Very-low calorie diets are relatively safe and effective in inducing significant weight loss, when used in selective individuals and under clinical supervision. However, weight loss maintenance in the long-term remains the main challenge, with many experiencing a significant weight regain. Several compensatory mechanisms are activated under weight reduction, both at the level of energy intake (such as increased appetite) and energy expenditure (such as reduced energy expenditure), and increase the risk of relapse. The main aim of this study is to compare the effect of two multidisciplinary lifestyle interventions on weight loss maintenance at one year, after initial weight loss during 8 weeks very-low calorie diet. Participants will be allocated (non-randomly) to either an outpatient program in the obesity unit of the local hospital, or to an inpatient program consisting of a "continuous care" intervention, with three intermittent stays (each with three-week duration) in a rehabilitation center over a one year period. Moreover, the investigators aim to assess the impact of weight loss (achieved with a very low calorie diet) and weight loss maintenance on compensatory mechanisms activated during weight reduction.
This study included a sub-study (n=30) to determine the timeline over which compensatory mechanisms (at both the level of energy expenditure and appetite control system) are activated with progressive weight loss. Additional measurements were taken at day-3, 5 and 10 % weight loss, and after 4 weeks weight stabilization (after gradually reintroduction of food).
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
100
Diet (phase 1) and multidisciplinary lifestyle intervention (phase 2)
Diet (phase 1) and lifestyle intervention (phase 2)
St Olavs Hospital
Trondheim, Norway
body weight
body weight change after end of very-low calory diet
Time frame: 1 year (changes from baseline to one year)
resting metabolic rate, short-term
using indirect calorimetry
Time frame: 10 weeks
appetite, short-term
assessed through: * the Three-Factor Eating Questionnaire (TFEQ) * fasting and postprandial release of appetite related hormones in blood samples, for a period of 3h (0, 30, 60, 120, 180 minutes), after a standard breakfast * feelings of hunger/fullness by a visual analog scale
Time frame: 10 weeks
exercise efficiency, short-term
assessed through graded cycle ergometry and indirect calorimetry
Time frame: 10 weeks
physical activity level, short-term
measurement with arm bands
Time frame: 10 weeks
resting metabolic rate, long-term
using indirect calorimetry
Time frame: 1 year
appetite, long-term
assessed through: * the Three-Factor Eating Questionnaire (TFEQ) * fasting and postprandial release of appetite related hormones in blood samples, for a period of 3h (0, 30, 60, 120, 180 minutes), after a standard breakfast * feelings of hunger/fullness by a visual analog scale
Time frame: 1 year
exercise efficiency, long-term
assessed through graded cycle ergometry and indirect calorimetry
Time frame: 1 year
physical activity level, long-term
measurement with arm bands
Time frame: 1 year
Sleep duration and quality
Sleep duration and quality will be measured using The Pittsburgh Sleep Quality Index (PSQI)
Time frame: Baseline, end of weigth loss phase and 1 year
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