Effect of a behavioral/nutritional intervention program on weight loss in obese adults: a randomized controlled trial

Postgrad Med. 2011 Sep;123(5):205-13. doi: 10.3810/pgm.2011.09.2476.


Background: Health professionals are in need of more information about the weight-loss outcomes of using commercial weight-loss programs.

Objective: A commercial behavioral intervention program using meal replacements, fruits, and vegetables (MR-FV) was compared with usual-care weight-loss counseling.

Design: Obese volunteers were randomly allocated to usual-care weight-loss counseling or participation in an MR-FV standardized behavioral education program. The MR-FV group attended weekly weight-loss classes for 16 weeks and weekly maintenance classes for 8 weeks.

Participants/setting: Obese women or men aged 20 to 65 years were recruited from the community through a commercial program provided at a university medical center.

Intervention: The control group (C group) received weight-management counseling from an experienced dietitian, while the intervention group (MR-FV group) participated in scheduled behavioral weight-loss classes. The MR-FV group participants were encouraged to consume 3 shakes, 2 entrées, and 5 servings of fruits or vegetables daily, and achieve physical activity goals (expend ≥ 8.4 mJ/week); they kept records and placed midweek phone calls. The C group was counseled at baseline, 8 weeks, and 16 weeks.

Outcome measures: Both groups were seen at baseline, and 8, 16, and 24 weeks for assessment of weight, risk factors, and side effects.

Statistical analysis: The primary data analysis was intention to treat.

Results: Thirteen of 16 subjects (81.3%) in the C group and 18 of 22 subjects (81.8%) in the MR-FV group completed the 24-week study. Mean weight losses for the C group were: 1.3% (standard error [SE], 0.9) at 8 weeks; 0.7% (SE, 1.1) at 16 weeks; and 0.7% (SE, 1.1) or 0.7 kg at 24 weeks. Mean weight losses for the MR-FV group were: 8.5% (SE, 0.6) at 8 weeks, 12.5% (SE, 0.9) at 16 weeks, and 13.9% (SE, 1.1) or 13.7 kg at 24 weeks.

Conclusions: A behavioral intervention with a low-energy diet including 5 meal replacements and 5 servings of fruits or vegetables enabled obese individuals to lose 13 kg more than control subjects over a 24-week period.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Behavior Therapy* / methods
  • Caloric Restriction
  • Counseling
  • Female
  • Humans
  • Male
  • Middle Aged
  • Obesity / diet therapy
  • Obesity / therapy*
  • Patient Education as Topic
  • Risk Factors
  • Weight Loss
  • Young Adult