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Dietary treatments of obesity

Published online by Cambridge University Press:  28 February 2007

Mary Moloney
Mary Moloney
Affiliation:
School of Biological Sciences, Dublin Institute of Technology, Kevin Street, Dublin 8, Republic of Ireland
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Abstract

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Numerous dietary treatments that purport to promote something unique for stimulating weight loss have been published. These treatments include fad diets, diets formulated by various commercial slimming clubs, very-low-energy diets (VLCD) and conventional diets. Fad diets may possibly reduce some weight short-term; however, there is no scientific basis to their long-term use. Commercial slimming clubs may be suitable for some individuals but they need to be properly assessed professionally. There are specific guidelines for the use of VLCD, which are only appropriate for short-term use. There is scientific evidence to suggest that conventional diets can produce both short- and long-term weight loss. A successful weight-loss programme depends on a multidisciplinary team approach. Management strategies should be devised for addressing issues such as goals, monitoring, follow-up, relapse and evaluation. Initial assessments should include medical, laboratory and anthropometric data, fitness level and dietary and behavioural attitudes. These results will form the basis of the treatment plan. Frequent visits to the clinic are fundamental in promoting continuing weight loss during the long-term maintenance stage of treatment. The visits should be made worthwhile for the patient. Realistic and attainable goals for diet, exercise and behaviour modification should be made. The diet should have a novel approach and be tailored to the needs of the patient. It should be adequate nutritionally, low in energy and fat. The overall aim should be to promote lifelong changes in lifestyle, improvement in quality of life and health risks.

Keywords

Conventional dietAssessments in obesityAttainable weight goalsLong-term weight maintenance
Type
Symposium on ‘Obesity: genes, drugs and dietary treatment’
Information
Proceedings of the Nutrition Society , Volume 59 , Issue 4 , November 2000 , pp. 601 - 608
Copyright
Copyright © The Nutrition Society 2000

References

Aronne, LJ (1998) Obesity. Medical Clinics of North America 82, 161–181.CrossRefGoogle ScholarPubMed
Astrup, A, Ryan, L, Grunwald, GK, Storgaard, M, Saris, W, Melanson, E & Hill, JO (2000) The role of dietary fat in body fatness: evidence from a preliminary meta-analysis of ad-libitum low-fat dietary intervention studies. British Journal of Nutrition 83, S25–S32.CrossRefGoogle ScholarPubMed
Atkins, RL (1998) Dr Atkin's New Diet Revolution. Kent, WA: Avon Books.Google Scholar
Atkinson, RL (1993) Proposed standards for judging the success of the treatment of obesity. Annals of Internal Medicine 119, 677–680.CrossRefGoogle ScholarPubMed
Avenall, A, Richmond, PR, Lean, ME & Reid, DM (1994) Bone loss associated with a high fibre weight reduction diet in post-menopausal women. European Journal of Clinical Nutrition 48, 561–566.Google Scholar
Bennett, WI (1995) Beyond overeating. New England Journal of Medicine 332, 672–674.CrossRefGoogle ScholarPubMed
Bray, GA (1985) Complications of obesity. Annals of Internal Medicine 103, 1052–1062.CrossRefGoogle ScholarPubMed
Bray, GA & Popkin, BM (1998) Dietary fat intake does affect obesity. American Journal of Clinical Nutrition 68, 1157–1173.CrossRefGoogle ScholarPubMed
Brownell, KD & Jeffrey, RW (1987) Improving long-term weight loss. Pushing the limits of treatment. Behaviour Therapy 18, 353–374.CrossRefGoogle Scholar
Brownell, KD & Kramer, FM (1994) Behavioural management of obesity. In Obesity: Pathophysiology, Psychology and Treatment, pp. 231–252. [Blackburn, GL and Kanders, BS, editors]. London: Chapman and Hall.Google Scholar
Brownell, KD & Wadden, TA (1991) The heterogenicity of obesity: Fitting treatments to individuals. Behavioural Therapy 22, 153.CrossRefGoogle Scholar
Brownell, P & Rodin, J (1994) Medical, metabolic and psychological effects of weight cycling. Archives of Internal Medicine 154, 1325–1330.CrossRefGoogle ScholarPubMed
Bruce, B & Wilfey, D (1996) Binge eating among the overweight population: a serious and prevalent problem. Journal of the American Dietetic Association 96, 58–61.CrossRefGoogle ScholarPubMed
Buchowski, MS & Sun, M (1996) Energy expenditure, television viewing and obesity. International Journal of Obesity 20, 236–244.Google ScholarPubMed
Byson, JM, King, SE, Burns, CM, Baur, LA, Swaraj, S & Caterson, ID (1996) Changes in glucose and lipid metabolism following weight loss produced by a very low calorie diet in obese subjects. International Journal of Obesity 20, 338–345.Google Scholar
Cade, J & O'Connell, S (1991) Management of weight problems and obesity: knowledge, attitudes and current practice of general practitioners. British Journal of General Practice 41, 147–150.Google ScholarPubMed
Council on Scientific Affairs (1988) Treatment of obesity in adults. Journal of the American Medical Association 260, 2547–2551.CrossRefGoogle Scholar
Croft, J, Keenan, NL, Sheridan, DP, Wheeler, FC & Speers, MA (1995) Waist-to-hip ratio in a biracial population: measurement, implications and cautions for using guidelines to define high risk for cardiovascular disease. Journal of the American Dietetic Association 95, 60–64.CrossRefGoogle Scholar
Department of Health and Human Services (1996). Physical Activity and Health. A Report of the Surgeon General (Executive Summary). Pittsburgh, PA: Superintendent of Documents.Google Scholar
Department of Health and Social Security (1987). The Use of VLCD's Report on Health and Social Subjects no 31. London: H.M. Stationery Office.Google Scholar
Eliahou, HE, Laufer, J, Blau, A & Shulman, L (1992) Effect of very-low-calorie diets on the sympathetic nervous system, body weight and plasma insulin in overweight hypertension. American Journal of Clinical Nutrition 119, 1029–1035.Google Scholar
Englyst, KN, Englyst, HN, Hudson, GJ, Cole, TJ & Cumming, JH (1999) Rapidly available glucose in foods: an in vitro measurement that reflects the glycemic response. American Journal of Clinical Nutrition 69, 448–454.CrossRefGoogle Scholar
Finer, N (1998) Clinical assessment, investigation and principles of management: realistic weight goals. In Clinical Obesity, pp. 350–376 [Kopelman, PG and Stock, MJ, editors]. London: Blackwell Science.Google Scholar
Fisler, JS (1992) Cardiac effects of starvation and semi-starvation diets: safety and mechanisms of action. American Journal of Clinical Nutrition 56, 230S–234S.CrossRefGoogle Scholar
Fletcher, GF, Balady, G, Blair, SN, Blumenthal, J, Caspersen, C, Chaitman, B, Epstein, S, Sivarajan Froelicher, ES, Froelicher, VF, Pina, IL & Pollack, ML (1996) Statement on exercise: benefits and recommendations for physical activity programs for all Americans. Circulation 94, 857–862.CrossRefGoogle ScholarPubMed
Food and Agricultural Organization/World Health Organization (1998). Carbohydrates in Nutrition Report of a Joint FAO/WHO Expert Consultation. FAO Food Nutrition paper no. 66. Rome: FAO.Google Scholar
Food and Agriculture Organization/World Health Organization/United Nations University (1985). Energy and Protein Requirements. WHO Technical Report Series no. 724. Geneva: WHO.Google Scholar
Food and Nutrition Board, Institute of Medicine, National Academy of Sciences (1995) Committee to develop criteria for evaluating the outcomes to the approaches to prevent and treat obesity. Journal of the American Dietetic Association 95, 96–105.Google Scholar
Foreyt, JP & Goodrick, GK (1994) Promoting long-term weight maintenance. In Obesity: Pathophysiology, Psychology and Treatment, pp. 300–311 [Blackburn, GL and Kanders, BS, editors\. London: Chapman and Hall.Google Scholar
Foster-Powell, K & Brand-Miller, CJ (1995) International tables of glycemic index. American Journal of Clinical Nutrition 62, 871S–893S.CrossRefGoogle ScholarPubMed
Frost, G, Leeds, AA, Dore, CJ, Madeiros, S, Branding, S & Dornhorst, A (1999) Glycaemic index as a determinant of serum HDL-cholesterol concentration. Lancet 353, 1045–1048.CrossRefGoogle ScholarPubMed
Frost, G, Masters, K, King, C, Kelly, M, Hasan, U, Heavens, P, White, R & Stanford, J (1991) A new method of energy prescription to improve weight loss. Journal of Human Nutrition and Dietetics 4, 369–373.CrossRefGoogle Scholar
Garrow, JS & Summerbell, CD (1995) Meta-analysis: effect of exercise, with or without dieting, on body composition of overweight subjects. European Journal of Clinical Nutrition 49, 1–10.Google ScholarPubMed
Gibney, M, Sigman-Grant, M, Stanton, J & Keast, D (1995) Consumption of sugars. American Journal of Clinical Nutrition 62, Suppl., 178S–194S.CrossRefGoogle ScholarPubMed
Goldstein, DJ (1992) Beneficial health effects of modest weight loss. International Journal of Obesity 16, 397–415.Google ScholarPubMed
Hakala, P (1994) Weight reduction programmes at a rehabilitation centre and a health centre based on group counselling and individual support: short- and long-term follow-up study. International Journal of Obesity 18, 483–489.Google Scholar
Hauner, H, Stangl, K, Schmatz, C, Burger, K, Blomer, H & Pfeiffer, EF (1990) Body fat distribution in men with angiographically confirmed coronary artery disease. Atherosclerosis 85, 203–210.CrossRefGoogle ScholarPubMed
Heitmann, BL & Lissner, L (1995) Dietary under-reporting by obese individuals. Is it specific or non-specific? British Medical Journal 311, 986–989.CrossRefGoogle ScholarPubMed
Holt, S, Brand-Miller, JC, Saveny, C & Hansky, J (1994) Glycemic index, satiety and the cholecystokinin response. American Journal of Clinical Nutrition 59, 787S.CrossRefGoogle Scholar
Institute of European Food Studies (1998) A Pan EU Survey on Consumer Attitudes to Physical Activity, Body Weight and Health. Luxembourg: Directorate General, European Union.Google Scholar
James, WP (1995) A public health approach to the problem of obesity. International Journal of Obesity 19, Suppl. 3, S37–S45.Google Scholar
Jarvi, A, Karlstrom, B, Granfeldt, Y, Bjorck, I, Asp, N-G, & Vessby, B (1999) Improved glycaemic control and lipid profile and normalised fibrinolytic activity on a low glycaemic index in type 2 diabetic patients. Diabetes Care 22, 10–18.CrossRefGoogle ScholarPubMed
Jebb, SA & Goldberg, GR (1998) Efficacy of very low energy diets and meal replacements in the treatment of obesity. Journal of Human Nutrition and Dietetics 11, 219–225.CrossRefGoogle Scholar
Jenkins, DJA, Wolever, TMS, Buckley, G, Lam, KY, Giudici, S, Kalmusky, J, Jenkins, AL, Patten, RL, Bird, J, Wong, GS & Josse, RG (1988) Low glycemic index starchy foods in the diabetic diet. American Journal of Clinical Nutrition 48, 248–254.CrossRefGoogle ScholarPubMed
Jenkins, DJA, Wolever, TMS & Jenkins, AL (1983) The glycemic index of foods tested in diabetic patients: a new basis for carbohydrate exchange favouring the use of legumes. Diabetologia 24, 257–264.CrossRefGoogle ScholarPubMed
Jenkins, DJA, Wolever, TMS, Kalmusky, J & Jenkins, AL (1987) Low glycemic index diet in hyperlipidaemia: use of traditional starchy foods. American Journal of Clinical Nutrition 46, 66–77.CrossRefGoogle ScholarPubMed
Klem, ML, Wing, RR, McGuire, MT, Seagle, H & Hill, JO (1997) A descriptive study of individuals successful at long-term maintenance of substantial weight loss. American Journal of Clinical Nutrition 66, 239–246.CrossRefGoogle ScholarPubMed
Kron, TV (1996) The cabbage diet. http://www.kron.com/nc4/use/ stories/cabbage.htmlGoogle Scholar
Krotkiewski, M, Bjorntorp, P, Sjostrom, L & Smith, U (1983) Impact of obesity on metabolism in men and women. Journal of Clinical Investigations 72, 1150–1162.CrossRefGoogle ScholarPubMed
Kuczmarski, RJ, Flegal, KM, Campbell, SM & Johnson, CL (1994) Increasing prevalence of overweight among US adults: The National Health and Nutrition Examination surveys, 1960–1991. Journal of the American Medical Association 272, 205–211.CrossRefGoogle Scholar
Langlois, JA, Harris, T, Looker, AC & Madans, J (1996) Weight change between age 50 years and old age is associated with risk of hip fracture in white women aged 67 years and older. Archives of Internal Medicine 156, 989–994.CrossRefGoogle ScholarPubMed
Lapidus, L, Bengtsson, C, Larsson, B, Pennert, I, Rybo, E & Sjostrom, L (1984) Distribution of adipose tissue and risk of cardiovascular disease and death: A 12 year follow-up of participants in the population study of women in Gothenburg, Sweden. British Medical Journal 289, 1257–1261.CrossRefGoogle Scholar
Larsson, B, Svardsudd, K, Welin, L, Wilhelmsen, L, Bjorntorp, P & Tibblin, G (1984) Abdominal adipose tissue distribution, obesity and risk of cardiovascular disease and death: 13 year follow-up of participants in the study of men born in 1913. British Medical Journal 288, 1401–1404.CrossRefGoogle Scholar
Lavery, MA & Loewy, JW (1993) Identifying predictive variables for long-term weight change after participation in a weight loss program. Journal of the American Dietetic Association 93, 1017–1024.CrossRefGoogle Scholar
Lean, MEJ, Han, TS & Morrison, CE (1995) Waist circumference as a measure for indicating need for weight management. British Medical Journal 311, 158–161.CrossRefGoogle ScholarPubMed
Lean, MEJ & James, WPT (1986) Prescription of diabetic diets in the 1980's. Lancet i, 723–725.CrossRefGoogle Scholar
Lean, MEJ, Powrioge, JK, Anderson, AS & Garthwaite, PH (1990) Obesity, weight loss and prognosis in type 2 diabetes. Diabetic Medicine 7, 228–233.CrossRefGoogle ScholarPubMed
Leathwood, P & Pollet, P (1988) Effects of slow release carbohydrates in the form of bean flakes on the evolution of hunger and satiety in man. Appetite 10, 1–11.CrossRefGoogle ScholarPubMed
Lee, CD, Blair, SN & Jackson, AS (1999) Cardiorespiratory fitness, body composition and all cause and cardiovascular disease mortality in men. American Journal of Clinical Nutrition 69, 373–380.CrossRefGoogle ScholarPubMed
Lissner, L, Heitmann, BL & Bengtsson, C (2000) Population studies of diet and obesity. British Journal of Nutrition 83, S21–S24.CrossRefGoogle ScholarPubMed
Ludwig, DS, Majzoub, JA, Al-Zahrani, A, Dallal, GE, Blanco, I & Roberts, SB (1999) High glycemic index foods, overeating and obesity. Pediatrics 103, e26–e35.CrossRefGoogle ScholarPubMed
Marsden, K (1993) The Food Combining Diet. London: Thorsons.Google Scholar
Miller, WC, Koceja, DM & Hamilton, EJ (1997) A meta-analysis of the past 25 years of weight loss research using diet, exercise or diet plus exercise intervention. International Journal of Obesity 21, 941–947.CrossRefGoogle ScholarPubMed
Morris, KL & Zemel, MB (1999) Glycaemic index, cardiovascular disease and obesity. Nutrition Reviews 57, 273–276.CrossRefGoogle ScholarPubMed
National Institutes of Health, National Heart, Lung and Blood Institute and the North American Association for the Study of Obesity (1998) Clinical guidelines on the identification, evaluation and treatment of overweight and obesity in adults – The evidence report Obesity Research 6, Suppl. 2, 51S–209S.Google Scholar
National Task Force on the Prevention and Treatment of Obesity (1993) Very low calorie diets. Journal of the American Medical Association 270, 967–974.CrossRefGoogle Scholar
National Task Force on the Prevention and Treatment of Obesity (1994) Weight cycling. Journal of the American Medical Association 272, 1196–1202.CrossRefGoogle Scholar
Nonas, CA (1998) A model for chronic care of obesity through dietary treatment. Journal of the American Dietetic Association 98, Suppl. 2, S16–S22.CrossRefGoogle Scholar
O'Neil, PM & Jarrell, MP (1992) Psychological aspects of obesity and dieting. In Treatment of the Seriously Obese Patient, pp. 252–271 [Wadden, TA and Van Itallie, TB, editors]. New York: Guildford Press.Google Scholar
Parenti, M, Babini, AC, Cacchetto, ME, Bartolo, P, Luchi, A, Saretts, B, Motta, R, Sorrenti, G, Melchionda, N & Barbara, L (1992) Lipid, lipoprotein and apolipoprotein assessment during an eight week very low calorie diet. American Journal of Clinical Nutrition 56, 268S–270S.CrossRefGoogle Scholar
Pi-Sunyer, FX (1991) Health implications of obesity. American Journal of Clinical Nutrition 53, 1595S.CrossRefGoogle ScholarPubMed
Pi-Sunyer, FX (1992) The role of very low calorie diets in obesity. American Journal of Clinical Nutrition 56, 240S–243S.CrossRefGoogle ScholarPubMed
Pi-Sunyer, FX (1993) Medical hazards of obesity. Annals of Internal Medicine 199, 655–660.CrossRefGoogle Scholar
Pollock, ML, Wilmore, JH & Fox, SM (1984) Exercise in Health and Disease, pp. 244–269. Philadelphia, PA: WB Saunders.Google Scholar
Poppitt, SD, Swann, D, Black, AE & Prentice, AM (1998) Assessment of selective under-reporting of food intake by both obese and non-obese women in a metabolic facility. International Journal of Obesity 22, 303–311.CrossRefGoogle Scholar
Pouiliot, MC, Despres, JP, Lemieux, SL, Moorjani, S, Bouchard, S, Trembley, A, Nadeau, A & Lupien, PJ (1994) Waist circumference and abdominal sagittal diameter: best simple anthropometric indexes of abdominal visceral adipose tissue accumulation and related cardiovascular disease risk in men and women. American Journal of Cardiology 73, 460–468.CrossRefGoogle Scholar
Prentice, AM (1995) Alcohol and obesity. International Journal of Obesity 19, Suppl. 5, S44–S50.Google ScholarPubMed
Prentice, AM & Jebb, SA (1995) Obesity in Britain: gluttony or sloth? British Medical Journal 311, 437–439.CrossRefGoogle ScholarPubMed
Prentice, AM, Jebb, SA, Goldberg, GR, Coward, WA, Murgatroyd, PR, Poppitt, SD & Cole, TJ (1992) Effects of weight cycling on body composition. American Journal of Clinical Nutrition 56, 209S–216S.CrossRefGoogle ScholarPubMed
Rabast, U (1994) Dietary fibre in the treatment of obesity. In Obesity in Europe 1993, pp. 279–283 [Ditschuneit, H, Gries, FA and Hauner, H, editors]. London: John Libbey and Co.Google Scholar
Saltzman, E (1999) The low glycaemic index diet: not yet ready for prime time. Nutrition Reviews 9, 297.Google Scholar
Scottish Intercollegiate Guidelines Network (1996). Obesity in Scotland: Integrating Prevention with Weight Management. Edinburgh: Royal College of Physicians.Google Scholar
Sears, B (2000) A Week in the Zone. ReganBooks. http://www. zoneperfect.com/Google Scholar
Seidell, JC (1997) Time trends in obesity: an epidemiological perspective. Hormone and Metabolic Research 29, 155–158.CrossRefGoogle ScholarPubMed
Shah, M, McGovern, P, French, S & Baxter, J (1994) Comparison of a low fat, ad libitum complex carbohydrate diet with a low-energy diet in moderately obese women. American Journal of Clinical Nutrition 59, 980–984.CrossRefGoogle ScholarPubMed
Spitzer, RL, Devlin, M, Walsh, BT, Hasin, D, Wing, R, Marcus, M, Stunkard, A, Wadden, T, Yanovski, S, Agras, S, Mitchell, J & Nonas, C (1992) Binge eating disorder: a multi-site field trial of the diagnostic criteria. International Journal of Eating Disorders 11, 191–204.3.0.CO;2-S>CrossRefGoogle Scholar
Steward, HL, Andrews, SS, Balart, LA & Bethea, MC (1998) Sugar Busters! Ballantine Books. http://www.sugarbusters.com/Google Scholar
Stunkard, AJ (1958) The management of obesity. New York State Journal of Medicine 58, 79–87.Google Scholar
Stunkard, AJ (1995) Prevention of obesity. In Eating Disorders and Obesity, pp. 572–576 [Brownell, KD and Fairburn, CG, editors]. New York: Guildford Press.Google Scholar
Stunkard, AJ & Wadden, TA (1992) Psychological aspects of severe obesity. American Journal of Clinical Nutrition 55, S524–S532.CrossRefGoogle ScholarPubMed
Sullivan, M, Karlsson, J, Sjostrom, L, Backman, L, Bengtsson, C, Bouchard, C, Dahlgren, S, Jonsson, E, Larsson, B & Lindstedt, S (1993) Swedish obese subjects (SOS) – an intervention study of obesity. Baseline evaluation of health and psychosocial functioning in the first 1743 subjects examined. International Journal of Obesity 17, 503–512.Google ScholarPubMed
Torduff, MG & Reed, DR (1991) Sham feeding sucrose or corn oil stimulates food intake in rats. Appetite 17, 97–103.CrossRefGoogle Scholar
Vasquez, JA, Kazi, U & Madani, N (1995) Protein metabolism during weight reduction with very low energy diets: evaluation of the independent effects of protein and carbohydrate on protein sparing. American Journal of Clinical Nutrition 62, 93–103.Google Scholar
Wadden, TA (1993) Treatment of obesity by moderate and severe calorie restriction. Annals of Internal Medicine 159, 688–693.CrossRefGoogle Scholar
Wadden, TA, Van Itallie, TB & Blackburn, GL (1990) Responsible and irresponsible use of very-low-calorie diets in the treatment of obesity. Journal of the American Medical Association 263, 83–85.CrossRefGoogle ScholarPubMed
Weintraub, M, Sundaresas, PR & Cox, C (1992) Long-term weight control study. VI. Individual participant response patterns. Clinical Pharmacology and Therapeutics 51, 619–633.CrossRefGoogle ScholarPubMed
Willett, WC (1998) Is dietary fat a major determinant of body fat ? American Journal of Clinical Nutrition 67, 556S–562S.CrossRefGoogle Scholar
Williamson, DF, Pamuk, ER, Thun, M, Flanders, D, Byers, T & Heath, C (1995) Prospective study of intentional weight loss and mortality in never-smoking overweight US white women aged 40–64 years. American Journal of Epidemiology 141, 1128–1141.CrossRefGoogle ScholarPubMed
Wilson, GT (1994) Behavioral treatment of childhood obesity: theoretical and practical implications. Health Psychology 13, 373–383.CrossRefGoogle ScholarPubMed
Wing, RR (1999) Behavioral strategies to improve long-term weight loss and maintenance. Medical Health 82, 123–130.Google ScholarPubMed
Wolever, TMS & Brand-Miller, JB (1995) Sugars and blood glucose control. American Journal of Clinical Nutrition 62, 212S–227S.CrossRefGoogle ScholarPubMed
World Health Organization (1995). Physical Status: The Use and Interpretation of Anthropometry. Report of a WHO Expert Committee. Technical Report Series no. 854, pp. 368–369. Geneva: WHO.Google Scholar
World Health Organization (1998). Prevention and Management of the Global Epidemic of Obesity. Geneva: WHO.Google Scholar
Yanovski, SZ (1993) A practical approach to the treatment of the obese patient. Archives of Family Medicine 3, 309–316.CrossRefGoogle Scholar