Randomized clinical trial of standard dietary treatment versus a low-carbohydrate/high-protein diet or the LighterLife Programme in the management of obesity*

Background: With the current obesity epidemic, the search for effective weight loss approaches is required. In the present study, changes in weight, body composition and cardiovascular (CV) risk in response to a low‐fat, reduced‐energy diet (LFRE), a low‐carbohydrate/high‐protein diet (LCHP), or a commercially available very low‐calorie diet (LighterLife; LL) were assessed. Methods: One hundred and twenty obese patients (body mass index ≥35 kg/m²) underwent a screening period of 3 months on the LFRE. Those who lost >5% of their body weight were maintained on this approach for an additional 3 months, whereas those who lost >10% at this time were maintained for 1 year. Patients failing to achieve these targets were randomly allocated to either the LCHP (n = 38) or LL (n = 34) for a period of 9 months. Results: Significantly greater weight loss was seen for patients on the LL than the LCHP at 3 (mean (±SD) ?11.6 ± 12.9 vs ?2.8 ± 4.5 kg, respectively; P < 0.0001) and 9 months (?15.1 ± 21.1 vs ?1.9 ± 5.0 kg, respectively; P < 0.0001) after screening. Significantly greater improvement in total cholesterol, low‐density lipoprotein–cholesterol, fasting glucose, and diastolic blood pressure was seen at 3 months in patients on the LL compared with the LCHP (P < 0.05). These differences were no longer significant at 9 months, with the exception of fasting glucose. The attrition rate was elevated in the LCHP group, but did not differ significantly from the LL group. Conclusion: Greater weight loss and improved CV risk were achieved with the LL, which mostly reflects the patient support provided for each dietary treatment.