Research Article
A Physician-Directed Commercial Low Calorie Diet with Intensive Behavioral Modification Decreases Metabolic Syndrome and Medication Use
Bobbie G Paull-Forney1, Frank Dong2*, Justin B Moore1,2, Jeanene J Fogli3, Linda D Gotthelf3, James L Early2,3, Elizabeth Ablah2 | |
1Via Christi Weight Management, Via Christi Hospitals Wichita, Inc, USA | |
2University of Kansas School of Medicine-Wichita, Wichita, USA | |
3Health Management Resources, Boston, Massachusetts, USA | |
Corresponding Author : | Frank Dong University of Kansas School of Medicine-Wichita 1010 N Kansas St, Wichita, KS, 67228, USA Tel: (316) 293-2627 Fax: (316) 293-2695 E-mail: fdong@kumc.edu |
Received May 22, 2014; Accepted June 18, 2014; Published June 20, 2014 | |
Citation: Paull-Forney BG, Dong F, Moore JB, Fogli JJ, Gotthelf LD, et al. (2014) A Physician-Directed Commercial Low Calorie Diet with Intensive Behavioral Modification Decreases Metabolic Syndrome and Medication Use. J Obes Weight Loss Ther 4:221. doi:10.4172/2165-7904.1000221 | |
Copyright: © 2014 Paull-Forney BG, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
Abstract
Background: In light of recent Centers for Medicare and Medicaid Services (CMS) recommendations on behavioral therapy for obesity, it is important to assess the outcomes of physician-directed low-calorie diet (LCD) interventions on metabolic risk factors. The aim of this study was to determine the effect of participation in a physiciandirected LCD program coupled with an intensive behavioral intervention on parameters of metabolic syndrome (MetS) and medication usage. Methods: This was a retrospective chart review of 445 participants, who completed at least 12 weeks in a community-based medical weight loss program. MetS was defined using the National Cholesterol Education Program/ Acute Treatment Panel III diagnostic criteria. Logistic regression analysis was conducted to identify factors predicting the MetS status at week 12. Results: Sixty eight percent of participants completing twelve weeks of the program achieved ≥10% initial body weight loss (IBWL). The mean weight loss is 11.8 %IBW. Proportions of participants meeting NCEP/ATP III criteria for MetS decreased for: waist circumference (100% at baseline vs 93.4% at week 12), triglycerides (51.8% at baseline vs 32.1% at week 12), fasting plasma glucose (60.1% at baseline vs 40.8% at week 12) and blood pressure (81.4% at baseline vs 61.1% at week 12). The prevalence of MetS decreased from 96% (n=248) at baseline to 67.8% (n=175) at week 12. Younger age, lower baseline BMI, and higher %IBWL were associated with an increased likelihood of MetS remission at week 12. Use of hypoglycemic and anti-hypertensive agents decreased by 27.5% and 12.8%, respectively, and doses of hypoglycemic and anti-hypertensive agents decreased for 75.3% and 40.4% of participants, respectively. Conclusions: A physician-directed low-calorie diet coupled with an intensive behavioral intervention is an effective option for achieving weight loss, improving individual metabolic risk factors, and reducing the overall need for hypoglycemic and anti-hypertensive medications.