An evaluation of a low-carbohydrate diet for the treatment of obesity in a ‘real life’ dietetic weight management clinic

Abstract

This dissertation aimed to investigate whether a low-carbohydrate diet could achieve clinically significant weight loss (≥5% body weight) in obese patients seen over a six month period. Patients were seen at an NHS specialist weight management service in a one-to-one dietetic outpatient clinic setting. Routinely collected quantitative data (weight and body mass index) was retrospectively examined following a service evaluation. The primary outcome measure was percentage weight change from baseline to six months. Professional contact was approximately every six weeks. This study included data from one hundred and three patients with a mean age of 47.0±12.2 years (mean ± SD) and mean body mass index of 48.0±8.5 (mean ± SD). 68% (n=70) were female. Overall, 32% (n=32) of patients had type 2 diabetes. Weight loss in completers (n=70) was 8.3±5.1% body weight (mean ±SD) at six months (P<0.001). When all patients (n=103) were included in the analysis, a clinically significant weight loss of 5.8±5.8% body weight (mean ± SD) was achieved (P<0.001). The overall dropout rate was 15.5% (n=16) and 16.5% (n=17) switched to another dietary approach within the six month period meaning that 32% (n=33) of patients starting the low-carbohydrate diet either dropped out or changed intervention. This study provides evidence that a low-carbohydrate diet is effective in achieving clinically significant weight loss, in obese patients seen in routine practice, for at least six months. These results can be generalised to patients with morbid obesity and obesity related co-morbidities, such as type 2 diabetes.