Numerous reviews have documented the effects of lifestyle interventions (2-5). Randomized trials conducted in the past decade show that lifestyle interventions, delivered in weekly group sessions over the course of 4-6 months, typically produce mean posttreatment weight reductions of ~8.5 kg. Weight losses of this magnitude usually result in beneficial changes in blood pressure, blood glucose, lipid profiles, and psychological well-being (3,6). However, the clinical significance of 5-10% reductions in body weight is ultimately determined by long-term rather than short-term outcomes. If the weight reduction is not maintained, it is unlikely that the health benefits derived from that weight loss will be achieved or sustained.
Table 1 summarizes the results of 10 behavioral weight loss intervention studies with follow-ups of 2 or more years (7-17). The initial weight changes in these studies ranged from 4.5 to 14.3 kg with a mean loss of 9.0 kg (unadjusted for study n). The magnitude of initial losses appears to reflect the pretreatment weight of the samples, the length of initial treatment, and the degree of caloric restriction. Studies with heavier subjects, longer initial treatments, or daily energy intakes <1000 kcal showed larger initial losses. Final follow-up evaluations,
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