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Randomised controlled trial of four commercial weight loss programmes in the UK: initial findings from the BBC "diet trials".

ABSTRACT: To compare the effectiveness of four commercial weight loss diets available to adults in the United Kingdom.Six month multicentre randomised unblinded controlled trial.Community based sample of otherwise healthy overweight and obese adults.Dr Atkins' new diet revolution, Slim-Fast plan, Weight Watchers pure points programme, and Rosemary Conley's eat yourself slim diet and fitness plan.Weight and body fat changes over six months.All diets resulted in significant loss of body fat and weight over six months. Groups did not differ significantly but loss of body fat and weight was greater in all groups compared with the control group. In an intention to treat analysis, average weight loss was 5.9 kg and average fat loss was 4.4 kg over six months. The Atkins diet resulted in significantly higher weight loss during the first four weeks, but by the end was no more or less effective than the other diets.Clinically useful weight loss and fat loss can be achieved in adults who are motivated to follow commercial diets for a substantial period. Given the limited resources for weight management in the NHS, healthcare practitioners should discuss with their patients programmes known to be effective.Clinical trials NCT00327821.

SUBMITTER: Truby H

PROVIDER: S-EPMC1473108 | biostudies-literature | 2006 Jun

REPOSITORIES: biostudies-literature

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Randomised controlled trial of four commercial weight loss programmes in the UK: initial findings from the BBC "diet trials".

Truby Helen H Baic Sue S deLooy Anne A Fox Kenneth R KR Livingstone M Barbara E MB Logan Catherine M CM Macdonald Ian A IA Morgan Linda M LM Taylor Moira A MA Millward D Joe DJ

BMJ (Clinical research ed.) 20060523 7553

<h4>Objective</h4>To compare the effectiveness of four commercial weight loss diets available to adults in the United Kingdom.<h4>Design</h4>Six month multicentre randomised unblinded controlled trial.<h4>Setting</h4>Community based sample of otherwise healthy overweight and obese adults.<h4>Interventions</h4>Dr Atkins' new diet revolution, Slim-Fast plan, Weight Watchers pure points programme, and Rosemary Conley's eat yourself slim diet and fitness plan.<h4>Main outcome measures</h4>Weight and ...[more]

PMID: 16720619

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Project description:ObjectiveTo assess the effectiveness of a range of weight management programmes in terms of weight loss.DesignEight arm randomised controlled trial.SettingPrimary care trust in Birmingham, England.Participants740 obese or overweight men and women with a comorbid disorder identified from general practice records.InterventionsWeight loss programmes of 12 weeks' duration: Weight Watchers; Slimming World; Rosemary Conley; group based, dietetics led programme; general practice one to one counselling; pharmacy led one to one counselling; choice of any of the six programmes. The comparator group was provided with 12 vouchers enabling free entrance to a local leisure (fitness) centre.Main outcome measuresThe primary outcome was weight loss at programme end (12 weeks). Secondary outcomes were weight loss at one year, self reported physical activity, and percentage weight loss at programme end and one year.ResultsFollow-up data were available for 658 (88.9%) participants at programme end and 522 (70.5%) at one year. All programmes achieved significant weight loss from baseline to programme end (range 1.37 kg (general practice) to 4.43 kg (Weight Watchers)), and all except general practice and pharmacy provision resulted in significant weight loss at one year. At one year, only the Weight Watchers group had significantly greater weight loss than did the comparator group (2.5 (95% confidence interval 0.8 to 4.2) kg greater loss,). The commercial programmes achieved significantly greater weight loss than did the primary care programmes at programme end (mean difference 2.3 (1.3 to 3.4) kg). The primary care programmes were the most costly to provide. Participants allocated to the choice arm did not have better outcomes than those randomly allocated to a programme.ConclusionsCommercially provided weight management services are more effective and cheaper than primary care based services led by specially trained staff, which are ineffective. Trial registration Current Controlled Trials ISRCTN25072883.

Project description:This systematic review and meta-analysis of effectiveness trials comparing multicomponent behavioural weight management programmes with controls in overweight and obese adults set out to determine the effectiveness of these interventions implemented in routine practice. To be included, interventions must have been multicomponent, delivered by the therapists who would deliver the intervention in routine practice and in that same context, and must be widely available or feasible to implement with little additional infrastructure or staffing. Searches of electronic databases were conducted, and augmented by screening reference lists and contacting experts (November 2012). Data were extracted by two reviewers, with mean difference between intervention and control for 12-month change in weight, blood pressure, lipids and glucose calculated using baseline observation carried forward. Data were also extracted on adverse events, quality of life and mood measures. Although there were many published efficacy trials, only eight effectiveness trials met the inclusion criteria. Pooled results from five study arms providing access to commercial weight management programmes detected significant weight loss at 12 months (mean difference -2.22 kg, 95% confidence interval [CI] -2.90 to -1.54). Results from two arms of a study testing a commercial programme providing meal replacements also detected significant weight loss (mean difference -6.83 kg, 95% CI -8.39 to -5.26). In contrast, pooled results from five interventions delivered by primary care teams showed no evidence of an effect on weight (mean difference -0.45 kg, 95% CI -1.34 to 0.43). One study testing an interactive web-based intervention detected a significant effect in favour of the intervention at 12 months, but the study was judged to be at high risk of bias and the effect did not persist at 18 months. Few studies reported other outcomes, limiting comparisons between interventions. Few trials have examined the effectiveness of behavioural weight loss programmes delivered in everyday contexts. These trials suggest that commercial interventions delivered in the community are effective for achieving weight loss. There is no evidence that interventions delivered within primary care settings by generalist primary care teams trained in weight management achieve meaningful weight loss.

Project description:Consumer demand for commercially prepared plant-based (PB) dog food is increasing, but studies evaluating the short- or long-term effects of PB diets on canine health are lacking. The objective of this study was to assess the short-term amino acid (AA), clinicopathologic, and echocardiographic findings in 34 client-owned dogs fed a commercial extruded plant-based diet (PBD) in which pea protein was the primary protein source and 4 control dogs fed a commercial extruded traditional diet (TD). Plasma AA and whole blood taurine concentrations were measured in dogs at baseline and after 4 weeks on the PBD or the TD. Hematologic, serum biochemical, and echocardiographic testing were performed at baseline and after 12 weeks on the PBD or the TD. Four dogs in the PBD group did not complete the study. All essential AAs, except methionine, were higher in dogs after 4 weeks on the PBD compared to baseline. Taurine (plasma and whole blood) was also higher after 4 weeks on the PBD compared to baseline. A meaningful difference was detected in whole blood taurine between the PBD group and the control group at 4 weeks (P = .026) with the PBD group being higher. Median hematologic and biochemical results for the PBD group were within normal limits at baseline and at 12 weeks. In the PBD group, left ventricular internal diastolic dimension (LVIDd, P = < .001) and normalized LVIDd (P = .031) were higher 12 weeks post-PBD compared to baseline. There were no meaningful differences in left ventricular internal systolic dimension (LVIDs), normalized LVIDs, or fractional shortening 12 weeks post-PBD. There was no statistical evidence of difference between the 2 groups of dogs for any of the echocardiographic parameters at baseline or at 12 weeks. Essential AA or taurine deficiency was not observed in this cohort of dogs fed a commercial extruded PBD. Additionally, clinically relevant hematologic, serum biochemical and echocardiographic alterations were not detected. Further research is required to determine if long-term static feeding of PB diets can meet and maintain AA and other nutrient targets in dogs.

Dataset Information

Randomised controlled trial of four commercial weight loss programmes in the UK: initial findings from the BBC "diet trials".

Publications

Randomised controlled trial of four commercial weight loss programmes in the UK: initial findings from the BBC "diet trials".

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