Article ; Online: Extended follow-up of a short total diet replacement programme: results of the Doctor Referral of Overweight People to Low Energy total diet replacement Treatment (DROPLET) randomised controlled trial at 3 years.
International journal of obesity (2005)
2021 Volume 45, Issue 11, Page(s) 2432–2438
Abstract: Objectives: To test the long-term effectiveness of a total diet replacement programme (TDR) for routine treatment of obesity in a primary care setting.: Methods: This study was a pragmatic, two-arm, parallel-group, open-label, individually randomised ...
| Abstract | Objectives: To test the long-term effectiveness of a total diet replacement programme (TDR) for routine treatment of obesity in a primary care setting. Methods: This study was a pragmatic, two-arm, parallel-group, open-label, individually randomised controlled trial in adults with obesity. The outcomes were change in weight and biomarkers of diabetes and cardiovascular disease risk from baseline to 3 years, analysed as intention-to-treat with mixed effects models. Interventions: The intervention was TDR for 8 weeks, followed by food-reintroduction over 4 weeks. Behavioural support was provided weekly for 8 weeks, bi-weekly for the next 4 weeks, then monthly for 3 months after which no further support was provided. The usual care (UC) group received dietary advice and behavioural support from a practice nurse for up to 3 months. Results: Outcome measures were collected from 179 (66%) participants. Compared with baseline, at 3 years the TDR group lost -6.2 kg (SD 9.1) and usual care -2.7 kg (SD 7.7); adjusted mean difference -3.3 kg (95% CI: -5.2, -1.5), p < 0.0001. Regain from programme end (6 months) to 3 years was greater in TDR group +8.9 kg (SD 9.4) than UC + 1.2, (SD 9.1); adjusted mean difference +6.9 kg (95% CI 4.2, 9.5) P < 0.001. At 3 years TDR led to greater reductions than UC in diastolic blood pressure (mean difference -3.3 mmHg (95% CI:-6.2; -0.4) P = 0.024), and systolic blood pressure (mean differences -3.7 mmHg (95% CI: -7.4; 0.1) P = 0.057). There was no evidence of differences between groups in the change from baseline to 3 years HbA Conclusions: Treatment of people with obesity with a TDR programme compared with support from a practice nurse leads to greater weight loss which persists to at least 3 years, but there was only evidence of sustained improvements in BP and not in other aspects of cardiometabolic risk. |
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| MeSH term(s) | Adult ; Aftercare/methods ; Aftercare/statistics & numerical data ; Diet Therapy/methods ; Diet Therapy/standards ; Diet Therapy/statistics & numerical data ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Overweight/diet therapy ; Overweight/epidemiology ; Referral and Consultation/standards ; Referral and Consultation/statistics & numerical data ; United Kingdom/epidemiology ; Weight Reduction Programs/methods ; Weight Reduction Programs/standards ; Weight Reduction Programs/statistics & numerical data |
| Language | English |
| Publishing date | 2021-07-23 |
| Publishing country | England |
| Document type | Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't |
| ZDB-ID | 752409-2 |
| ISSN | 1476-5497 ; 0307-0565 |
| ISSN (online) | 1476-5497 |
| ISSN | 0307-0565 |
| DOI | 10.1038/s41366-021-00915-1 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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