Diabetes, Metabolic Syndrome and Obesity (Jan 2020)
Effects of a Milk-Based Meal Replacement Program on Weight and Metabolic Characteristics in Adults with Severe Obesity
Abstract
Mohammed F Rafey,1,2,* Conor F Murphy,1,2,* Razk Abdalgwad,1,2 Katriona Kilkelly,1 Helena Griffin,1 Niamh Beatty,1 Paula M O’Shea,3 Chris Collins,2,4 Robert McGrath,1 Mary Hynes,1 Colin Davenport,1,2 Martin O’Donnell,2 Francis M Finucane1,2 1Bariatric Medicine Service, Centre for Diabetes, Endocrinology and Metabolism, Galway University Hospitals, Galway, Ireland; 2HRB Clinical Research Facility, National University of Ireland, Galway, Ireland; 3Department of Clinical Biochemistry, Galway University Hospitals, Galway, Ireland; 4Department of Surgery, Galway University Hospitals, Galway, Ireland*These authors contributed equally to this workCorrespondence: Francis M FinucaneBariatric Medicine Service, Centre for Diabetes, Endocrinology and Metabolism, Galway University Hospital, Galway, IrelandTel +353 91 542711Email [email protected]: Low energy meal replacement regimens can induce short-term weight loss in patients with severe obesity, but usually require specially formulated dietary supplements. We sought to determine the effects of a milk-based meal replacement program on anthropometric and metabolic characteristics in adults with severe obesity.Methods: We conducted a retrospective cohort study of patients attending our hospital-based bariatric medicine service who completed a 24-week program consisting of eight weeks of milk-based meal replacement followed by weight stabilisation and maintenance phases. Patients were seen fortnightly by the bariatric physician, nurse and dietitian. We assessed changes in anthropometric and metabolic outcomes in completers at 0, 8, 16 and 24 weeks.Results: Of 105 program completers available for follow-up, 53.3% were female. Mean age was 51.1± 11.2 years. Body weight decreased from 144.0± 27.6 kg at baseline to 121.1± 25.0 kg at 24 weeks (P< 0.001), a mean total body weight loss of 15.9± 6.0%, with a reduction in body mass index from 50.6± 8.0 to 42.6± 7.6 kg m− 2 (P< 0.001). In patients with diabetes, haemoglobin A1c decreased from 66.3± 13.0 to 48.3± 13.5 mmol/mol (P< 0.001) and diabetes medication use decreased significantly. There were significant improvements also in lipid profiles and reductions in antihypertensive medication use.Conclusion: These preliminary findings suggest that completion of a 24-week milk-based meal replacement program has large effects on important outcomes in adults with severe obesity. However, attrition was high. Prospective assessment of the efficacy, safety, durability and cost-effectiveness of this intervention seems warranted.Keywords: hypocaloric diet, milk, lifestyle modification, obesity treatment, type 2 diabetes
