Those in the self-directed group lost less weight. On average, the self-directed group shed 1.7 pounds, the remote group lost 10.1 pounds, and the in-person group 11.2 pounds over the two-year study.
A higher proportion of those in the intervention groups lost 5 percent or more of their starting weight. That may not sound like much, but experts agree it is enough to make a difference to your health.
In the second study, Dr. Thomas Wadden, at the University of Pennsylvania, and his team assigned 390 obese adults to one of three types of programs. One group was termed ''usual care" and saw their doctors for weight-loss education and support every three months. One group received brief lifestyle counseling, including visits with their doctor every three months and monthly sessions with lifestyle coaches. One group received enhanced lifestyle counseling, which included everything the brief lifestyle counseling group got, along with being offered a choice of meal replacements or weight-loss medications.
The weight-loss medicines were either orlistat or sibutramine. Orlistat now carries a warning about potential liver damage. Sibutramine is not available in the United States now, after reports of an increased risk of heart attacks and strokes with its use. By the end of the study, most were using the meal replacements, not the medicines.
At the end of the two years, 86 percent were still participating. Those who received the enhanced lifestyle counseling lost the most: 10.1 pounds. Those in the usual care group lost just 3.7 pounds and those in the brief lifestyle counseling group lost 6.4 pounds.
Those in the enhanced lifestyle group were more likely to drop 5 percent of their starting weight, according to the report.
Both studies suggest a model using primary care doctors works, said Wadden, professor of psychology and psychiatry and director of the Center for Weight and Eating Disorders at the unive
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