Integrated Weight Management Program For Successful Weight Loss and Heart Disease Risk Reduction.
Bharathi Reddy M.D., Barbara Pistone M.S., R.D., Keosik Lee M.S., R.C.E.P., Donna Cheslik R.N.,M.S.N., John Nicholson M.D
Background: Obesity is both a major epidemic and an independent risk factor for coronary artery disease. Weight loss is a proven approach to cardiovascular risk reduction, however most programs have limited success because of recidivism and many diets do not have palatable meal plans, lack ongoing educational classes, and do not have an integrated exercise component.
Objective: To assess the success of weight loss and the adherence rates of NYHQ, Cardiac Health Center’s (CHC) “Weigh to Go” Weight Management Program. This is a more palatable meal plan and uses a multidisciplinary approach which includes education and exercise.
Methods: From 2003-2008, 376 participants enrolled in Weight Management Program at CHC. From spring 2003-spring 2006 the Weight Management Program followed the American Heart Association (AHA) diet plan. This was comprised of 50% carbohydrate, 20% protein, and 30% fat macronutrient distribution. In the fall of 2006 thru fall of 2008 the Weight Management Program introduced the ‘Weigh To Go` plan which changed the macronutrient distribution to 45% carbohydrates, 25% protein and 30% fat including complementary lists of included foods and a circadian rhythm pattern of eating. Both programs included a structured exercise component 3times a week for 12 weeks supervised by an Exercise Physiologist and a weekly educational series given by the Registered Dietitians and the other health professionals. Of the 376 pts, pts were categorized into two groups, group A pts who followed AHA diet plan and group B who followed `Weigh To Go` plan. The weight loss comparison only included those pts who completed at least 8 weeks of program. In Group A, out of 236 pts enrolled, 118 did not complete the program, 89 completed > 8weeks of the program (N=88, 18males and 70 females, age 57.4+ 13.5). In Group B, out of 140 pts enrolled, 56 did not complete the program, 84 completed > 8weeks of the program (N=83, 18 males and 65females, age 54.1+ 11.8). Using Paired t test average mean difference in weight loss was tested.
Results: There was a significant decrease in weight in Group B (221.6+54.3 to 210.9+52.3, ∆ =10.6+8.9 p < 0.05) compared to Group A (220.1+47.9 to 212.8+46.9, ∆=7.3+6.2 p < 0.05) and in addition observed higher adherence to the Weight Management Program in Group B (N=70 completed 12 weeks, 83.3%) compared to Group A (N=54 completed 12 weeks, 60.7%).
Conclusion: Although both weight management plans at CHC reduced body weight, the “Weigh To Go” plan (plan B) demonstrated more significant weight loss and increased adherence to the program. Compared to popular diets, both programs attained weight loss but the “Weigh To Go” plan results were significantly better for that period of time. Some of this could be due to better acceptability and palatability of the “Weigh To Go” meal plan. The 4.8 kg weight loss in 12 weeks proposes the “Weigh To Go” plan as a successful weight management plan for pts with obesity. Further research is needed to focus on long-term outcomes in these patients, especially its effect on blood pressure, glucose, lipids and more notably sustained wt loss.