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A systematic review showed that very low–energy diets (≤800 kcal/day) result in greater weight loss than behavioral-support programs for obese patients. However, these trials were conducted in specialized centers, not in primary care practices. In this randomized trial, conducted in a U.K. primary care setting, researchers assigned 278 obese adults (mean age, 48; mean body-mass index, 37.2 kg/m2) to either usual care or to total diet replacement (TDR; comprised of commercially prepared formula products that provided 810 kcal daily as the only food) for 8 weeks, followed by reintroduction of regular food and weekly behavioral support for 12 weeks, followed by monthly support for 3 months.
TDR participants lost significantly more weight (mean,…