Of the participants, 57 in the low-carb diet group and 65 in the orlistat and low-fat diet group completed the study. Weight loss was similar for both groups (an average of 8.5 percent to 9.5 percent of body weight), but the low-carb diet resulted in greater reductions to systolic (top number) and diastolic (bottom number) blood pressures. High-density lipoprotein cholesterol and triglyceride levels improved similarly in both groups.
"In conclusion, the low-carbohydrate ketogenic diet and the orlistat plus low-fat diet were equally effective for weight loss and several cardiovascular disease risk factors, although the low-carbohydrate diet was more effective for lowering blood pressure," the authors conclude. "Efforts should be made to incorporate similarly intensive weight loss programs into medical practice."
Non-Surgical Program Helps Some Extremely Obese Adults Lose Weight
About one-third of adults with extreme obesity benefited after two years of an intensive medical management program conducted by primary care clinicians. Donna H. Ryan, M.D., of Pennington Biomedical Research Center, Baton Rouge, La., and colleagues trained seven primary care physicians and one research clinic in obesity management.
A group of 200 adults with extreme obesity (body mass index of higher than 40) were randomly assigned to participate in the intervention, which involved a short-term liquid diet, group behavioral counseling, a longer-term maintenance diet and one of several medications. After two years, 51 percent remained on the program, 31 percent lost 5 percent or more of their body weight and 7 percent lost 20 percent or more. Comparatively, in the group of 190 control participants assigned to follow their usual diet, 46 percent remained in the study, 9 percent lost 5 percent or more of their body weight and 1 percent lost 20 percent or more after two years.
"Primary care practices can initiate effective medical management for extreme obesity; future efforts must target improving retention and weight loss maintenance," the authors conclude.
Source: Archives of Internal Medicine