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Randomized Controlled Trial
. 2014 May 16:11:64.
doi: 10.1186/1479-5868-11-64.

Patient freedom to choose a weight loss diet in the treatment of overweight and obesity: a randomized dietary intervention in type 2 diabetes and pre-diabetes

Leah T Coles  1 , Elly A Fletcher, Claire E Galbraith, Peter M Clifton
Affiliations
Randomized Controlled Trial

Patient freedom to choose a weight loss diet in the treatment of overweight and obesity: a randomized dietary intervention in type 2 diabetes and pre-diabetes

Leah T Coles et al. Int J Behav Nutr Phys Act. .

Abstract

Background: Offering the overweight or obese patient the option of choosing from a selection of weight loss diets has not been investigated in type 2 diabetes. The aim of the study was to investigate if the option to choose from, and interchange between a selection of diets ("Choice"), as opposed to being prescribed one set diet ("No Choice"), improves drop out rates and leads to improved weight loss and cardio-metabolic outcomes.

Methods: The study was a 12 month, randomized parallel intervention. A total of 144 volunteers with type 2 diabetes or pre-diabetes and a BMI >27 were randomized to "No Choice" or "Choice". Those in the No Choice group were placed on a set weight loss diet (CSIRO) with no change permitted. Those in the Choice group could choose from, and interchange between, the CSIRO, South Beach or Mediterranean diets.

Results: There were no differences in attrition rates or weight loss between the "Choice" and "No Choice". In a secondary analysis of the intention-to-treat weight loss data with last measured weight carried forward gave a highly significant diet group by time by gender interaction (p = 0.002) with men doing better in the No Choice group overall (maximum difference "No Choice "-2.9 ± 4.6 kg vs. "Choice"-6.2 kg ± 5.3 kg at 6 months) and women doing better in the Choice group overall (maximum difference Choice -3.1 ± 3.7 kg vs. "No Choice" -2.0 kg ± 2.6 kg at 6 months).

Conclusions: Men prefer direction in their weight loss advice and do less well with choice. A gender-specific approach is recommended when prescribing weight loss diets.

Trial registration: anzctr.org.au ACTRN12612000310864.

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Figures

Figure 1
Figure 1
CONSORT-style flow chart.
Figure 2
Figure 2
Weight change (kg) from baseline by diet group and gender. A. Shows only those participants who completed the 12 month weight loss program. B. Shows weights for all participants enrolled at baseline with weights carried forward from last known measurement for participants who discontinued the weight loss program. Data are means, error bars represent SE. P-values determined using repeated measures ANOVA. Participant numbers were: A. No Choice – women (n = 21) and men (n = 28); Choice - women (n = 18) and men (n = 29); and B. No Choice – women (n = 35) and men (n = 38); Choice women (n = 31) and men (n = 40).
See this image and copyright information in PMC

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