(HealthDay News) — For obese and overweight young adults who have lost weight, a low-fat diet results in the greatest decreases in resting and total energy expenditure, which is an unfavorable effect that makes weight regain more likely; and for overweight and obese adults, a stepped-care weight-loss intervention (STEP) is linked to similar weight loss as a standard behavioral weight-loss intervention (SBWI), at a reduced cost per patient, according to two studies published in the June 27 issue of the Journal of the American Medical Association.
Cara B. Ebbeling, Ph.D., from the Children’s Hospital Boston, and colleagues conducted a three-way crossover study involving overweight and obese young adults. Participants were allocated to weight-loss maintenance involving four weeks of an isocaloric low-fat diet, a low-glycemic index diet, and a very low-carbohydrate diet, in random order. The researchers found the decrease in resting and total energy expenditure to be greatest with the low-fat diet, intermediate with the low-glycemic index diet, and least with the very low-carbohydrate diet, compared with the pre-weight-loss baseline.
John M. Jakicic, Ph.D., from the University of Pittsburgh in Pennsylvania, and colleagues conducted a randomized study involving 363 overweight and obese adults to compare weight loss with STEP (198 participants), whereby strategies were modified in response to observed weight loss, or SBWI (165 participants). The researchers found that the 18-month intervention resulted in a −8.1 percent weight change from baseline in the SBWI group and −6.9 percent in the STEP group. The between-group difference was not significant. The cost per participant was significantly lower for the STEP versus SBWI program.
“It may be possible to have a more individualized approach to weight loss, rather than a one-size-fits-all approach,” writes the author of an accompanying editorial.
Several authors from the Jakicic study disclosed financial ties to the health care, nutrition, and weight-loss industries.