Medical complications of severe obesity: importance of treatment by very-low-calorie diets: intermediate and long-term effects
Mancini, M.; Di Biase, G.; Contaldo, F.; Fischetti, A.; Grasso, L.; Mattioli, P.L.
International Journal of Obesity 5(3): 341-352
1981
ISSN/ISBN: 0307-0565 PMID: 7275473 Document Number: 175127
From 1972 to 1979, 275 female and 114 male severely obese patients, 40.5 plus or minus 1.0 (mean plus or minus s.e. mean) years old, with body mass index of 43.4 plus or minus 0.6, were admitted to a metabolic unit. Main medical complications were overt diabetes in 17% of women and men, glucose intolerance in 26% and 32%, hypertension in 23% and 30%, cholelithiasis in 21% and 9%, hypertriglyceridaemia in 23% and 45%, hypercholesterolaemia in 17% and 25%, uterine fibroid in 8% and carcinoma of endometrium in 3% of women. Very-low-energy diets supplemented with protein, and in some instances protein plus carbohydrate, were prescribed for 4 to 8 weeks in 210 female and 79 male severely obese patients. Afterwards, on an outpatient basis, a conventional low-energy diet (600 to 900 to 1200 kcal; 2.5, 3.8, 5.0 MJ) was given. Short-term effects were usually successful, with prompt improvement of all reversible medical complications. Intermediate (after 2 years) and long-term (after 4 years) effects were evaluated in 179 of those patients. There was a persistent reduction in bodyweight, mainly after 2 years. When substantial weight loss was maintained, plasma glucose, uric acid and triglyceride, systolic and diastolic blood pressure were all less than before the treatment. The patients improved clinically as shown by evaluation of dyspnoea, pain of the joints, oedema, sleepiness and motility.