Prolonged refeeding improves weight maintenance after weight loss with very-low-energy diets

The aim of the present study was to test the hypothesis that a prolonged refeeding duration after successful very-low-energy diet (VLED)-induced weight loss beneficially affects weight development and eating behaviour. Patients (n 269) were recruited to a 1-year obesity treatment programme with 12 weeks of an initial VLED. After the VLED, patients with >or= 10 % weight loss were randomly allocated to 1 week (group 1) or 6 weeks (group 6) refeeding to an ordinary, energy-reduced diet, and thereafter followed and actively treated for an additional 40 weeks. Eating behaviour (revised twenty-one-item Three-Factor Eating Questionnaire) was measured at baseline, during and after refeeding, and at week 52. Weight change over time in the two treatment groups was tested by repeated-measures analysis in completers and by intention to treat (ITT). Of the patients, 169 (109 women) lost >or= 10 % during the VLED and were randomised. At randomisation, weight loss was - 16.5 (SD 3.7) % in group 1 and - 16.7 (SD 4.3) % in group 6 (P = 0.73). Between weeks 12 and 52, completers in group 6 regained significantly less weight (3.9 (SD 9.1) %) as compared with group 1 (8.2 (SD 8.3) %; P = 0.006) (ITT, P = 0.05). Completers in group 6 also maintained a higher level of dietary restraint after refeeding was completed, but eating behaviour did not differ at week 52. Weight change after the refeeding periods were completed did not differ significantly between the groups (P = 0.06). Overall, longer refeeding duration after successful weight loss with a VLED improves weight maintenance in a 1-year perspective.