the best fit across all outcomes, which were associated with baseline %BMIp95 and health clinic location. Neither visit nor PL diagnoses helped to identify variation in referral, consent, and engagement in a pediatric OW/OB intervention, and their role in understanding participation in such interventions remains unclear. However, additional efforts are needed to refer and engage younger girls with less extreme cases of OW/OB, and to support non-Hispanic families to consent.

The buffering effect of family support on the association between weight-based teasing and adolescent weight management outcomes.

Weight-based victimization (WBV) is associated with poor weight-related outcomes in adolescence. Family support may be one protective factor against the negative impact of WBV. The goal of this study is to examine the moderating effect of family support on the association between WBV and early weight loss for adolescents in a clinical weight management program. Parents of adolescents (N = 78) completed psychosocial measures at baseline. Objective height and weight were measured at baseline and follow-up (Visit 3). The overall model was significant (p = .02), explaining 12.76% of the variance in weight change over the first 2 months of treatment. As hypothesized, there was a significant moderating effect of family support on the association between WBV and weight change (p = .04), accounting 5.0% of the variance in weight change. Increased support from the family buffered the negative impact of WBV on early treatment outcomes for adolescents in a weight management program. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Greater Improvement in Obesity Among Children With Prediabetes in a Clinical Weight Management Program.

Background: There is a range of responses among individuals seen for medical management of their obesity. This retrospective analysis of longitudinal data considers the relationship between identified prediabetes and subsequent weight change among children (8-17 years) in a weight management clinic. Methods: Analysis included 733 patients (2687 visits in 2008-2016) with overweight and obesity (but not diabetes) whose referral laboratories included a hemoglobin A1c (HbA1c) within 90 days. Mixed-effects modeling examined the association between baseline prediabetes (serum HbA1c 5.7%-6.4%) and growth curve of percentage of the 95th percentile for BMI (%BMIp95). Random effects (individual growth curves) and fixed effects (prediabetes status, starting age and %BMIp95, sex, race/ethnicity, and linear slope and quadratic term of months since the initial visit) were modeled. Interactions between prediabetes and elapsed time estimated the influence of a recent prediabetic-range HbA1c on weight during the subsequent 12 months. Results: Mean %BMIp95 was 125.5% (SD 22.5), corresponding to severe obesity, and 35% had prediabetes. Adjusted monthly decrease in %BMIp95 was stronger for children with prediabetes compared with the peers in this clinic (slope: -0.62, standard error 0.10, p < 0.001). Conclusion: There was greater weight improvement among children with prediabetes compared with their peers with normal HbA1c.

Predictors of Weight Loss and Weight Gain in Weight Management Patients during the COVID-19 Pandemic.

Objective To examine the associations between patient struggles, health, and weight management changes during the COVID-19 pandemic. Methods 585 patients attending a publicly funded clinical weight management program responded to an electronic survey. Results Over half of the patients reported worsened overall health, mental health, physical activity, or diet during the pandemic. Approximately 30% of patients lost ≥3% of their body weight and 21% gained ≥3% of their body weight between March and July of the pandemic. Reports of social isolation was associated with increased odds for weight loss in women (OR = 2.0, 1.2–3.3), while low motivation (OR = 1.9, 1.0–3.7), depression (OR = 2.5, 1.0–6.3), and struggles with carbohydrate intake (OR = 2.1, 1.0–4.3) were associated with weight gain. Cooking more at home/eating less take out was associated with increased likelihood of weight loss (OR = 2.1, 1.1–3.9) and lower odds for weight gain (OR = 0.2, 0.1 to 0.97). Working from home was not associated with weight loss or weight gain (P > 0.6). Conclusion The COVID-19 pandemic is associated with certain factors that may facilitate weight loss and other factors that promote weight gain. Thus, depending on the patient experience during the pandemic, prevention of weight gain may be more appropriate than weight loss.

Reactions to the U.S. Preventive Services Task Force guidelines for the management of adolescent obesity: A multi-informant qualitative approach.

The U.S. Preventive Services Task Force (USPSTF) has set forth recommendations for clinicians to screen youth (6-18 years) for obesity. Those identified should be referred to comprehensive weight management programs consisting of at least 26 contact hours and focus on multiple targets of behaviour (ie, diet, physical activity, behaviour change). However, these recommendations are primarily based upon outcomes from randomized controlled trials and the feasibility of meeting these guidelines for adolescents in a clinical setting is unknown. The present study employed a multi-informant qualitative approach with adolescents, parents, and physicians, to identify and understand multiple perspectives on the feasibility and acceptability of implementing the USPSTF guidelines. In-depth interviews with seven adolescents, seven parents, and four physicians were analysed. Generally, participants viewed the guidelines positively but identified changes that may be necessary to increase the feasibility of adolescents engaging in programs that meet these guidelines. Participants also noted the importance of flexibility within programs, indicating that it would be difficult for many adolescents to participate in a program that was not tailored to their needs and resources. Future research should focus on adapting clinical weight management programs to meet both USPSTF guidelines and the needs of adolescents and their families.

An analysis of weight loss efforts and expectations in a Canadian Cohort: A retrospective medical chart review.

The weight loss history and weight loss goals were examined in 4108 patients referred to a publicly funded evidence-based clinical weight management program using a retrospective chart review. The majority of patients were white females, aged of 50.1 ± 13.7 years and a BMI of 39.0 ± 7.5 kg/m2 . Pregnancy was the most common reason for weight gain in women (17.7%) and while the reasons in men are more varied (injury, stress and medication: all ~5%). Over 50% of patients cited no specific reason for their weight gain. Self-directed diet and exercise were the most commonly used self-reported weight loss methods. Women were more likely to report using medication and bariatric surgical weight loss methods than men (P < .05), and only 5% of women and 12.8% men report never having tried to lose weight in the past. Patients had an ideal weight loss goal of 28.9% to 34.4%, which was similar to the patient's lowest reported adult weight. Approximately 70% of patients enrolling at the clinic had previously lost at least 4.5 kg (10 lb) one or more times and 16.7% lost weight at least 5 times in their life, but patient weight at enrolment was similar to their highest adult reported weight. Thus, most patients referred to this clinical weight management program have previously attempted self-directed diet and exercise weight loss. Patients were close to their highest adult weight and had very large weight loss goals, similar to what is typically achieved only by surgical intervention, despite having already had several bouts of weight loss.

Weight Change During a Clinical Weight Management Program: An Observational Cohort Study

ABSTRACT Background: The objective of this analysis was to describe weight loss results at 12 months of a clinical weight management program in which patients selected their treatment preference. Methods: 3,007 patients (mean ± SD; age = 50 ± 12 years, body mass index = 42 ± 8 kg·m−2, 80% female, 51% black) enrolled in the program at Henry Ford Hospital self-selected a 1,200 to 2,000 kcals hypocaloric, 1,000 to 1,500 kcals low calorie, or 500 to 900 kcals very low calorie meal plan. Meal plans were instructed by a dietitian and the low calorie and very low calorie meal plans incorporated the use of commercial meal replacements. Regular biweekly appointments were conducted by a clinical exercise physiologist. Program termination was at the patient's discretion. Change in body weight was analyzed at 12 months by linear mixed modeling and using the baseline observation carried forward method with repeated measure analysis of variance. Results: Average program participation was 5 months. Based on an intent-to-treat linear mixed modeling, the very low calorie group had the greatest 12-month weight loss (−13.9 ± 1.0 kg), followed by the low calorie and hypocaloric groups (−9.5 ± 0.6 and −6.0 ± 0.4 kg, respectively; P &amp;lt; 0.05 for both low calorie and hypocaloric vs very low calorie plan). The baseline observation carried forward analysis also demonstrated significant weight loss in all groups at 12 months. Conclusion: In this real-world weight management program setting of patients who self-selected a meal plan and length of participation, both very low calorie and low calorie plans resulted in more weight loss at 12 months than the hypocaloric plan.

Absolute Weight Loss, and Not Weight Loss Rate, Is Associated with Better Improvements in Metabolic Health.

Objective To determine if the rate of weight loss (WL) is associated with metabolic changes independent of the absolute WL. Methods WL and health changes were assessed in 11,281 patients attending a publicly funded clinical weight management program over a treatment period of 12.7 months. Early weight loss rate (WLR) in the first 3–6 months and overall WLR were categorized as Fast WLR (≥1 kg/wk), Recommended WLR (0.5 to 0.9 kg/wk), or Slow WLR (<0.5 kg/wk). Results On average, patients attained a 6.6 ± 7.3 kg (5.8 ± 5.7%) WL over 12.8 ± 13.1 months. Prior to adjusting for covariates, patients with Fast WLR (−24.7 ± 13.4 kg) at 3–6 months had a greater overall WL as compared to those with Recommended WLR (−13.3 ± 8.7 kg) and Slow WLR (−5.0 ± 5.4 kg). Fast WLR also had greater improvements in the overall waist circumference and blood pressure than patients with Slow or Recommended WLR. However, after adjustment for absolute WL, Early and overall Recommended and Fast WLR did not differ in the changes in any of the health markers (P > 0.05). Conversely, the absolute WL sustained is significantly associated with changes in metabolic health independent of WLR (P < 0.001). Similar results were observed with WLR over the entire treatment period. Conclusions Faster rates of WL are associated with a greater absolute WL and larger improvements in waist circumference and blood pressure. However, after adjusting for the larger absolute WL sustained, early and overall faster WLR do not appear to have advantages for improving metabolic health markers. Thus, the absolute WL attained may be the most important factor for improving metabolic health.

Tipping the scales: Provider perspectives on a multi-disciplinary approach to obesity

Obesity is a major multi-faceted, chronic disease that increases the risk of morbidity and mortality of children and adults particularly impacting high-risk populations and those of lower socioeconomic status. Given provider time constraints, models of care to effectively and efficiently address obesity in primary care are key. Although physician recommendations can exert a powerful influence on behavior, providers often feel powerless to adequately address obesity due to the complexity of physical and behavioral health problems. This mini-review focuses on describing the feasibility and evidence for tackling obesity through provider-led multidisciplinary weight management programs.

Referrals and Management Strategies for Pediatric Obesity-DocStyles Survey 2017.

Background: Childhood obesity care management options can be delivered in community-, clinic-, and hospital-settings. The referral practices of clinicians to these various settings have not previously been characterized beyond the local level. This study describes the management strategies and referral practices of clinicians caring for pediatric patients with obesity and associated clinician characteristics in a geographically diverse sample.Methods: This cross-sectional study used data from the DocStyles 2017 panel-based survey of 891 clinicians who see pediatric patients. We used multivariable logistic regression to estimate associations between the demographic and practice characteristics of clinicians and types of referrals for the purposes of pediatric weight management.Results: About half of surveyed clinicians (54%) referred <25% of their pediatric patients with obesity for the purposes of weight management. Only 15% referred most (≥75%) of their pediatric patients with obesity for weight management. Referral types included clinical referrals, behavioral referrals, and weight management program (WMP) referrals. Within these categories, the percentage referrals ranged from 19% for behavioral/mental health professionals to 72% for registered dieticians. Among the significant associations, female clinicians had higher odds of referral to community and clinical WMP; practices in the Northeast had higher odds of referral to subspecialists, dieticians, mental health professionals, and clinical WMP; and clinics having ≥15 well child visits per week were associated with higher odds of referral to subspecialists, mental health professionals, and health educators. Not having an affiliation with teaching hospitals and serving low-income patients were associated with lower odds of referral to mental health professionals, and community and clinical WMP. Compared to pediatricians, family practitioners, internists, and nurse practitioners had higher odds of providing referrals to mental health professionals and to health educators.Conclusion: This study helps characterize the current landscape of referral practices and management strategies of clinicians who care for pediatric patients with obesity. Our data provide insight into the clinician, clinical practice, and reported patient characteristics associated with childhood obesity referral types. Understanding referral patterns and management strategies may help improve care for children with obesity and their families.

Impact of Adding Resistance Training to a Clinical Weight Management Program

Impact of Adding Resistance Training to a Clinical Weight Management Program

Effects of a weight management program delivered by social media on weight and metabolic syndrome risk factors in overweight and obese adults: A randomised controlled trial.

IntroductionThe aim of this project was to evaluate the effectiveness of using social media to augment the delivery of, and provide support for, a weight management program delivered to overweight and obese individuals during a twenty four week intervention.MethodsParticipants randomly divided into either one of two intervention groups or a control group. The two intervention groups were instructed to follow identical weight-management program. One group received the program within a Facebook group, along with a support network with the group, and the other intervention group received the same program in a booklet. The control group was given standard care. Participants’ weight and other metabolic syndrome risk factors were measured at baseline and at weeks 6, 12, 18 and 24.ResultsThe Facebook Group reported a 4.8% reduction in initial weight, significant compared to the CG only (p = 0.01), as well as numerically greater improvements in body mass index, waist circumference, fat mass, lean mass, and energy intake compared to the Pamphlet Group and the Control Group.ConclusionsThese results demonstrate the potential of social media to assist overweight and obese individuals with respect to dietary and physical activity modifications for weight management, and justify further research into the inclusion of social media in clinical weight management programs. It is anticipated that social media will provide an invaluable resource for health professionals, as a low maintenance vehicle for communicating with patients, as well as a source of social support and information sharing for individuals undergoing lifestyle modifications.

Factors Associated with Attrition and Successful Weight Loss in a Clinical Weight Management Program

Factors Associated with Attrition and Successful Weight Loss in a Clinical Weight Management Program

Factors associated with participant retention in a clinical, intensive, behavioral weight management program.

BackgroundWe sought to identify factors associated with participant retention in a 2-year, physician-lead, multidisciplinary, clinical weight management program that employs meal replacements to produce weight loss and intensive behavioral interventions and financial incentives for weight loss maintenance. We studied 270 participants enrolled in 2010 and 2011. Sociodemographic factors, health insurance, distance traveled, body mass index, comorbidities, health-related quality-of-life, and depression were explored as potential predictors of retention.ResultsMean age was 49 ± 8 years and BMI was 41 ± 5 kg/m2. Retention was excellent at 3 months (90%) and 6 months (83%). Attrition was greatest after participants were transitioned to regular foodstuffs and fell to 67% at 12 months and 51% at 2 years. Weight decreased by 15 ± 12 kg and BMI decreased by 5.1 ± 4.0 kg/m2 in 2-year completers. Older age, lower baseline BMI, and financial incentives for program participation were independently associated with retention. Fewer depressive symptoms at baseline were associated with retention.ConclusionsThis multidisciplinary, clinical, weight management program demonstrated high retention and excellent outcomes. Older age at baseline, less extreme obesity, and financial incentives were associated with program retention.

Implementing the MOVE! Weight-Management Program in the Veterans Health Administration, 2007-2010: A Qualitative Study

One-third of US veterans receiving care at Veterans Health Administration (VHA) medical facilities are obese and, therefore, at higher risk for developing multiple chronic diseases. To address this problem, the VHA designed and nationally disseminated an evidence-based weight-management program (MOVE!). The objective of this study was to examine the organizational factors that aided or inhibited the implementation of MOVE! in 10 VHA medical facilities. Using a multiple, holistic case study design, we conducted 68 interviews with medical center program coordinators, physicians formally appointed as program champions, managers directly responsible for overseeing the program, clinicians from the program's multidisciplinary team, and primary care physicians identified by program coordinators as local opinion leaders. Qualitative data analysis involved coding, memorandum writing, and construction of data displays. Organizational readiness for change and having an innovation champion were most consistently the 2 factors associated with MOVE! implementation. Other organizational factors, such as management support and resource availability, were barriers to implementation or exerted mixed effects on implementation. Barriers did not prevent facilities from implementing MOVE! However, they were obstacles that had to be overcome, worked around, or accepted as limits on the program's scope or scale. Policy-directed implementation of clinical weight-management programs in health care facilities is challenging, especially when no new resources are available. Instituting powerful, mutually reinforcing organizational policies and practices may be necessary for consistent, high-quality implementation.

Estimating changes in free-living energy intake and its confidence interval

Free-living energy intake in humans is notoriously difficult to measure but is required to properly assess outpatient weight-control interventions. Our objective was to develop a simple methodology that uses longitudinal body weight measurements to estimate changes in energy intake and its 95% CI in individual subjects. We showed how an energy balance equation with 2 parameters can be derived from any mathematical model of human metabolism. We solved the energy balance equation for changes in free-living energy intake as a function of body weight and its rate of change. We tested the predicted changes in energy intake by using weight-loss data from controlled inpatient feeding studies as well as simulated free-living data from a group of "virtual study subjects" that included realistic fluctuations in body water and day-to-day variations in energy intake. Our method accurately predicted individual energy intake changes with the use of weight-loss data from controlled inpatient feeding experiments. By applying the method to our simulated free-living virtual study subjects, we showed that daily weight measurements over periods >28 d were required to obtain accurate estimates of energy intake change with a 95% CI of <300 kcal/d. These estimates were relatively insensitive to initial body composition or physical activity level. Frequent measurements of body weight over extended time periods are required to precisely estimate changes in energy intake in free-living individuals. Such measurements are feasible, relatively inexpensive, and can be used to estimate diet adherence during clinical weight-management programs.

Weight Loss in a Clinical Weight Loss Program Offering Traditional and Aggressive Meal Plan Options

Few reports exist of weight loss in clinical programs offering increasingly aggressive meal plans. Weight management programs (WMP) that can provide efficacious care to large segments of the population are needed. PURPOSE: Describe differences in weight change at 3, 6 and 12 months after self-selection of a meal plan and participation in a clinical WMP. METHODS:A retrospective analysis was performed using prospectively collected longitudinal data of a cohort who participated in a clinical WMP (age= 49 ± 12 years, mean body mass index= 42 ± 8 kg·m-2, weight= 117 ± 26 kg, 80% female, 53% black). Following self-selection of one of three meal plan options [Hypocaloric (HC), Partial (PM) or Complete Meal (CM) Replacement], patients began the program at a visit with a registered dietitian to implement their meal plan. They then met with a clinical exercise physiologist every 2- 4 weeks for counseling which included discussion about their meal plan, exercise routine and associated behaviors. Data collection occurred at program entry, during routine counseling appointments and at physician visits between January 2004 and January 2007. Intent-to-treat analysis and linear mixed modeling were used for data analysis. RESULTS:Data was available for analysis in 2,316 patients. Weight loss results and meal plan comparisons are shown in the figure. Higher visit attendance was associated with a 3-5 fold increase in weight loss at 12-months.FigureCONCLUSION: Among patients who enrolled in a clinical WMP, those who self-selected a Complete or Partial Meal Replacement plan lost more weight at 3, 6 and 12 months than those selecting a Hypocaloric plan. And the Complete Meal Replacement plan was more effective at each time point than the Partial Meal Replacement plan.

Clinical Pediatric Weight Management Physical Activity Program Results In Decreased Cvd Risk Factors

PURPOSE: Assessment of exercise/physical activity tolerance and indirect assessment of aerobic fitness in obese children and adolescents is necessary to improve interventions that will result in long-term, successful participation and evaluate the effectiveness of the intervention. 216 youth 58% females (F) and 51% African-Americans (AA) who were enrolled in a clinical weight management program were examined to determine changes in a 400m walk test, BMI and lipid levels before and after participation in a clinical, pediatric weight management program. METHODS: A 400m walk test was preformed as part of a clinical initial assessment and again following completion of Phase I of the weight management program. At each assessment, participants were instructed to briskly walk the measured corridor. Walk time (WT), pre-WT and post-WT HR and BP, fasting lipids, glucose, insulin and BMI was assessed at each assessment. RESULTS: Repeated measures ANOVA revealed a significant decrease in WT before & following the intervention (pretest WT = 333.5(31.6) vs posttest WT = 315.9(29.9); p<0.0001). The average length of the intervention program was 279(199) days (F=276(204), M=283(193); AA=301(206), C=253(174); NS for gender & race). There were no significant changes in BMI (pre=34.6(7.9) - post=35.2(14.1) following the intervention. However, WT (p<0.005) & BMI (p<0.02) was significantly greater prior to the intervention for AA, but change in WT & BMI was not significantly different by gender or race. Additionally, age was not associated with either the change in WT or BMI. Total cholesterol (pre=162.1(32.0) - post=156.4(31.0); p<0.001), LDL (104.8(64.5) - 96.9(27.6); p<0.09), Triglycerides (92.7(59.4) - 80.8(43.8); p<0.005) and insulin (28.4(21.8) - 23.8(13.8); p<0.005) were significantly and positively changed as a function of the intervention; only insulin was significantly greater as a function of race (AA>C) prior to the intervention (p<0.05). CONCLUSIONS: This clinical weight management intervention results in favorable changes in aerobic fitness, fasting lipids and insulin levels without a decrease in BMI. Also, the 400m walk test is a sensitive and appropriate approach for field testing populations with low exercise tolerance such as obese adolescents in a clinical setting.

400m Walk Test for Obese Children and Adolescents Participating in a Clinical Weight Management Program

PURPOSE: Clinical assessment of exercise/physical activity tolerance and indirect assessment of aerobic fitness in obese children and adolescents are necessary to improve the development of exercise/physical activity interventions that will result in long-term, successful participation and help evaluate the effectiveness of the intervention. Initial data on 619 children and adolescents enrolled in a clinical weight management program were examined to provide the basis for establishing baseline information on a 400 meter walk test administered in a clinical setting. METHODS: At the initial assessment visit biographical and anthropometric measures were taken; BMI, BMI percentile for age and sex, and BMIz score was calculated. Walk Time in seconds (WTS) was measured and Walk Speed (m/min & mph), and the change in heart rate (Polar HR Telemetry) from pretest baseline to immediately following completion of a measured and standardized 400 m walk test (DHR) was calculated. Subjects were placed in one of three age categories; 1 = <10yrs (28.6%); 2 = 10 - 14 yrs (42.3%); 3 = >14 yrs (29.1%). This sample was comprised of 59.6% females (F) and 47.3% African-Americans (AA). RESULTS: GLM procedures with a priori planned comparisons revealed no differences in WTS, m/min, mph, and DHR between age categories, sex, and race. BMIz was greater in males and AA and age categories (1 < 2 > 3). CONCLUSIONS: Regardless of age category, sex, or race walk time and walk speed are similar when obese youth first perform a 400 m walk test in a clinical setting. These data can be used to establish normative information for clinicians working with obese youth.

Comparison of a low carbohydrate and low fat diet for weight maintenance in overweight or obese adults enrolled in a clinical weight management program

BackgroundRecent evidence suggests that a low carbohydrate (LC) diet may be equally or more effective for short-term weight loss than a traditional low fat (LF) diet; however, less is known about how they compare for weight maintenance. The purpose of this study was to compare body weight (BW) for participants in a clinical weight management program, consuming a LC or LF weight maintenance diet for 6 months following weight loss.MethodsFifty-five (29 low carbohydrate diet; 26 low fat diet) overweight/obese middle-aged adults completed a 9 month weight management program that included instruction for behavior, physical activity (PA), and nutrition. For 3 months all participants consumed an identical liquid diet (2177 kJ/day) followed by 1 month of re-feeding with solid foods either low in carbohydrate or low in fat. For the remaining 5 months, participants were prescribed a meal plan low in dietary carbohydrate (~20%) or fat (~30%). BW and carbohydrate or fat grams were collected at each group meeting. Energy and macronutrient intake were assessed at baseline, 3, 6, and 9 months.ResultsThe LC group increased BW from 89.2 ± 14.4 kg at 3 months to 89.3 ± 16.1 kg at 9 months (P = 0.84). The LF group decreased BW from 86.3 ± 12.0 kg at 3 months to 86.0 ± 14.0 kg at 9 months (P = 0.96). BW was not different between groups during weight maintenance (P = 0.87). Fifty-five percent (16/29) and 50% (13/26) of participants for the LC and LF groups, respectively, continued to decrease their body weight during weight maintenance.ConclusionFollowing a 3 month liquid diet, the LC and LF diet groups were equally effective for BW maintenance over 6 months; however, there was significant variation in weight change within each group.