Comparison of Weight Loss Induced by Dietary and Pharmaceuticals in Individuals with Overweight and Obesity: A Case Control Study

Comparison of Weight Loss Induced by Dietary and Pharmaceuticals in Individuals with Overweight and Obesity: A Case Control Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Comparison of Weight Loss Induced by Dietary and Pharmaceuticals in Individuals with Overweight and Obesity: A Case Control Study Lei-lei Wang, Ling-ling Wang, Xiao-chen Liu, Hai-ying Hu, Hong-xia Li, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4485017/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective This study aims to evaluate the impact of low-carbohydrate diet, balanced dietary guidance, and pharmacotherapy on weight loss among individuals with overweight or obesity over a period of three months. Methods The study involves 339 individuals with overweight or obesity and received weight loss treatment at the Department of Clinical Nutrition at the Second Affiliated Hospital of Zhejiang University, School of Medicine, between January 1st, 2020 and December 31st, 2023. The primary outcome is the percentage weight loss. Results Among the studied patients, the majority chose low-carbohydrate diet as their primary treatment (168 [49.56%]), followed by balanced dietary guidance (139[41.00%]) and pharmacotherapy (32 [9.44%]). The total percentage weight loss for patients who were followed up for 1 month, 2 months, and 3 months was 4.98 (3.04,6.29) %,7.93 (5.42, 7.93) % and 10.71 (7.74,13.83) %, respectively. Multivariable logistic regression analysis identified low-carbohydrate diet as an independent factor associated with percentage weight loss of ≥ 3% and ≥ 5% at 1 month ( OR [ odds ratio ] = 0.461, P <0.05; OR = 0.349, P <0.001). Conclusion The results showed that a low-carbohydrate diet was an effective weight loss strategy in the short term. However, its long-term effects were comparable to those observed with balanced dietary guidance and pharmacotherapy. Health sciences/Diseases/Metabolic disorders Health sciences/Diseases/Nutrition disorders Overweight Obesity Low-carbohydrate diet Balanced dietary guidance Pharmacotherapy Figures Figure 1 Figure 2 1. Introduction The introduction Obesity and overweight are complex chronic metabolic diseases that result from a combination of factors, including genetics, psychosocial factors, endocrine dysfunction, and unhealthy lifestyle choices such as physical inactivity and calorie-dense diets. These conditions can lead to the abnormal accumulation of adipose tissue, increasing the risk of various chronic diseases like cardiovascular disease (CVDs), insulin resistance, type 2 diabetes, dyslipidemia, hypertension, fatty liver disease, and cancer. 1,2 Body mass index (BMI) is a convenient and widely used tool for screening adults for overweight and obesity. According to the World Health Organization (WHO), a BMI between 25 and 29.9 kg/m2 is considered overweight, while a BMI of 30 kg/m2 or higher is classified as obesity. 3 In China, overweight and obesity are defined as a BMI between 24 and less than 28 kg/m 2 and a BMI of 28 kg/m 2 or higher, respectively. 4 WHO's Global Health Estimates show that the global prevalence of overweight and obesity has been increasing year after year for the past 50 years. 3 In 2016, over 1.9 billion adults (39%) aged 18 and above were overweight, with over 650 million (13%) classified as obesity 5 . When compared to 1975, the number of overweight and obesity had doubled or even tripled in some cases. 6 The World Obesity Federation reports that, by 2020, more than 2.6 billion people over the age of 5 had been affected by overweight and obesity. 7 According to the expert consensus on obesity prevention and treatment in China (2022), more than half of Chinese adults suffer from overweight (34.3%) and obesity (16.4%) using Chinese BMI classification. This is a significant increase from the data obtained from China's national surveys in 1992 (20% of adults being overweight and obesity), which aligns with global survey results. 8,9 It is estimated that by 2035, the combined prevalence of overweight and obesity worldwide will reach a new high of 50%, and in China, this figure will reach 65.5% by 2030. 7,10 Given the rapidly increasing global epidemic and potential health hazards, effective intervention strategies for obesity are urgently needed. The Centers for Disease Control and Prevention advises that losing 5–10% of body weight can help improve the metabolic syndrome. 11 The Obesity Management Guidelines recommend lifestyle interventions, obesity pharmacotherapy, and bariatric surgery as common weight loss approaches. 12 Bariatric surgery has established evidence for treating adults with severe obesity (BMI > 35 kg/m2) and complications. 13 However, people are hesitant to choose bariatric surgery due to its invasiveness and long-term complications. Medication serves as an adjunct to behavioral intervention. For instance, in the treatment of prediabetes or type 2 diabetes, weight loss is promoted by suppressing appetite and carbohydrate absorption, including drugs like semaglutide, liraglutide, and metformin. 12,14 Semaglutide has been reported to reduce body weight in adults with obesity by 17–18% over 68 weeks. 15 The weight loss effect of metformin on non-insulin dependent type 2 diabetes patients, especially patients with obesity, is significant, but its effect on healthy people with obesity is uncertain. 16,17 In recent years, metformin has been widely used in patients with obesity combined insulin resistance. Lifestyle interventions are considered the optimal choice for achieving weight loss. Therefore, numerous dietary patterns such as balanced-carbohydrate diet (carbohydrate ≥ 50% of total energy), low-carbohydrate diet (carbohydrate < 30%-40% of total energy), low-glycemic index diets, and Mediterranean-style diets have been reported to promote weight loss. 18 The various macronutrient distributions in these dietary patterns offer distinct advantages for individuals with obesity or overweight. The balanced-carbohydrate diet and low-carbohydrate diet are commonly utilized in clinical settings. 19 A randomized trial revealed that the low-carbohydrate diet led to a 6.8% weight loss, while the balanced diet resulted in a 2.7% weight loss at 3 months. 20 However, there is no consensus among guidelines on the optimal dietary type, and few studies have provided evidence-based comparisons of changes in body composition among patients with overweight or obesity across various weight loss interventions. In this study, we collected data from individuals with overweight and obesity who visited the clinical nutrition department twice or more within three months and received balanced dietary guidance, a low-carbohydrate diet, and pharmaceuticals to lose weight. We retrospectively evaluated the extent and effectiveness of weight loss using different therapies to provide evidence for clinicians, nutritionists, and other health professionals making unified clinical decisions when prescribing weight loss strategies. 2. Materials and Methods 2.1 Participants This retrospective study examined the weight loss effect in individuals with overweight or obesity at the Department of Clinical Nutrition at the Second Affiliated Hospital of Zhejiang University School of Medicine between January 1st, 2020, and December 31st, 2023. The participants had at least two follow-up visits with a BMI of 24 or higher and the primary goal of losing weight. 736 individuals were enrolled regardless of whether they had another metabolic syndrome. However, 397 individuals were excluded for various reason (Fig. 1 ). The study protocol was reviewed and approved by the Institute Review Board of the Second Affiliated Hospital of Zhejiang University (ethical approval number 20231215). Trial registration: Clinical trial registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT06182618. 2.2 Methods The weight and other body composition were measured through multi-frequency bioelectrical impedance analysis using the InBody 720 device (Bio Space Co., Seoul, Korea). The parameters included body mass index (BMI), visceral fat area (VFA), skeletal muscle mass (SMM), body fat mass (BFM), percent body fat (PBF), waist-hip ratio (WHR). Personal information such as age, sex, height, health complications, marital status, family history, history of psychiatric disorders or treatment, number of visits with a dietician and the duration of overweight or obesity were collected. The total energy requirement for each individual was estimated based on their basal metabolic rate (BMR) measured by the InBody 720. Additionally, they were encouraged to incorporate regular exercise (150–300 minutes per week) into their daily routine, including both aerobic and anaerobic activities. Pharmacotherapy involved individuals with overweight or obesity taking semaglutide (1mg per week) or/and metformin (0.5g three times a day) to control their body weight and other metabolic-related indicators. Individuals who received balanced dietary guidance were provided with a menu that consisted of a composition of 50–65% carbohydrates, 20–30% fat and 10–20% protein. The protein mainly came from beans, bean products, nuts, milk, poultry, aquatic products, and lean livestock meat. Fats were mainly derived from unsaturated fatty acids, while reducing the intake of saturated fatty acids. Carbohydrates mainly came from whole grains. The composition of a low-carbohydrate diet was 20–30% carbohydrates, 40–45% fat, and 30–40% protein. Patients were advised to eat two meal replacement bars per day instead of staple foods to help reduce carbohydrate intake and ensure adequate nutrient intake. Dietitian required the patients kept daily records and follow-up online or face to face at least one month to assess energy and nutritional intake. Boohe App was used to calculate food composition with consumption data. This study utilized Chinese-specific BMI cutoff values, defining overweight as a BMI of ≥ 24 kg/m 2 and obesity as a BMI of ≥ 28 kg/m 2 . 12 The percentage weight loss was calculated as 100 × ([Weight at Baseline Visit – Weight at Follow-up Visit]/Weight at Baseline Visit) . 21 Three to five weeks (average 1 month) after the initial visit, the first time point was designated. The second time point occurred seven to nine weeks (average 2 months) after the first visit, and the third time point occurred 11 to 13 weeks (average 3 months) after the initial visit. Ethics declarations The study protocol was reviewed and approved by the Institute Review Board of the Second Affiliated Hospital of Zhejiang University (ethical approval number 20231215). 2.3 Outcomes The primary outcome was the percentage weight loss at 1, 2, and 3 months after commencing a low-carbohydrate diet, balanced dietary guidance, and pharmacotherapy (semaglutide or/and metformin). Since the monthly percentage weight loss was non-normally distributed data (Table S1 ), it was converted into a categorical variable (Significant weight loss and insignificant weight loss). Significant weight loss was defined as the percentage weight loss ≥ 3% or ≥ 5% based on its clinical meaningful health benefits, while insignificant weight loss was the percentage weight loss < 3% or < 5%. 21,22 2.4 Statistical Analysis The Shapiro-Wilk test (Table S1 ) was used to assess the normality of continuous variables. The baseline demographic data and body composition parameters were presented as mean values ± standard deviation (SD), median (interquartile range), or numbers (percentages). For unmorally distributed data, the Wilcoxon Signed Ranks Test and Kruskal-Wallis H Test were utilized for comparison. For normally distributed data, the Independent-Sample T Test and one-way ANOVA (Analysis of variance) were used to compare different groups. Categorical variables were compared using the Chi-squared test. Variables with a p-value of less than 0.2 were included in the multivariable logistic regression analysis model. 23 Multivariable logistic regression analysis was conducted to investigate the impact of the baseline demographic data and body composition parameters on significant weight loss. The statistical significance was set at α = 0.05. All statistical analyses were performed using IBM SPSS Statistics 25 (IBM SPSS, Armonk, NY, USA). 3. Results 3.1 Baseline Characteristics A total of 339 patients who were prescribed dietary and pharmaceuticals for weight loss and had at least 2 follow-up visits within three months were included in the analysis. The low-carbohydrate diet was the most prevalent treatment (168 [49.56%]), followed by balanced dietary guidance (139[41.00%]) and pharmacotherapy (32 [9.44%]). Their median age was 28(25,33) years, with males accounting for 38.94%. 26 (7.67%)patients had a family history of obesity and 20 (5.90%) subjects had a history of psychiatric disease. Age, gender, history of obesity, history of psychiatric disease, marriage, duration of overweight or obesity were similar among the three groups( P > 0.05). MAFLD was the most common comorbidity (67[19.76%]) among these individuals, followed by Prediabetes (37[10.91%]) and POCS was the lowest (11[3.24%]). The proportions of MAFLD, type 2 diabetes, prediabetes and dyslipidemia were statistically different among the three groups ( P < 0.05). The number of visits with a dietician and body composition parameter in pharmacotherapy were significantly higher than that of low-carbohydrate diet and balanced dietary guidance group ( P < 0.05) (Table 1). The outcome variable in this study was the percentage weight loss, so the significant differences in baseline body composition parameters and some obesity-related comorbidities among the three groups had little impact on the results. Table 1. Baseline characteristics Variables, n (%) Low-carbohydrate diet 168 (49.56) Balanced dietary guidance 139 (41.00) Pharmacotherapy 32 (9.44) Total 339(100.00) H/χ2/F P Demographic information Age, median (IQR), y 28.5(25,34) 29(26,34) 26(20.25,33) 28(25,33) 3.096 0.213 Gender: male, n(%) 62(37.13) 54(38.57) 16(50.00) 132(38.94) 1.886 0.390 History of obesity, n(%) 14(8.38) 10(7.14) 2(6.25) 26(7.67) 0.270 0.874 Psychiatric disease, n (%) 11(6.59) 9(6.43) 0(0.00) 20(5.90) 4.098 0.129 Marriage: married, n(%) 62(37.13) 64(45.71) 10(31.25) 136(40.11) 3.495 0.174 Obesity-related comorbidities, n(%) Hypertension 15(8.98) 8(5.71) 0(0.00) 23(6.78) 5.928 0.052 Dyslipidemia 5(3.00) 14(10.00) 3(9.40) 22(6.49) 7.009 0.030* Type 2 diabetes 7(4.19) 4(2.86) 5(15.63) 16(4.72) 6.765 0.034* Prediabetes 3(1.80) 11(7.86) 23(71.88) 37(10.91) 88.561 0.000* Hyperuricemia 9(5.39) 14(10.00) 2(6.25) 25(7.37) 2.400 0.301 MAFLD 30(17.96) 24(17.14) 13(40.62) 67(19.76) 8.270 0.016* PCOS 5(2.99) 6(4.29) 0(0.00) 11(3.24) 2.585 0.275 Number of visits with dietician, median (IQR) 3(2,4) 3(2,3) 4(3,5) 3(2,4) 31.092 0.000* Duration of overweight or obesity, n (%) ＜5 years 101(60.48) 86(62.32) 20(62.50) 207(61.06) 8.353 0.079 5-10 years 37(22.16) 31(22.46) 12(37.50) 80(23.60) ＞10 years 29(17.37) 21(15.22) 0(0.00) 50(14.75) Body composition parameter Weight, median (IQR), kg 85.05(74.40,97.08) 77.50(69.80,88.60) 93.95(81.53,105.63) 88.15(74.58, 103.38) 24.866 0.000* BMI, median (IQR), kg/m 2 31.27(28.03,34.17) 28.60(26.50,31.30) 33.29(29.43,37.13) 32.75(29.65, 34.80) 33.523 0.000* VFA, median (IQR), cm 2 135.39(108.64,168.55) 121.00(95.30,149.59) 138.05(123.47,167.95) 127.58(104.6, 161.00) 15.907 0.000* SMM, median (IQR), kg 27.70(24.35,35.30) 27.00(23.30,33.20) 31.65(27.80,36.08) 27.1(24.45, 34.6) 10.952 0.004* BFM, median (IQR), kg 33.70(27.60,38.98) 28.40(23.60,33.90) 38.55(29.95,44.75) 36.95(30.38, 41.53) 30.176 0.000* PBF , median (IQR), % 39.21±6.24 37.05±6.61 40.00±5.48 38.39±6.42 5,545 0.004* WHR, median (IQR) 0.93(0.89,0.97) 0.92(0.89,0.95) 0.96(0.91,0.99) 0.93(0.89,0.96) 8.583 0.014* Abbreviations: IQR: Interquartile Range; SD: standard deviation; MAFLD : metabolic associated fatty liver disease; BMI: body mass index; VFA: visceral fat area; SMM: skeletal muscle mass; BFM: body fat mass; PBF: percent body fat; WHR: wait-hip ratio; * P <0.05 3.2 Percentage Weight Loss with Different Therapeutic Methods at Various Time Points The total percentage weight loss for patients who were followed up for 1 month, 2 months and 3 months was 4.98 (3.04,6.29) %,7.93 (5.42, 7.93) %and 10.71 (7.74,13.83) % respectively. At 1 month, Kruskal-Wallis H Test r evealed that patients who received the low-carbohydrate diet achieved a percentage weight loss of 5.26[3.90, 6.70)] % compared with a percentage weight loss of 3.95[2.53, 5.68] %and 3.72[2.34,5.97] % for patients receiving balanced dietary guidance and pharmacotherapy ( P ＜0.001). At 2 months, patients who received the low-carbohydrate diet (8.86[6.45,10.84] %) and pharmacotherapy (8.16[5.79,9.68] %) achieved a higher percentage weight loss than those who received balanced dietary guidance (6.77[3.72,8.65] %) ( P ＜0 .01). At 3 months, there was no significant differences among groups for the percentage of weight loss ( P =0.362) (Figure 2 and Table S2). 3.3 Therapeutic Methods and Baseline Characteristics of Patients Achieving 3% or More and 5% or More Weight Loss at 1-Month Point At 1 month, there was a significant difference in the proportion of patients achieving 3% or more compared to those achieving less than 3% weight loss among low-carbohydrate diet, balanced dietary guidance and pharmacotherapy ( P ＜ 0.01). Baseline BFM in patients with 3% or more weight loss was higher than those with 3% or less weight loss ( P =0.036). 86(63.24%) patients in low-carbohydrate diet, 41(30.15%) in balanced dietary guidance and 9(6.62%) in pharmacotherapy achieved weight loss of 5% or more, with a statistical significance compared with those achieved weight loss of less than 5%( P<0.05 ). Baseline weight and BMI in patients with 5% or more weight loss was higher than those with 5% or less weight loss ( P ＜0.05; P ＜0.01). There was no statistically significant difference in other baseline data between the significant weight loss group and insignificant weight loss group (Table 2). Table 2. Therapeutic methods and baseline characteristics of patients achieving 3% or more and 5% or more weight loss at 1-month point Variables Percentage weight loss <3% Percentage weight loss ≥3% P Percentage weight loss <5% Percentage weight loss ≥5% P Therapeutic methods , n (%) Low-carbohydrate diet 23(33.82) 115(56.10) 0.006* 52(37.96) 86(63.24) 0.000* Balanced dietary guidance 38(55.88) 76(37.07) 73(53.28) 41(30.15) Pharmacotherapy 7(10.29) 14(6.83) 12(8.76) 9(6.62) Demographic information Age, median (IQR), y 27(25,33) 29(25,34) 0.748 28(25,33) 29(25,35) 0.710 Gender: male, n(%) 29(42.65) 74(36.10) 0.334 51(37.23) 52(38.24) 0.863 History of obesity, n(%) 7(10.29) 12(5.85) 0.331 11(8.03) 8(5.88) 0.486 Psychiatric disease, n (%) 1(1.47) 15(7.32) 0.139 7(5.11) 9(6.62) 0.596 Marriage: married, n(%) 26(38.24) 74(36.10) 0.751 52(37.96) 48(35.29) 0.648 Obesity-related comorbidities, n(%) Hypertension 7(10.29) 13(6.34) 0.415 11(8.03) 9(6.62) 0.654 Dyslipidemia 7(10.29) 7(3.41) 0.056 9(6.57) 5(3.68) 0.279 Type 2 diabetes 6(8.82) 7(3.41) 0.137 9(6.57) 4(2.94) 0.159 Prediabetes 6(8.82) 20(9.76) 0.820 13(9.49) 13(9.56) 0.984 Hyperuricemia 5(7.35) 14(6.83) 0.883 9(6.57) 10(7.35) 0.799 MAFLD 18(26.47) 36(17.56) 0.110 28(20.44) 26(19.12) 0.784 POCS 4(5.88) 7(3.41) 0.589 6(4.40) 5(3.68) 0.768 Number of visits with dietician, median (IQR) 3(2,3) 3(2,4) 0.214 3(2,4) 3(2,4) 1.000 Duration of overweight or obesity, n (%) ＜5 years 45(67.16) 138(67.32) 93(68.38) 90(66.18) 5-10 years 12(19.40) 37(8.05) 0.951 23(16.91) 27(19.85) 0.821 ＞10 years 9(13.43) 30(14.63) 20(14.71) 19(13.97) Body composition parameter Weight, median (IQR), kg 77.95(67.83,95.50) 83.80(73.20,95.45) 0.068 80.70(69.25,94.90) 84.40(74.40,96.35) 0.039* BMI, median (IQR), kg/m 2 29.10(26.50,32.88) 30.30(27.70,33.46) 0.055 29.50(26.55,32.85) 30.70(28.00,33.78) 0.007* VFA, median (IQR), cm 2 125.95(105.75,154.25) 128.30(105.70,163.86) 0.359 125.60(103.6,159.60) 129.25(106.97,168.21) 0.262 SMM, median (IQR), kg 27.60(22.40,34.55) 27.40(24.05,33.95) 0.507 27.00(23.10,33.50) 27.75(24.75,34.38) 0.092 BFM, median (IQR), kg 30.00(23.43,36.75) 32.30(26.40,36.40) 0.036* 31.50(24.80,37.60) 32.75(27.13,38.40) 0.075 PBF ,mean ±SD, % 37.13(33.73,42.04) 39.10(34.15,43.35) 0.092 38.20(33.85,42.54) 38.70(34.10,43.28) 0.442 WHR, median (IQR) 0.92(0.89,0.96) 0.93(0.89,0.96) 0.417 0.91(0.86,0.96) 0.93(0.90,0.97) 0.053 *P<0.05 3.4 Therapeutic Methods and Baseline Characteristics of Patients Achieving 3% or More and 5% or More Weight Loss at 2- and 3-Month Points At 2 months, there were no significant differences in therapeutic methods and baseline characteristics between patients achieving 3% or more weight loss and those with less than 3%. 67(56.30%) patients in low-carbohydrate diet, 36(30.06%) in balanced dietary guidance, and 16(13.45%) in pharmacotherapy achieved a weight loss of 5% or more, which was statistically significant compared to those who lost less than 5% of their weight ( P ＜ 0.05 ). Baseline weight and BMI were higher in patients who lost 5% or more of their weight compared to those who lost less than 5% ( P ＜0.01; P ＜0.01). There were no significant differences in other baseline data between the ≥5% weight loss group and the <5% weight loss group (Table S3). At 3 months, there were no significant differences in therapeutic methods and baseline characteristics between patients who achieved significant weight loss and those who did not (Table S4). 3.5 Multivariable Logistic Regression Analysis with Enter Method for Factors Associated with Percentage Weight Loss at 1-Month Point In this study, variables with a p-value of less than 0.2 were included in the multivariable logistic regression analysis model. The analysis identified low-carbohydrate diet as an independent factor associated with percentage weight loss of ≥3% (odds ratio [OR] = 0.461, P＜0.05) at 1 month. Additionally, low-carbohydrate diet and baseline BMI were significantly associated with the odds of percentage weight loss of ≥5% (OR=0.349, P=0.000; OR=1.332, P＜0.01) (Table 3). Table 3 Multivariable logistic regression analysis with enter method for factors associated with percentage weight loss at 1month point Percentage weight loss≥3% Percentage weight loss≥5% B S.E. Wald P OR CI 95 % OR B S.E. Wald P OR CI 95 % OR Low-carbohydrate diet a -0.775 0.324 5.728 0.017* 0.461 0.244~0.869 -1.053 0.280 14.140 0.000* 0.349 0.202~0.604 Pharmacotherapy a -0.056 0.573 0.009 0.922 0.946 0.308~2.908 -0.162 0.533 0.093 0.761 0.850 0.299~2.417 Psychiatric disease -1.618 1.057 2.345 0.126 0.198 0.025~1.573 - - - - - - Dyslipidemia 0.819 0.588 1.940 0.164 2.267 0.717~7.174 - - - - - - Type 2 diabetes 0.864 0.647 1.782 0.182 2.373 0.667~8.439 1.262 0.675 3.497 0.061 3.533 0.941~13.264 MAFLD 0.435 0.374 1.356 0.244 1.545 0.743~3.214 Weight 0.050 0.043 1.360 0.244 1.052 0.966~1.145 0.210 0.404 0.270 0.603 1.234 0.559~2.723 BMI 0.084 0.103 0.663 0.415 1.088 0.888~1.332 0.287 0.102 7.832 0.005* 1.332 1.090~1.628 SMM - - - - - - -0.367 0.673 0.297 0.586 0.693 0.185~2.592 BFM -0.136 0.115 1.386 0.239 0.873 0.697~1.094 -0.331 0.431 0.590 0.442 0.718 0.308~1.672 PBF 0.110 0.097 1.290 0.256 1.116 0.923~1.350 - - - - - - WHR - - - - - - 3.412 2.919 1.367 0.242 30.332 0.099~9252.655 Constant -5.387 4.475 1.449 0.229 0.005 - -8.820 3.965 4.947 0.026 0.000 - Abbreviations: B: Coefficient; S.E.: std error; OR: odds ratio; CI: confidence interval; a compared with balanced dietary guidance ; *P<0.05 ； 3.6 Multivariable Logistic Regression Analysis with Enter Method for Factors Associated with Percentage Weight Loss at 2-Month Points Multivariate logistic regressions adjusted showed that therapeutic methods and baseline characteristics with a p-value greater than 0.20 in Table S3 had no significant effect on percentage weight loss of ≥3% and ≥5% at 2-month points (Table 4). At 3-month points, the factors associated with percentage weight loss in univariate analysis were all greater than 0.20, so no further multivariate logistic regressions were conducted. Table 4 Multivariable logistic regression analysis with enter method for factors associated with percentage weight loss at 2-month points Percentage weight loss≥3% Percentage weight loss≥5% B S.E. Wald P OR CI 95 % OR B S.E. Wald P OR CI 95 % OR Low-carbohydrate diet a -0.687 0.551 1.559 0.212 0.503 0.171~1.480 -0.901 0.481 3.516 0.061 0.406 0.158~1.042 Pharmacotherapy a -0.044 0.768 0.003 0.954 0.957 0.212~4.307 -0.387 0.796 0.237 0.627 0.679 0.143~3.231 Gender - - - - - - 0.689 0.709 0.944 0.331 1.991 0.496~7.988 Number of visits with dietician - - - - - - 0.164 0.151 1.171 0.279 1.178 0.876~1.584 BMI - - - - - - -0.023 0.138 0.028 0.867 0.977 0.745~1.281 VFA 0.006 0.011 0.293 0.588 1.006 0.984~1.028 -0.003 0.010 0.069 0.793 0.997 0.977~1.018 BFM 0.000 0.059 0.000 0.997 1.000 0.891~1.122 0.060 0.097 0.375 0.540 1.061 0.877~1.285 PBF 0.034 0.054 0.396 0.529 1.035 0.930~1.151 0.006 0.081 0.006 0.939 1.006 0.858~1.180 Constant 0.128 1.913 0.004 0.947 1.137 - 0.069 3.595 0.000 0.985 1.072 - Abbreviations: B: Coefficient; S.E.: std error; OR: odds ratio; CI: confidence interval; a compared with balanced dietary guidance 4. Discussion In our research, patients with MAFLD, type 2 diabetes, prediabetes, and elevated body composition parameters were more likely to be prescribed weight-loss medications. Pharmacotherapy has increasingly become a supplementary weight loss approach for patients with overweight and obesity, especially those with at least one obesity-related comorbidity. 14 Multiple studies have demonstrated the efficacy of semaglutide and metformin in achieving significant and rapid weight loss. A weekly dose of 1.7 mg or 2.4 mg of semaglutide led to a 5.9% weight reduction after 3 months, while metformin 0.5 g three times daily resulted in a 5.1% weight loss after 3 months. 24,25 Consequently, in clinical practice, doctors often recommend medications as a treatment option for patients with severe obesity or at least one obesity-related comorbidity rather than dietary therapy. In 2013, the AHA (American Heart Association), ACC (American College of Cardiology), and TOS (The Obesity Society) jointly released guidelines suggesting that achieving sustained weight loss of 3%-5% is likely to improve blood lipids, reduce blood glucose and blood pressure, and lower the risk of developing type 2 diabetes. Weight loss of 5% or more (up to 10%) can further improve metabolic-related indicators like blood pressure, blood glucose, HbA1C, triglycerides, and cholesterol. This weight loss can also improve associated conditions like fatty liver disease, type 2 diabetes, obstructive sleep apnea, osteoarthritis, and even reduce the risk of certain cancers. 21,26 The ideal rate of weight loss for patients with obesity is 0.5 to 1 kg per week, or 2 to 4 kg per month, which amounts to approximately 5 to 10 kg lost over three months. This translates to a weight loss of 3% to 5%, and it is based on dietary therapy. 22 In other words, dietary therapy may achieve similar weight loss outcomes as pharmacotherapy. In this retrospective study, we found that after dietary and intervention for patients who were followed up for 1 month, 2 months, and 3 months, the total percentage weight loss was %, % and % respectively. Although patients who used pharmaceuticals had higher baseline body composition parameters, there was no significant increase in percentage weight loss compared to dietary therapy, especially those on a low-carbohydrate diet. On the contrary, patients on a low-carbohydrate diet achieved greater magnitude of weight loss at 1 month. At 2 months, those taking anti-obesity medication lost similar weight compared with those on a low-carbohydrate diet, but more than those in the balanced dietary guidance group. When carbohydrates account for less than 40% of calories, the diet provides less energy, which promotes fat tissue metabolism and weight loss. 27 Medications, however, can easily cause gastrointestinal adverse events such as nausea, dizziness, and diarrhea, leading to lower energy intake for patients. Anti-obesity medication can also delay food absorption. 24 These factors may result in more rapid weight loss compared to patients who only follow balanced dietary guidance. However, at 3 months, there were no significant differences in the percentage of weight loss among different therapies. This may be related to the relatively small number of patients who completed a 3-month follow-up. The univariate analysis revealed that gender, therapeutic methods, baseline body composition, and obesity-related complications played a crucial role in significant weight loss at 1 month and 2 months, but not at 3 months. Multiple logistic regression analyses further indicated that the low-carbohydrate diet was an independent predictor of percentage weight loss of ≥3% and ≥5% after adjusting for baseline characteristics. However, therapeutic methods and baseline characteristics had no impact on significant weight loss at 2 and 3 months. These findings align with reports that low-carbohydrate diets result in more effective body weight reduction in the short term but not in the long term. 28 A randomized trial also suggested that patients with obesity on a low-carbohydrate diet lost more percentage of body weight than those on a conventional diet in the short term. This could be attributed to factors such as a single diet, changes in plasma or central satiety factors, or other factors that affect appetite and dietary adherence. However, as the body gradually adapts to this dietary pattern over the long term, these factors weaken, and the magnitude of weight loss becomes similar to other interventions. 20 The findings emphasize that energy intake, rather than nutrient composition, determines weight loss. 29 , 30 For long-term weight control, a trained interventionist or nutrition professional is essential, regardless of whether lifestyle intervention is used alone or in combination with adjunctive therapies such as medications. 12,21 This study has several limitations that must be acknowledged. Firstly, as a retrospective study, we did not have access to detailed records of patients' calorie intake and physical exercise levels, which could have introduced bias into the results. Secondly, we excluded patients who were not followed up monthly, which may have led to an overestimation of the effectiveness of weight loss. Additionally, there was a possibility of recall bias because the dosage and duration of medication were provided by patients during their communication with dieticians and may not have been accurate. Furthermore, the number of patients followed up for 3 months was relatively small, which may have limited the accuracy of the results. Our analyses only examined the effects within three months and did not consider the longer-term effects of weight loss. Finally, our analysis was incomplete due to the absence of laboratory indicators related to metabolic syndrome, which made it challenging to establish the connection between weight loss and changes in the risk factors for metabolic syndrome. In conclusion, this retrospective study showed that a low-carbohydrate diet was an effective weight loss strategy in the short term (1 month). However, its long-term effects (2 and 3 months) were comparable to those observed with balanced dietary guidance and pharmacotherapy. Therefore, it is important to consider individual patient characteristics and long-term outcomes when selecting appropriate weight loss strategies. Future research should focus on longer-term follow-up and include more comprehensive assessments of patient lifestyle factors to better understand the impact of different dietary interventions on weight loss and metabolic health. Abbreviations IQR: Interquartile Range; SD: standard deviation; MAFLD : metabolic associated fatty liver disease; BMI: body mass index; VFA: visceral fat area; SMM: skeletal muscle mass; BFM: body fat mass; PBF: percent body fat; WHR: wait-hip ratio；B: Coefficient; S.E.: std error; OR: odds ratio; CI: confidence interval. Declarations Conflict of interest: The authors declare that they have no conflicts of interest. Author Contributions: Lei-lei Wang designed the study and collected the data. Hui-hui Yan contributed to the technical assistance. Ling-ling Wang, Xiao-chen Liu, Hai-ying Hu, Hong-xia Li, Wei Wei and Qin Du were major contributors to research and academic guidance. All authors contributed to the writing and revision of the manuscript. Acknowledgments: None Approval for human experiments：We Confirm that all experiments were performed in accordance with relevant named guidelines and regulations. This study was a retrospective study, ethics committee was in favor of informed consent exemption. Funding: The study was supported by Zhejiang Provincial Natural Science Foundation of China (LY22H160002) References Bray, G. A., Kim, K. K. & Wilding, J. P. H. Obesity: a chronic relapsing progressive disease process. A position statement of the World Obesity Federation. Obesity reviews : an official journal of the International Association for the Study of Obesity 18 , 715-723, doi:10.1111/obr.12551 (2017). Blüher, M. Obesity: global epidemiology and pathogenesis. Nat Rev Endocrinol 15 , 288-298, doi:10.1038/s41574-019-0176-8 (2019). the World Health Organization(WHO). obesity and overweight. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight (2021). Pan, X. F., Wang, L. & Pan, A. Epidemiology and determinants of obesity in China. The lancet. Diabetes & endocrinology 9 , 373-392, doi:10.1016/s2213-8587(21)00045-0 (2021). Collaboration, N. C. D. R. F. Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults. Lancet 390 , 2627-2642, doi:10.1016/S0140-6736(17)32129-3 (2017). NCD Risk Factor Collaboration (NCD-RisC). Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19·2 million participants. Lancet 387 , 1377-1396, doi:10.1016/s0140-6736(16)30054-x (2016). World Obesity Federation. https://www.worldobesityday.org/assets/downloads/World_Obesity_Atlas_2023_Report . Chen, K. et al. Prevalence of obesity and associated complications in China: A cross-sectional, real-world study in 15.8 million adults. Diabetes Obes Metab , doi:10.1111/dom.15238 (2023). Chinese Nutrition Society Obesity Prevention and Control Section, C. N. S. C. N. S., Chinese Preventive Medicine Association Behavioral Health Section,Chinese Preventive Medicine Association Sports and Health Section. Expert Consensus on Obesity Prevention and Treatment in China. Chin J epidemiol 43 , 609-626, doi:10.3760/cma.j.cn112338-20220402-00253 (2022). Tian, X. & Wang, H. Projecting National-Level Prevalence of General Obesity and Abdominal Obesity Among Chinese Adults With Aging Effects. Frontiers in endocrinology 13 , 849392, doi:10.3389/fendo.2022.849392 (2022). Ryan, D. H. & Yockey, S. R. Weight Loss and Improvement in Comorbidity: Differences at 5%, 10%, 15%, and Over. Curr Obes Rep 6 , 187-194, doi:10.1007/s13679-017-0262-y (2017). Ryan, D. H. & Kahan, S. Guideline Recommendations for Obesity Management. Med Clin North Am 102 , 49-63, doi:10.1016/j.mcna.2017.08.006 (2018). Wolfe, B. M., Kvach, E. & Eckel, R. H. Treatment of Obesity: Weight Loss and Bariatric Surgery. Circ Res 118 , 1844-1855, doi:10.1161/CIRCRESAHA.116.307591 (2016). Apovian, C. M. et al. Pharmacological management of obesity: an endocrine Society clinical practice guideline. The Journal of clinical endocrinology and metabolism 100 , 342-362, doi:10.1210/jc.2014-3415 (2015). Wilding, J. P. H. et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. The New England journal of medicine 384 , 989-1002, doi:10.1056/NEJMoa2032183 (2021). Masarwa, R. et al. Efficacy and Safety of Metformin for Obesity: A Systematic Review. Pediatrics 147 , doi:10.1542/peds.2020-1610 (2021). Seifarth, C., Schehler, B. & Schneider, H. J. Effectiveness of metformin on weight loss in non-diabetic individuals with obesity. Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association 121 , 27-31, doi:10.1055/s-0032-1327734 (2013). Wadden, T. A., Tronieri, J. S. & Butryn, M. L. Lifestyle modification approaches for the treatment of obesity in adults. The American psychologist 75 , 235-251, doi:10.1037/amp0000517 (2020). Nutrition and Metabolic Management Branch of China International Exchange and Promotive Association for Medical and Health Care, C. N. B. o. C. N. S., Chinese Diabetes Society, Chinese Society for Parenteral and Enteral Nutrition, Chinese Clinical Nutritionist Center of Chinese Medical Doctor Association. Guidelines for medical nutrition treatment of overweight/obesity in China (2021). Asia Pacific journal of clinical nutrition 31 , 450-482, doi:10.6133/apjcn.202209_31(3).0013 (2022). Jensen, M. D. et al. 2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults. Circulation 129 , doi:10.1161/01.cir.0000437739.71477.ee (2014). Schwartz, J. Nutritional Therapy. Prim Care 43 , 69-81, viii, doi:10.1016/j.pop.2015.08.012 (2016). Tesema, G. A., Gezie, L. D. & Nigatu, S. G. Spatial distribution of stillbirth and associated factors in Ethiopia: a spatial and multilevel analysis. BMJ open 10 , e034562, doi:10.1136/bmjopen-2019-034562 (2020). Gao, L. et al. Comparison of Beinaglutide Versus Metformin for Weight Loss in Overweight and Obese Non-diabetic Patients. Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association 130 , 358-367, doi:10.1055/a-1608-0345 (2022). Ghusn, W. et al. Weight Loss Outcomes Associated With Semaglutide Treatment for Patients With Overweight or Obesity. JAMA Network Open 5 , e2231982, doi:10.1001/jamanetworkopen.2022.31982 (2022). American College of Cardiology/American Heart Association Task Force on Practice Guidelines, O. E. P., 2013. Expert Panel Report: Guidelines (2013) for the management of overweight and obesity in adults. Obesity (Silver Spring, Md.) 22 Suppl 2 , S41-410, doi:10.1002/oby.20660 (2014). Bravata, D. M. et al. Efficacy and safety of low-carbohydrate diets: a systematic review. Jama 289 , 1837-1850, doi:10.1001/jama.289.14.1837 (2003). Di Rosa, C. et al. Mediterranean Diet versus Very Low-Calorie Ketogenic Diet: Effects of Reaching 5% Body Weight Loss on Body Composition in Subjects with Overweight and with Obesity-A Cohort Study. Int J Environ Res Public Health 19 , doi:10.3390/ijerph192013040 (2022). Foster, G. D. et al. A randomized trial of a low-carbohydrate diet for obesity. The New England journal of medicine 348 , 2082-2090, doi:10.1056/NEJMoa022207 (2003). York, L. W., Puthalapattu, S. & Wu, G. Y. Nonalcoholic fatty liver disease and low-carbohydrate diets. Annual review of nutrition 29 , 365-379, doi:10.1146/annurev-nutr-070208-114232 (2009). Elmaleh-Sachs A, Schwartz JL, Bramante CT, Nicklas JM, Gudzune KA, Jay M. Obesity Management in Adults: A Review. Jama 2023; 330 (20): 2000-15, doi: 10.1001/jama.2023.19897 (2023). Additional Declarations No competing interests reported. Supplementary Files supportinginformation.doc Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4485017","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":312804294,"identity":"36debad5-bf35-40bb-815a-b0a096125da3","order_by":0,"name":"Lei-lei Wang","email":"","orcid":"","institution":"Zhejiang University","correspondingAuthor":false,"prefix":"","firstName":"Lei-lei","middleName":"","lastName":"Wang","suffix":""},{"id":312804296,"identity":"e829e444-9e9d-401a-b034-ecfb378b3cdf","order_by":1,"name":"Ling-ling Wang","email":"","orcid":"","institution":"Zhejiang 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Yan","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA80lEQVRIiWNgGAWjYJACCQaGAzJg8gMDG0jAgCgtPCDy4AyStTDzQATwazE4fvbgjY9td3j4pXsMD9v84UtsYG/eJsFQcwe3ljN5yZYz257xSM45Y3A4h4ctsYHnWJkEw7FnuLUcyDGT5m07zGNwIweoRQKoRSLHTIKx4TBuLeffQLTYg7RYGAC1yL8hoOUGzBYJoBaGBJAtPPi1SN54Y2w549wzHokbaQUHew6wGbfxpBVbJBzDrYXvfI7hjQ9ld+T4ZyRv/vDjzzHZfvbDG298qMGtReEAKv8YJDITcGpgYJBvQOXX4FE7CkbBKBgFIxUAAOO4V1W/Orf4AAAAAElFTkSuQmCC","orcid":"","institution":"Zhejiang University","correspondingAuthor":true,"prefix":"","firstName":"Hui-hui","middleName":"","lastName":"Yan","suffix":""}],"badges":[],"createdAt":"2024-05-27 12:29:11","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4485017/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4485017/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":58230938,"identity":"d44b7248-8d44-41b3-a071-9e42807f383f","added_by":"auto","created_at":"2024-06-12 19:22:51","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":21339,"visible":true,"origin":"","legend":"\u003cp\u003eFlow chart of the Study\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-4485017/v1/315c6b68f084e66ce6a705e1.png"},{"id":58230939,"identity":"9ed78ee9-73ee-4f9e-98d1-1ac3bacaedeb","added_by":"auto","created_at":"2024-06-12 19:22:51","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":28134,"visible":true,"origin":"","legend":"\u003cp\u003ePercentage weight loss with different therapeutic methods at various time points\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-4485017/v1/dded73eb25a7f746d2395905.png"},{"id":58545381,"identity":"7cdf9b9a-ee61-4b60-a02d-d9ea0765cc31","added_by":"auto","created_at":"2024-06-18 05:33:05","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":915573,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4485017/v1/802a7233-d6f1-4ab0-a0b8-12f34f1c1112.pdf"},{"id":58230941,"identity":"ca67498e-a945-4f36-8479-88faaf43bb0e","added_by":"auto","created_at":"2024-06-12 19:22:51","extension":"doc","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":117760,"visible":true,"origin":"","legend":"","description":"","filename":"supportinginformation.doc","url":"https://assets-eu.researchsquare.com/files/rs-4485017/v1/f55c8bbcb80efb34d8a56b6b.doc"}],"financialInterests":"No competing interests reported.","formattedTitle":"Comparison of Weight Loss Induced by Dietary and Pharmaceuticals in Individuals with Overweight and Obesity: A Case Control Study","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eThe introduction Obesity and overweight are complex chronic metabolic diseases that result from a combination of factors, including genetics, psychosocial factors, endocrine dysfunction, and unhealthy lifestyle choices such as physical inactivity and calorie-dense diets. These conditions can lead to the abnormal accumulation of adipose tissue, increasing the risk of various chronic diseases like cardiovascular disease (CVDs), insulin resistance, type 2 diabetes, dyslipidemia, hypertension, fatty liver disease, and cancer.\u003csup\u003e1,2\u003c/sup\u003e Body mass index (BMI) is a convenient and widely used tool for screening adults for overweight and obesity. According to the World Health Organization (WHO), a BMI between 25 and 29.9 kg/m2 is considered overweight, while a BMI of 30 kg/m2 or higher is classified as obesity.\u003csup\u003e3\u003c/sup\u003e In China, overweight and obesity are defined as a BMI between 24 and less than 28 kg/m\u003csup\u003e2\u003c/sup\u003e and a BMI of 28 kg/m\u003csup\u003e2\u003c/sup\u003e or higher, respectively.\u003csup\u003e4\u003c/sup\u003e WHO's Global Health Estimates show that the global prevalence of overweight and obesity has been increasing year after year for the past 50 years.\u003csup\u003e3\u003c/sup\u003e In 2016, over 1.9\u0026nbsp;billion adults (39%) aged 18 and above were overweight, with over 650\u0026nbsp;million (13%) classified as obesity \u003csup\u003e5\u003c/sup\u003e. When compared to 1975, the number of overweight and obesity had doubled or even tripled in some cases.\u003csup\u003e6\u003c/sup\u003e The World Obesity Federation reports that, by 2020, more than 2.6\u0026nbsp;billion people over the age of 5 had been affected by overweight and obesity.\u003csup\u003e7\u003c/sup\u003e According to the expert consensus on obesity prevention and treatment in China (2022), more than half of Chinese adults suffer from overweight (34.3%) and obesity (16.4%) using Chinese BMI classification. This is a significant increase from the data obtained from China's national surveys in 1992 (20% of adults being overweight and obesity), which aligns with global survey results. \u003csup\u003e8,9\u003c/sup\u003e It is estimated that by 2035, the combined prevalence of overweight and obesity worldwide will reach a new high of 50%, and in China, this figure will reach 65.5% by 2030.\u003csup\u003e7,10\u003c/sup\u003e Given the rapidly increasing global epidemic and potential health hazards, effective intervention strategies for obesity are urgently needed.\u003c/p\u003e \u003cp\u003eThe Centers for Disease Control and Prevention advises that losing 5\u0026ndash;10% of body weight can help improve the metabolic syndrome. \u003csup\u003e11\u003c/sup\u003e The Obesity Management Guidelines recommend lifestyle interventions, obesity pharmacotherapy, and bariatric surgery as common weight loss approaches.\u003csup\u003e12\u003c/sup\u003e Bariatric surgery has established evidence for treating adults with severe obesity (BMI\u0026thinsp;\u0026gt;\u0026thinsp;35 kg/m2) and complications. \u003csup\u003e13\u003c/sup\u003eHowever, people are hesitant to choose bariatric surgery due to its invasiveness and long-term complications. Medication serves as an adjunct to behavioral intervention. For instance, in the treatment of prediabetes or type 2 diabetes, weight loss is promoted by suppressing appetite and carbohydrate absorption, including drugs like semaglutide, liraglutide, and metformin.\u003csup\u003e12,14\u003c/sup\u003e Semaglutide has been reported to reduce body weight in adults with obesity by 17\u0026ndash;18% over 68 weeks.\u003csup\u003e15\u003c/sup\u003e The weight loss effect of metformin on non-insulin dependent type 2 diabetes patients, especially patients with obesity, is significant, but its effect on healthy people with obesity is uncertain.\u003csup\u003e16,17\u003c/sup\u003e In recent years, metformin has been widely used in patients with obesity combined insulin resistance. Lifestyle interventions are considered the optimal choice for achieving weight loss. Therefore, numerous dietary patterns such as balanced-carbohydrate diet (carbohydrate\u0026thinsp;\u0026ge;\u0026thinsp;50% of total energy), low-carbohydrate diet (carbohydrate\u0026thinsp;\u0026lt;\u0026thinsp;30%-40% of total energy), low-glycemic index diets, and Mediterranean-style diets have been reported to promote weight loss.\u003csup\u003e18\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThe various macronutrient distributions in these dietary patterns offer distinct advantages for individuals with obesity or overweight. The balanced-carbohydrate diet and low-carbohydrate diet are commonly utilized in clinical settings.\u003csup\u003e19\u003c/sup\u003e A randomized trial revealed that the low-carbohydrate diet led to a 6.8% weight loss, while the balanced diet resulted in a 2.7% weight loss at 3 months. \u003csup\u003e20\u003c/sup\u003e However, there is no consensus among guidelines on the optimal dietary type, and few studies have provided evidence-based comparisons of changes in body composition among patients with overweight or obesity across various weight loss interventions. In this study, we collected data from individuals with overweight and obesity who visited the clinical nutrition department twice or more within three months and received balanced dietary guidance, a low-carbohydrate diet, and pharmaceuticals to lose weight. We retrospectively evaluated the extent and effectiveness of weight loss using different therapies to provide evidence for clinicians, nutritionists, and other health professionals making unified clinical decisions when prescribing weight loss strategies.\u003c/p\u003e"},{"header":"2. Materials and Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Participants\u003c/h2\u003e \u003cp\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eThis retrospective study examined the weight loss effect in individuals with overweight or obesity at the Department of Clinical Nutrition at the Second Affiliated Hospital of Zhejiang University School of Medicine between January 1st, 2020, and December 31st, 2023. The participants had at least two follow-up visits with a BMI of 24 or higher and the primary goal of losing weight. 736 individuals were enrolled regardless of whether they had another metabolic syndrome. However, 397 individuals were excluded for various reason (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). The study protocol was reviewed and approved by the Institute Review Board of the Second Affiliated Hospital of Zhejiang University (ethical approval number 20231215). Trial registration: Clinical trial registration: URL: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.clinicaltrials.gov\u003c/span\u003e\u003cspan address=\"https://www.clinicaltrials.gov\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Unique identifier: NCT06182618.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Methods\u003c/h2\u003e \u003cp\u003eThe weight and other body composition were measured through multi-frequency bioelectrical impedance analysis using the InBody 720 device (Bio Space Co., Seoul, Korea). The parameters included body mass index (BMI), visceral fat area (VFA), skeletal muscle mass (SMM), body fat mass (BFM), percent body fat (PBF), waist-hip ratio (WHR). Personal information such as age, sex, height, health complications, marital status, family history, history of psychiatric disorders or treatment, number of visits with a dietician and the duration of overweight or obesity were collected.\u003c/p\u003e \u003cp\u003eThe total energy requirement for each individual was estimated based on their basal metabolic rate (BMR) measured by the InBody 720. Additionally, they were encouraged to incorporate regular exercise (150\u0026ndash;300 minutes per week) into their daily routine, including both aerobic and anaerobic activities. Pharmacotherapy involved individuals with overweight or obesity taking semaglutide (1mg per week) or/and metformin (0.5g three times a day) to control their body weight and other metabolic-related indicators.\u003c/p\u003e \u003cp\u003eIndividuals who received balanced dietary guidance were provided with a menu that consisted of a composition of 50\u0026ndash;65% carbohydrates, 20\u0026ndash;30% fat and 10\u0026ndash;20% protein. The protein mainly came from beans, bean products, nuts, milk, poultry, aquatic products, and lean livestock meat. Fats were mainly derived from unsaturated fatty acids, while reducing the intake of saturated fatty acids. Carbohydrates mainly came from whole grains. The composition of a low-carbohydrate diet was 20\u0026ndash;30% carbohydrates, 40\u0026ndash;45% fat, and 30\u0026ndash;40% protein. Patients were advised to eat two meal replacement bars per day instead of staple foods to help reduce carbohydrate intake and ensure adequate nutrient intake. Dietitian required the patients kept daily records and follow-up online or face to face at least one month to assess energy and nutritional intake. Boohe App was used to calculate food composition with consumption data.\u003c/p\u003e \u003cp\u003eThis study utilized Chinese-specific BMI cutoff values, defining overweight as a BMI of \u0026ge;\u0026thinsp;24 kg/m\u003csup\u003e2\u003c/sup\u003e and obesity as a BMI of \u0026ge;\u0026thinsp;28 kg/m\u003csup\u003e2\u003c/sup\u003e.\u003csup\u003e12\u003c/sup\u003eThe percentage weight loss was calculated as 100 \u0026times; ([Weight at Baseline Visit \u0026ndash; Weight at Follow-up Visit]/Weight at Baseline Visit) .\u003csup\u003e21\u003c/sup\u003e Three to five weeks (average 1 month) after the initial visit, the first time point was designated. The second time point occurred seven to nine weeks (average 2 months) after the first visit, and the third time point occurred 11 to 13 weeks (average 3 months) after the initial visit.\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eEthics declarations\u003c/strong\u003e \u003cp\u003eThe study protocol was reviewed and approved by the Institute Review Board of the Second Affiliated Hospital of Zhejiang University (ethical approval number 20231215).\u003c/p\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Outcomes\u003c/h2\u003e \u003cp\u003eThe primary outcome was the percentage weight loss at 1, 2, and 3 months after commencing a low-carbohydrate diet, balanced dietary guidance, and pharmacotherapy (semaglutide or/and metformin). Since the monthly percentage weight loss was non-normally distributed data (Table \u003cspan refid=\"MOESM1\" class=\"InternalRef\"\u003eS1\u003c/span\u003e), it was converted into a categorical variable (Significant weight loss and insignificant weight loss). Significant weight loss was defined as the percentage weight loss\u0026thinsp;\u0026ge;\u0026thinsp;3% or \u0026ge;\u0026thinsp;5% based on its clinical meaningful health benefits, while insignificant weight loss was the percentage weight loss\u0026thinsp;\u0026lt;\u0026thinsp;3% or \u0026lt;\u0026thinsp;5%.\u003csup\u003e21,22\u003c/sup\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e2.4 Statistical Analysis\u003c/h2\u003e \u003cp\u003eThe Shapiro-Wilk test (Table \u003cspan refid=\"MOESM1\" class=\"InternalRef\"\u003eS1\u003c/span\u003e) was used to assess the normality of continuous variables. The baseline demographic data and body composition parameters were presented as mean values\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation (SD), median (interquartile range), or numbers (percentages). For unmorally distributed data, the Wilcoxon Signed Ranks Test and Kruskal-Wallis H Test were utilized for comparison. For normally distributed data, the Independent-Sample T Test and one-way ANOVA (Analysis of variance) were used to compare different groups. Categorical variables were compared using the Chi-squared test. Variables with a p-value of less than 0.2 were included in the multivariable logistic regression analysis model.\u003csup\u003e23\u003c/sup\u003e Multivariable logistic regression analysis was conducted to investigate the impact of the baseline demographic data and body composition parameters on significant weight loss. The statistical significance was set at α\u0026thinsp;=\u0026thinsp;0.05. All statistical analyses were performed using IBM SPSS Statistics 25 (IBM SPSS, Armonk, NY, USA).\u003c/p\u003e \u003c/div\u003e"},{"header":"3. Results","content":"\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e3.1 Baseline Characteristics\u003c/h2\u003e \u003cp\u003eA total of 339 patients who were prescribed dietary and pharmaceuticals for weight loss and had at least 2 follow-up visits within three months were included in the analysis. The low-carbohydrate diet was the most prevalent treatment (168 [49.56%]), followed by balanced dietary guidance (139[41.00%]) and pharmacotherapy (32 [9.44%]). Their median age was 28(25,33) years, with males accounting for 38.94%. 26 (7.67%)patients had a family history of obesity and 20 (5.90%) subjects had a history of psychiatric disease. Age, gender, history of obesity, history of psychiatric disease, marriage, duration of overweight or obesity were similar among the three groups(\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05). MAFLD was the most common comorbidity (67[19.76%]) among these individuals, followed by Prediabetes (37[10.91%]) and POCS was the lowest (11[3.24%]). The proportions of MAFLD, type 2 diabetes, prediabetes and dyslipidemia were statistically different among the three groups (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). The number of visits with a dietician and body composition parameter in pharmacotherapy were significantly higher than that of low-carbohydrate diet and balanced dietary guidance group (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05) (Table\u0026nbsp;1). The outcome variable in this study was the percentage weight loss, so the significant differences in baseline body composition parameters and some obesity-related comorbidities among the three groups had little impact on the results.\u003c/p\u003e \u003cp\u003eTable\u0026nbsp;1. Baseline characteristics\u003c/p\u003e \u003c/div\u003e\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.166666666666668%\"\u003e\n \u003cp\u003e Variables, n (%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003eLow-carbohydrate diet\u003c/p\u003e\n \u003cp\u003e168 (49.56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\"\u003e\n \u003cp\u003eBalanced dietary guidance\u003c/p\u003e\n \u003cp\u003e139 (41.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003ePharmacotherapy\u003c/p\u003e\n \u003cp\u003e32 (9.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003cp\u003e339(100.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\"\u003e\n \u003cp\u003e\u003cem\u003eH/\u0026chi;2/F\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" colspan=\"2\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.282828282828284%\" valign=\"top\"\u003e\n \u003cp\u003eDemographic information\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"71.71717171717172%\" colspan=\"7\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.166666666666668%\"\u003e\n \u003cp\u003eAge, median (IQR), y\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e28.5(25,34)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\"\u003e\n \u003cp\u003e29(26,34)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e26(20.25,33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e28(25,33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\"\u003e\n \u003cp\u003e3.096\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" colspan=\"2\"\u003e\n \u003cp\u003e0.213\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.166666666666668%\"\u003e\n \u003cp\u003eGender: male, n(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e62(37.13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\"\u003e\n \u003cp\u003e54(38.57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e16(50.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e132(38.94)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\"\u003e\n \u003cp\u003e1.886\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" colspan=\"2\"\u003e\n \u003cp\u003e0.390\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.166666666666668%\"\u003e\n \u003cp\u003eHistory of obesity, n(%) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e14(8.38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\"\u003e\n \u003cp\u003e10(7.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e2(6.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e26(7.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\"\u003e\n \u003cp\u003e0.270\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" colspan=\"2\"\u003e\n \u003cp\u003e0.874\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.166666666666668%\"\u003e\n \u003cp\u003ePsychiatric disease, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e11(6.59)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\"\u003e\n \u003cp\u003e9(6.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e0(0.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e20(5.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\"\u003e\n \u003cp\u003e4.098\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" colspan=\"2\"\u003e\n \u003cp\u003e0.129\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.166666666666668%\"\u003e\n \u003cp\u003eMarriage: married, n(%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e62(37.13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\"\u003e\n \u003cp\u003e64(45.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e10(31.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e136(40.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\"\u003e\n \u003cp\u003e3.495\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" colspan=\"2\"\u003e\n \u003cp\u003e0.174\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"45.36082474226804%\" colspan=\"2\"\u003e\n \u003cp\u003eObesity-related comorbidities, n(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.402061855670103%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.154639175257732%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.154639175257732%\" colspan=\"2\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.166666666666668%\"\u003e\n \u003cp\u003eHypertension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e15(8.98)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\"\u003e\n \u003cp\u003e8(5.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e0(0.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e23(6.78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\"\u003e\n \u003cp\u003e5.928\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" colspan=\"2\"\u003e\n \u003cp\u003e0.052\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.166666666666668%\"\u003e\n \u003cp\u003eDyslipidemia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e5(3.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\"\u003e\n \u003cp\u003e14(10.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e3(9.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e22(6.49)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\"\u003e\n \u003cp\u003e7.009\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" colspan=\"2\"\u003e\n \u003cp\u003e0.030*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.166666666666668%\"\u003e\n \u003cp\u003eType 2 diabetes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e7(4.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\"\u003e\n \u003cp\u003e4(2.86)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e5(15.63)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e16(4.72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\"\u003e\n \u003cp\u003e6.765\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" colspan=\"2\"\u003e\n \u003cp\u003e0.034*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.166666666666668%\"\u003e\n \u003cp\u003ePrediabetes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e3(1.80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\"\u003e\n \u003cp\u003e11(7.86)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e23(71.88)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e37(10.91)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\"\u003e\n \u003cp\u003e88.561\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" colspan=\"2\"\u003e\n \u003cp\u003e0.000*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.166666666666668%\"\u003e\n \u003cp\u003eHyperuricemia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e9(5.39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\"\u003e\n \u003cp\u003e14(10.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e2(6.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e25(7.37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\"\u003e\n \u003cp\u003e2.400\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" colspan=\"2\"\u003e\n \u003cp\u003e0.301\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.166666666666668%\"\u003e\n \u003cp\u003eMAFLD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e30(17.96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\"\u003e\n \u003cp\u003e24(17.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e13(40.62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e67(19.76)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\"\u003e\n \u003cp\u003e8.270\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" colspan=\"2\"\u003e\n \u003cp\u003e0.016*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.166666666666668%\"\u003e\n \u003cp\u003ePCOS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e5(2.99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\"\u003e\n \u003cp\u003e6(4.29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e0(0.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e11(3.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\"\u003e\n \u003cp\u003e2.585\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" colspan=\"2\"\u003e\n \u003cp\u003e0.275\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.166666666666668%\"\u003e\n \u003cp\u003eNumber of visits with dietician, median (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e3(2,4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\"\u003e\n \u003cp\u003e3(2,3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e4(3,5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e3(2,4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\"\u003e\n \u003cp\u003e31.092\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" colspan=\"2\"\u003e\n \u003cp\u003e0.000*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.166666666666668%\"\u003e\n \u003cp\u003eDuration of overweight or obesity, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"2.0833333333333335%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.166666666666668%\"\u003e\n \u003cp\u003e＜5 years\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e101(60.48)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\"\u003e\n \u003cp\u003e86(62.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e20(62.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e207(61.06)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" rowspan=\"3\"\u003e\n \u003cp\u003e8.353\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" colspan=\"2\" rowspan=\"3\"\u003e\n \u003cp\u003e0.079\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"32.55813953488372%\"\u003e\n \u003cp\u003e5-10 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.441860465116278%\"\u003e\n \u003cp\u003e37(22.16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.767441860465116%\"\u003e\n \u003cp\u003e31(22.46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.116279069767442%\"\u003e\n \u003cp\u003e12(37.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.116279069767442%\" valign=\"top\"\u003e\n \u003cp\u003e80(23.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"32.55813953488372%\"\u003e\n \u003cp\u003e＞10 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.441860465116278%\"\u003e\n \u003cp\u003e29(17.37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.767441860465116%\"\u003e\n \u003cp\u003e21(15.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.116279069767442%\"\u003e\n \u003cp\u003e0(0.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.116279069767442%\" valign=\"top\"\u003e\n \u003cp\u003e50(14.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"45.36082474226804%\" colspan=\"2\"\u003e\n \u003cp\u003eBody composition parameter\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.402061855670103%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.154639175257732%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.154639175257732%\" colspan=\"2\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.166666666666668%\"\u003e\n \u003cp\u003eWeight, median (IQR), kg\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e85.05(74.40,97.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\"\u003e\n \u003cp\u003e77.50(69.80,88.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e93.95(81.53,105.63)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"bottom\"\u003e\n \u003cp\u003e88.15(74.58, 103.38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\"\u003e\n \u003cp\u003e24.866\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" colspan=\"2\"\u003e\n \u003cp\u003e0.000*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.166666666666668%\"\u003e\n \u003cp\u003eBMI, median (IQR), \u0026nbsp;kg/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e31.27(28.03,34.17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\"\u003e\n \u003cp\u003e28.60(26.50,31.30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e33.29(29.43,37.13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"bottom\"\u003e\n \u003cp\u003e32.75(29.65, 34.80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\"\u003e\n \u003cp\u003e33.523\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" colspan=\"2\"\u003e\n \u003cp\u003e0.000*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.166666666666668%\"\u003e\n \u003cp\u003eVFA, median (IQR), cm\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e135.39(108.64,168.55)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\"\u003e\n \u003cp\u003e121.00(95.30,149.59)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e138.05(123.47,167.95)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"bottom\"\u003e\n \u003cp\u003e127.58(104.6, 161.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\"\u003e\n \u003cp\u003e15.907\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" colspan=\"2\"\u003e\n \u003cp\u003e0.000*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.166666666666668%\"\u003e\n \u003cp\u003eSMM, median (IQR), kg\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e27.70(24.35,35.30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\"\u003e\n \u003cp\u003e27.00(23.30,33.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e31.65(27.80,36.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"bottom\"\u003e\n \u003cp\u003e27.1(24.45, 34.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\"\u003e\n \u003cp\u003e10.952\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" colspan=\"2\"\u003e\n \u003cp\u003e0.004*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.166666666666668%\"\u003e\n \u003cp\u003eBFM, median (IQR), kg\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e33.70(27.60,38.98)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\"\u003e\n \u003cp\u003e28.40(23.60,33.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e38.55(29.95,44.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"bottom\"\u003e\n \u003cp\u003e36.95(30.38, 41.53)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\"\u003e\n \u003cp\u003e30.176\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" colspan=\"2\"\u003e\n \u003cp\u003e0.000*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.166666666666668%\"\u003e\n \u003cp\u003ePBF\u0026nbsp;,\u0026nbsp;median (IQR), %\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e39.21\u0026plusmn;6.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\"\u003e\n \u003cp\u003e37.05\u0026plusmn;6.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e40.00\u0026plusmn;5.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"bottom\"\u003e\n \u003cp\u003e38.39\u0026plusmn;6.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\"\u003e\n \u003cp\u003e5,545\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" colspan=\"2\"\u003e\n \u003cp\u003e0.004*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.166666666666668%\"\u003e\n \u003cp\u003eWHR, median (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e0.93(0.89,0.97)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\"\u003e\n \u003cp\u003e0.92(0.89,0.95)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e0.96(0.91,0.99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.93(0.89,0.96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\"\u003e\n \u003cp\u003e8.583\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" colspan=\"2\"\u003e\n \u003cp\u003e0.014*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cdiv dir=\"RTL\"\u003e\n \u003cp dir=\"LTR\"\u003eAbbreviations: IQR: Interquartile Range; \u003cstrong\u003eSD: standard deviation;\u003c/strong\u003e MAFLD\u003cstrong\u003e:\u003c/strong\u003e metabolic associated\u003cstrong\u003e\u0026nbsp;fatty liver disease;\u0026nbsp;\u003c/strong\u003eBMI: body mass index;\u0026nbsp;VFA: visceral fat area; SMM: skeletal muscle mass; BFM: body fat mass; PBF: percent body fat; WHR: wait-hip ratio; *\u003cem\u003eP\u003c/em\u003e\u0026lt;0.05\u003c/p\u003e\n\u003c/div\u003e\n\u003cp\u003e3.2 Percentage Weight Loss with Different Therapeutic Methods at Various Time Points\u003c/p\u003e\n\u003cp\u003eThe total percentage weight loss for patients who were followed up for 1 month, 2 months and 3 months was 4.98 (3.04,6.29) %,7.93 (5.42, 7.93) %and 10.71 (7.74,13.83) % respectively. At 1 month, Kruskal-Wallis H Test\u003cstrong\u003e\u0026nbsp;r\u003c/strong\u003eevealed\u0026nbsp;that patients\u0026nbsp;who received the\u0026nbsp;low-carbohydrate diet\u0026nbsp;achieved a percentage weight loss of\u0026nbsp;5.26[3.90, 6.70)] % compared with a percentage weight loss of 3.95[2.53, 5.68] %and 3.72[2.34,5.97] % for patients receiving\u0026nbsp;balanced dietary guidance\u0026nbsp;and\u0026nbsp;pharmacotherapy (\u003cem\u003eP\u003c/em\u003e＜0.001). At 2 months, patients who received the low-carbohydrate diet (8.86[6.45,10.84] %) and pharmacotherapy (8.16[5.79,9.68] %) achieved a higher percentage weight loss than those who received\u0026nbsp;balanced dietary guidance (6.77[3.72,8.65] %) (\u003cem\u003eP\u003c/em\u003e＜0 .01). At 3 months,\u0026nbsp;there was no significant differences among groups for the percentage of weight loss (\u003cem\u003eP\u003c/em\u003e=0.362) (Figure 2 and Table S2). \u0026nbsp;\u003c/p\u003e\n\u003cdiv dir=\"RTL\"\u003e\n \u003cp dir=\"LTR\"\u003e3.3\u0026nbsp;Therapeutic Methods and Baseline\u0026nbsp;Characteristics of Patients Achieving 3% or More and 5% or More Weight Loss at 1-Month Point\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003eAt 1 month, there was a significant difference in the proportion of patients achieving 3% or more compared to those achieving less than 3% weight loss among low-carbohydrate diet, balanced dietary guidance and\u0026nbsp;pharmacotherapy (\u003cem\u003eP\u003c/em\u003e\u003cem\u003e＜\u003c/em\u003e0.01). Baseline BFM in patients with 3% or more weight loss was higher than those with 3% or less weight loss (\u003cem\u003eP\u003c/em\u003e=0.036).\u0026nbsp;86(63.24%) patients in\u0026nbsp;low-carbohydrate diet,\u0026nbsp;41(30.15%)\u0026nbsp;in balanced dietary guidance\u0026nbsp;and\u0026nbsp;9(6.62%) in\u0026nbsp;pharmacotherapy\u0026nbsp;achieved weight loss of 5% or more, with a statistical significance compared with those achieved weight loss of less than 5%(\u003cem\u003eP\u0026lt;0.05\u003c/em\u003e). Baseline weight and BMI in patients with 5% or more weight loss was higher than those with 5% or less weight loss (\u003cem\u003eP\u003c/em\u003e＜0.05;\u003cem\u003e\u0026nbsp;P\u003c/em\u003e＜0.01). There was no statistically significant difference in other baseline data between the significant weight loss group and insignificant weight loss group (Table 2).\u003c/p\u003e\n\u003c/div\u003e\n\u003cp\u003eTable 2. Therapeutic methods and baseline\u0026nbsp;characteristics of patients achieving 3% or more and 5% or more weight loss at 1-month point\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"98%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003ePercentage weight loss \u0026lt;3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003ePercentage weight loss \u0026ge;3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\"\u003e\n \u003cp\u003ePercentage weight loss \u0026lt;5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003ePercentage weight loss \u0026ge;5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.329896907216494%\" colspan=\"2\"\u003e\n \u003cp\u003eTherapeutic methods\u0026nbsp;, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.402061855670103%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.43298969072165%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.402061855670103%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.185567010309279%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\"\u003e\n \u003cp\u003eLow-carbohydrate diet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003e23(33.82)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e115(56.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\" rowspan=\"3\"\u003e\n \u003cp\u003e0.006*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\"\u003e\n \u003cp\u003e52(37.96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e86(63.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" rowspan=\"3\"\u003e\n \u003cp\u003e0.000*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"32.926829268292686%\"\u003e\n \u003cp\u003eBalanced dietary guidance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.29268292682927%\" valign=\"top\"\u003e\n \u003cp\u003e38(55.88)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.853658536585366%\" valign=\"top\"\u003e\n \u003cp\u003e76(37.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.073170731707318%\"\u003e\n \u003cp\u003e73(53.28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.853658536585366%\"\u003e\n \u003cp\u003e41(30.15)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"32.926829268292686%\"\u003e\n \u003cp\u003ePharmacotherapy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.29268292682927%\" valign=\"top\"\u003e\n \u003cp\u003e7(10.29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.853658536585366%\" valign=\"top\"\u003e\n \u003cp\u003e14(6.83)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.073170731707318%\"\u003e\n \u003cp\u003e12(8.76)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.853658536585366%\"\u003e\n \u003cp\u003e9(6.62)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\"\u003e\n \u003cp\u003eDemographic information\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\"\u003e\n \u003cp\u003eAge, median (IQR), y\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003e27(25,33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e29(25,34)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e0.748\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e28(25,33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e29(25,35)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\"\u003e\n \u003cp\u003e0.710\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\"\u003e\n \u003cp\u003eGender: male, n(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003e29(42.65)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e74(36.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e0.334\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e51(37.23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e52(38.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\"\u003e\n \u003cp\u003e0.863\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\"\u003e\n \u003cp\u003eHistory of obesity, n(%) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003e7(10.29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e12(5.85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e0.331\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e11(8.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e8(5.88)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\"\u003e\n \u003cp\u003e0.486\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\"\u003e\n \u003cp\u003ePsychiatric disease, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003e1(1.47)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e15(7.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e0.139\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e7(5.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e9(6.62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\"\u003e\n \u003cp\u003e0.596\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\"\u003e\n \u003cp\u003eMarriage: married, n(%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003e26(38.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e74(36.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e0.751\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e52(37.96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e48(35.29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\"\u003e\n \u003cp\u003e0.648\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.329896907216494%\" colspan=\"2\"\u003e\n \u003cp\u003eObesity-related comorbidities, n(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.402061855670103%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.43298969072165%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.402061855670103%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.185567010309279%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\"\u003e\n \u003cp\u003eHypertension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003e7(10.29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e13(6.34)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e0.415\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e11(8.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e9(6.62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\"\u003e\n \u003cp\u003e0.654\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\"\u003e\n \u003cp\u003eDyslipidemia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003e7(10.29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e7(3.41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e0.056\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e9(6.57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e5(3.68)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\"\u003e\n \u003cp\u003e0.279\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\"\u003e\n \u003cp\u003eType 2 diabetes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003e6(8.82)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e7(3.41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e0.137\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e9(6.57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e4(2.94)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\"\u003e\n \u003cp\u003e0.159\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\"\u003e\n \u003cp\u003ePrediabetes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003e6(8.82)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e20(9.76)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e0.820\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e13(9.49)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e13(9.56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\"\u003e\n \u003cp\u003e0.984\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\"\u003e\n \u003cp\u003eHyperuricemia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003e5(7.35)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e14(6.83)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e0.883\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e9(6.57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e10(7.35)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\"\u003e\n \u003cp\u003e0.799\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\"\u003e\n \u003cp\u003eMAFLD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003e18(26.47)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e36(17.56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e0.110\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e28(20.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e26(19.12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\"\u003e\n \u003cp\u003e0.784\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\"\u003e\n \u003cp\u003ePOCS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003e4(5.88)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e7(3.41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e0.589\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e6(4.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e5(3.68)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\"\u003e\n \u003cp\u003e0.768\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\"\u003e\n \u003cp\u003eNumber of visits with dietician, median (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003e3(2,3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e3(2,4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e0.214\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e3(2,4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e3(2,4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\" valign=\"top\"\u003e\n \u003cp\u003eDuration of overweight or obesity, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\"\u003e\n \u003cp\u003e＜5 years\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003e45(67.16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e138(67.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e93(68.38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e90(66.18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\"\u003e\n \u003cp\u003e5-10 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003e12(19.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e37(8.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e0.951\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e23(16.91)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e27(19.85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\"\u003e\n \u003cp\u003e0.821\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\"\u003e\n \u003cp\u003e＞10 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003e9(13.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e30(14.63)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e20(14.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e19(13.97)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.329896907216494%\" colspan=\"2\"\u003e\n \u003cp\u003eBody composition parameter\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.402061855670103%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.43298969072165%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.402061855670103%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.185567010309279%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\"\u003e\n \u003cp\u003eWeight, median (IQR), kg\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"bottom\"\u003e\n \u003cp\u003e77.95(67.83,95.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e83.80(73.20,95.45)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e0.068\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e80.70(69.25,94.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e84.40(74.40,96.35)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\"\u003e\n \u003cp\u003e0.039*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\"\u003e\n \u003cp\u003eBMI, median (IQR), \u0026nbsp;kg/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"bottom\"\u003e\n \u003cp\u003e29.10(26.50,32.88)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e30.30(27.70,33.46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e0.055\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e29.50(26.55,32.85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e30.70(28.00,33.78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\"\u003e\n \u003cp\u003e0.007*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\"\u003e\n \u003cp\u003eVFA, median (IQR), cm\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"bottom\"\u003e\n \u003cp\u003e125.95(105.75,154.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e128.30(105.70,163.86)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e0.359\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e125.60(103.6,159.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e129.25(106.97,168.21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\"\u003e\n \u003cp\u003e0.262\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\"\u003e\n \u003cp\u003eSMM, median (IQR), kg\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"bottom\"\u003e\n \u003cp\u003e27.60(22.40,34.55)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e27.40(24.05,33.95)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e0.507\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e27.00(23.10,33.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e27.75(24.75,34.38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\"\u003e\n \u003cp\u003e0.092\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\"\u003e\n \u003cp\u003eBFM, median (IQR), kg\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"bottom\"\u003e\n \u003cp\u003e30.00(23.43,36.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e32.30(26.40,36.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e0.036*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e31.50(24.80,37.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e32.75(27.13,38.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\"\u003e\n \u003cp\u003e0.075\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\"\u003e\n \u003cp\u003ePBF\u0026nbsp;,mean \u0026plusmn;SD, %\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"bottom\"\u003e\n \u003cp\u003e37.13(33.73,42.04)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e39.10(34.15,43.35)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e0.092\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e38.20(33.85,42.54)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e38.70(34.10,43.28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\"\u003e\n \u003cp\u003e0.442\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\"\u003e\n \u003cp\u003eWHR, median (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.92(0.89,0.96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e0.93(0.89,0.96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e0.417\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e0.91(0.86,0.96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e0.93(0.90,0.97)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\"\u003e\n \u003cp\u003e0.053\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003e*P\u0026lt;0.05\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e3.4\u0026nbsp;Therapeutic Methods and Baseline\u0026nbsp;Characteristics of Patients Achieving 3% or More and 5% or More Weight Loss at 2- and 3-Month Points\u003c/p\u003e\n\u003cp\u003eAt 2 months,\u0026nbsp;there were no significant differences in therapeutic methods and baseline characteristics between patients achieving 3% or more weight loss and those with less than 3%.\u0026nbsp;67(56.30%) patients in\u0026nbsp;low-carbohydrate diet,\u0026nbsp;36(30.06%)\u0026nbsp;in balanced dietary guidance,\u0026nbsp;and\u0026nbsp;16(13.45%) in\u0026nbsp;pharmacotherapy\u0026nbsp;achieved a weight loss of 5% or more, which was statistically significant compared to those\u0026nbsp;who lost less than 5% of their weight (\u003cem\u003eP\u003c/em\u003e＜\u003cem\u003e0.05\u003c/em\u003e).\u0026nbsp;Baseline weight and BMI were higher in patients who lost 5% or more of their weight compared to those who lost less than 5% (\u003cem\u003eP\u003c/em\u003e＜0.01;\u003cem\u003e\u0026nbsp;P\u003c/em\u003e＜0.01). There were no significant differences in other baseline data between the \u0026ge;5% weight loss group and the \u0026lt;5% weight loss group (Table S3). \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAt 3 months, there were no significant differences in therapeutic methods and baseline characteristics between patients who achieved significant weight loss and those who did not\u0026nbsp;(Table S4). \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e3.5\u0026nbsp;Multivariable Logistic Regression Analysis with Enter Method for Factors Associated with Percentage Weight Loss at 1-Month Point\u003c/p\u003e\n\u003cp\u003eIn this study, variables with a p-value of less than 0.2 were\u0026nbsp;included in the multivariable logistic regression analysis model.\u0026nbsp;The analysis identified low-carbohydrate diet as an independent factor associated with percentage weight loss of \u0026ge;3%\u0026nbsp;(odds ratio [OR]\u0026nbsp;= 0.461,\u0026nbsp;P＜0.05) at 1 month.\u0026nbsp;Additionally, low-carbohydrate diet and baseline BMI were significantly associated with the odds of percentage weight loss of \u0026ge;5%\u0026nbsp;(OR=0.349,\u0026nbsp;P=0.000;\u0026nbsp;OR=1.332,\u0026nbsp;P＜0.01) (Table 3).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 3\u0026nbsp;Multivariable logistic regression analysis with enter method for factors associated with percentage weight loss at 1month point\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.2020202020202%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"39.39393939393939%\" colspan=\"6\"\u003e\n \u003cp\u003ePercentage weight loss\u0026ge;3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"0%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"40.4040404040404%\" colspan=\"6\"\u003e\n \u003cp\u003ePercentage weight loss\u0026ge;5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.50537634408602%\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e\u003cem\u003eB\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e\u003cem\u003eS.E.\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e\u003cem\u003eWald\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e\u003cem\u003eOR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.827956989247312%\"\u003e\n \u003cp\u003e\u003cem\u003eCI 95 % OR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"0%\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e\u003cem\u003eB\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e\u003cem\u003eS.E.\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.451612903225806%\"\u003e\n \u003cp\u003e\u003cem\u003eWald\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e\u003cem\u003eOR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.827956989247312%\"\u003e\n \u003cp\u003e\u003cem\u003eCI 95 % OR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.50537634408602%\"\u003e\n \u003cp\u003eLow-carbohydrate diet\u003csup\u003e\u0026nbsp;a\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e-0.775\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.324\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e5.728\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.017*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.461\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.827956989247312%\"\u003e\n \u003cp\u003e0.244~0.869\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"0%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e-1.053\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.280\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.451612903225806%\"\u003e\n \u003cp\u003e14.140\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.000*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.349\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.827956989247312%\"\u003e\n \u003cp\u003e0.202~0.604\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.50537634408602%\"\u003e\n \u003cp\u003ePharmacotherapy\u003csup\u003e\u0026nbsp;a\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e-0.056\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.573\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.009\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.922\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.946\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.827956989247312%\"\u003e\n \u003cp\u003e0.308~2.908\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"0%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e-0.162\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.533\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.451612903225806%\"\u003e\n \u003cp\u003e0.093\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.761\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.850\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.827956989247312%\"\u003e\n \u003cp\u003e0.299~2.417\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.50537634408602%\"\u003e\n \u003cp\u003ePsychiatric disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e-1.618\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e1.057\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e2.345\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.198\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.827956989247312%\"\u003e\n \u003cp\u003e0.025~1.573\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"0%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.451612903225806%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.827956989247312%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.50537634408602%\"\u003e\n \u003cp\u003eDyslipidemia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.819\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.588\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e1.940\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.164\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e2.267\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.827956989247312%\"\u003e\n \u003cp\u003e0.717~7.174\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"0%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.451612903225806%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.827956989247312%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.50537634408602%\"\u003e\n \u003cp\u003eType 2 diabetes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.864\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.647\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e1.782\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.182\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e2.373\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.827956989247312%\"\u003e\n \u003cp\u003e0.667~8.439\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"0%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e1.262\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.675\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.451612903225806%\"\u003e\n \u003cp\u003e3.497\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.061\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e3.533\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.827956989247312%\"\u003e\n \u003cp\u003e0.941~13.264\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.50537634408602%\"\u003e\n \u003cp\u003eMAFLD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.435\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.374\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e1.356\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.244\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e1.545\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.827956989247312%\"\u003e\n \u003cp\u003e0.743~3.214\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"0%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.451612903225806%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.827956989247312%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.50537634408602%\"\u003e\n \u003cp\u003eWeight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.050\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.043\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e1.360\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.244\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e1.052\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.827956989247312%\"\u003e\n \u003cp\u003e0.966~1.145\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"0%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.210\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.404\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.451612903225806%\"\u003e\n \u003cp\u003e0.270\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.603\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e1.234\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.827956989247312%\"\u003e\n \u003cp\u003e0.559~2.723\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.50537634408602%\"\u003e\n \u003cp\u003eBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.084\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.103\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.663\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.415\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e1.088\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.827956989247312%\"\u003e\n \u003cp\u003e0.888~1.332\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"0%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.287\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.102\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.451612903225806%\"\u003e\n \u003cp\u003e7.832\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.005*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e1.332\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.827956989247312%\"\u003e\n \u003cp\u003e1.090~1.628\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.50537634408602%\"\u003e\n \u003cp\u003eSMM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.827956989247312%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"0%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e-0.367\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.673\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.451612903225806%\"\u003e\n \u003cp\u003e0.297\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.586\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.693\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.827956989247312%\"\u003e\n \u003cp\u003e0.185~2.592\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.50537634408602%\"\u003e\n \u003cp\u003eBFM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e-0.136\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.115\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e1.386\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.239\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.873\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.827956989247312%\"\u003e\n \u003cp\u003e0.697~1.094\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"0%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e-0.331\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.431\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.451612903225806%\"\u003e\n \u003cp\u003e0.590\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.442\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.718\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.827956989247312%\"\u003e\n \u003cp\u003e0.308~1.672\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.50537634408602%\"\u003e\n \u003cp\u003ePBF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.110\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.097\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e1.290\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.256\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e1.116\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.827956989247312%\"\u003e\n \u003cp\u003e0.923~1.350\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"0%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.451612903225806%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.827956989247312%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.50537634408602%\"\u003e\n \u003cp\u003eWHR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.827956989247312%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"0%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e3.412\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e2.919\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.451612903225806%\"\u003e\n \u003cp\u003e1.367\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.242\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e30.332\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.827956989247312%\"\u003e\n \u003cp\u003e0.099~9252.655\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.50537634408602%\"\u003e\n \u003cp\u003eConstant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e-5.387\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e4.475\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e1.449\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.229\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.827956989247312%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"0%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e-8.820\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e3.965\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.451612903225806%\"\u003e\n \u003cp\u003e4.947\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.026\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.376344086021505%\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.827956989247312%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAbbreviations:\u0026nbsp;B: Coefficient; S.E.: std error; OR: odds ratio; CI: confidence interval; \u003csup\u003ea\u003c/sup\u003e compared with\u0026nbsp;balanced dietary guidance\u003cem\u003e; *P\u0026lt;0.05\u003c/em\u003e；\u003c/p\u003e\n\u003cp\u003e3.6\u0026nbsp;Multivariable Logistic Regression Analysis with Enter Method for Factors Associated with Percentage Weight Loss at 2-Month Points\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMultivariate logistic regressions adjusted showed that therapeutic methods and baseline characteristics with a p-value greater than 0.20 in Table S3 had no significant effect on percentage weight loss of \u0026ge;3% and \u0026ge;5% at 2-month points\u0026nbsp;(Table 4).\u0026nbsp;At 3-month points, the factors associated with percentage weight loss in univariate analysis were all greater than 0.20, so no further multivariate logistic regressions were conducted.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 4\u0026nbsp;Multivariable logistic regression analysis with enter method for factors associated with percentage weight loss at 2-month points\u003c/p\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"101%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.387755102040817%\" style=\"width: 14.9518%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"37.755102040816325%\" colspan=\"6\" style=\"width: 28.3895%;\"\u003e\n \u003cp\u003ePercentage weight loss\u0026ge;3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"39.795918367346935%\" colspan=\"6\" style=\"width: 29.9036%;\"\u003e\n \u003cp\u003ePercentage weight loss\u0026ge;5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.791666666666668%\" style=\"width: 14.9518%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" style=\"width: 4.7316%;\"\u003e\n \u003cp\u003e\u003cem\u003eB\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e\u003cem\u003eS.E.\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e\u003cem\u003eWald\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e\u003cem\u003eOR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.416666666666666%\" style=\"width: 7.8544%;\"\u003e\n \u003cp\u003e\u003cem\u003eCI 95 % OR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" style=\"width: 4.7316%;\"\u003e\n \u003cp\u003e\u003cem\u003eB\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e\u003cem\u003eS.E.\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" style=\"width: 4.7316%;\"\u003e\n \u003cp\u003e\u003cem\u003eWald\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e\u003cem\u003eOR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" style=\"width: 8.7061%;\"\u003e\n \u003cp\u003e\u003cem\u003eCI 95 % OR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.791666666666668%\" style=\"width: 14.9518%;\"\u003e\n \u003cp\u003eLow-carbohydrate diet\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\" style=\"width: 4.7316%;\"\u003e\n \u003cp\u003e-0.687\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e0.551\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e1.559\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e0.212\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e0.503\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.416666666666666%\" valign=\"top\" style=\"width: 7.8544%;\"\u003e\n \u003cp\u003e0.171~1.480\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\" style=\"width: 4.7316%;\"\u003e\n \u003cp\u003e-0.901\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e0.481\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\" style=\"width: 4.7316%;\"\u003e\n \u003cp\u003e3.516\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e0.061\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e0.406\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\" style=\"width: 8.7061%;\"\u003e\n \u003cp\u003e0.158~1.042\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.791666666666668%\" style=\"width: 14.9518%;\"\u003e\n \u003cp\u003ePharmacotherapy\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\" style=\"width: 4.7316%;\"\u003e\n \u003cp\u003e-0.044\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e0.768\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e0.954\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e0.957\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.416666666666666%\" valign=\"top\" style=\"width: 7.8544%;\"\u003e\n \u003cp\u003e0.212~4.307\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\" style=\"width: 4.7316%;\"\u003e\n \u003cp\u003e-0.387\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e0.796\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\" style=\"width: 4.7316%;\"\u003e\n \u003cp\u003e0.237\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e0.627\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e0.679\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\" style=\"width: 8.7061%;\"\u003e\n \u003cp\u003e0.143~3.231\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.791666666666668%\" style=\"width: 14.9518%;\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\" style=\"width: 4.7316%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.416666666666666%\" valign=\"top\" style=\"width: 7.8544%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\" style=\"width: 4.7316%;\"\u003e\n \u003cp\u003e0.689\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e0.709\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\" style=\"width: 4.7316%;\"\u003e\n \u003cp\u003e0.944\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e0.331\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e1.991\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\" style=\"width: 8.7061%;\"\u003e\n \u003cp\u003e0.496~7.988\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.791666666666668%\" style=\"width: 14.9518%;\"\u003e\n \u003cp\u003eNumber of visits with dietician\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\" style=\"width: 4.7316%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.416666666666666%\" valign=\"top\" style=\"width: 7.8544%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\" style=\"width: 4.7316%;\"\u003e\n \u003cp\u003e0.164\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e0.151\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\" style=\"width: 4.7316%;\"\u003e\n \u003cp\u003e1.171\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e0.279\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e1.178\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\" style=\"width: 8.7061%;\"\u003e\n \u003cp\u003e0.876~1.584\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.791666666666668%\" style=\"width: 14.9518%;\"\u003e\n \u003cp\u003eBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\" style=\"width: 4.7316%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.416666666666666%\" valign=\"top\" style=\"width: 7.8544%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\" style=\"width: 4.7316%;\"\u003e\n \u003cp\u003e-0.023\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e0.138\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\" style=\"width: 4.7316%;\"\u003e\n \u003cp\u003e0.028\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e0.867\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e0.977\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\" style=\"width: 8.7061%;\"\u003e\n \u003cp\u003e0.745~1.281\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.791666666666668%\" style=\"width: 14.9518%;\"\u003e\n \u003cp\u003eVFA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\" style=\"width: 4.7316%;\"\u003e\n \u003cp\u003e0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e0.011\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e0.293\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e0.588\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e1.006\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.416666666666666%\" valign=\"top\" style=\"width: 7.8544%;\"\u003e\n \u003cp\u003e0.984~1.028\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\" style=\"width: 4.7316%;\"\u003e\n \u003cp\u003e-0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e0.010\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\" style=\"width: 4.7316%;\"\u003e\n \u003cp\u003e0.069\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e0.793\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e0.997\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\" style=\"width: 8.7061%;\"\u003e\n \u003cp\u003e0.977~1.018\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.791666666666668%\" style=\"width: 14.9518%;\"\u003e\n \u003cp\u003eBFM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\" style=\"width: 4.7316%;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e0.059\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e0.997\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.416666666666666%\" valign=\"top\" style=\"width: 7.8544%;\"\u003e\n \u003cp\u003e0.891~1.122\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\" style=\"width: 4.7316%;\"\u003e\n \u003cp\u003e0.060\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e0.097\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\" style=\"width: 4.7316%;\"\u003e\n \u003cp\u003e0.375\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e0.540\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e1.061\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\" style=\"width: 8.7061%;\"\u003e\n \u003cp\u003e0.877~1.285\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.791666666666668%\" style=\"width: 14.9518%;\"\u003e\n \u003cp\u003ePBF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\" style=\"width: 4.7316%;\"\u003e\n \u003cp\u003e0.034\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e0.054\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e0.396\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e0.529\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e1.035\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.416666666666666%\" valign=\"top\" style=\"width: 7.8544%;\"\u003e\n \u003cp\u003e0.930~1.151\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\" style=\"width: 4.7316%;\"\u003e\n \u003cp\u003e0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e0.081\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\" style=\"width: 4.7316%;\"\u003e\n \u003cp\u003e0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e0.939\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e1.006\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\" style=\"width: 8.7061%;\"\u003e\n \u003cp\u003e0.858~1.180\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.791666666666668%\" style=\"width: 14.9518%;\"\u003e\n \u003cp\u003eConstant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\" style=\"width: 4.7316%;\"\u003e\n \u003cp\u003e0.128\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e1.913\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e0.947\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e1.137\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.416666666666666%\" style=\"width: 7.8544%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\" style=\"width: 4.7316%;\"\u003e\n \u003cp\u003e0.069\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e3.595\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.25%\" valign=\"top\" style=\"width: 4.7316%;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e0.985\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.208333333333333%\" valign=\"top\" style=\"width: 3.9745%;\"\u003e\n \u003cp\u003e1.072\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" style=\"width: 8.7061%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eAbbreviations:\u0026nbsp;B: Coefficient; S.E.: std error; OR: odds ratio; CI: confidence interval;\u0026nbsp;\u003csup\u003ea\u003c/sup\u003e compared with balanced dietary guidance\u003c/p\u003e"},{"header":"4. Discussion ","content":"\u003cp\u003eIn our research, patients with MAFLD, type 2 diabetes, prediabetes, and elevated body composition parameters were more likely to be prescribed weight-loss medications. Pharmacotherapy has increasingly become a supplementary weight loss approach for patients with overweight and obesity, especially those with at least one obesity-related comorbidity.\u0026nbsp;\u003csup\u003e14\u003c/sup\u003e Multiple studies have demonstrated the efficacy of semaglutide and metformin in achieving significant and rapid weight loss. A weekly dose of 1.7 mg or 2.4 mg of semaglutide led to a 5.9% weight reduction after 3 months, while metformin 0.5 g three times daily resulted in a 5.1% weight loss after 3 months.\u003csup\u003e24,25\u003c/sup\u003e Consequently, in clinical practice, doctors often recommend medications as a treatment option for patients with severe obesity or at least one obesity-related comorbidity rather than dietary therapy.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn 2013, the AHA (American Heart Association), ACC (American College of Cardiology), and TOS (The Obesity Society) jointly released guidelines suggesting that achieving sustained weight loss of 3%-5% is likely to improve blood lipids, reduce blood glucose and blood pressure, and lower the risk of developing type 2 diabetes. Weight loss of 5% or more (up to 10%) can further improve metabolic-related indicators like blood pressure, blood glucose, HbA1C, triglycerides, and cholesterol. This weight loss can also improve associated conditions like fatty liver disease, type 2 diabetes, obstructive sleep apnea, osteoarthritis, and even reduce the risk of certain cancers.\u003csup\u003e21,26\u003c/sup\u003e The ideal rate of weight loss for patients with obesity is 0.5 to 1 kg per week, or 2 to 4 kg per month, which amounts to approximately 5 to 10 kg lost over three months. This translates to a weight loss of 3% to 5%, and it is based on dietary therapy.\u003csup\u003e22\u003c/sup\u003e In other words, dietary therapy may achieve similar weight loss outcomes as pharmacotherapy. In this retrospective study, we found that after dietary and intervention for patients who were followed up for 1 month, 2 months, and 3 months, the total percentage weight loss was %, % and % respectively. Although patients who used pharmaceuticals had higher baseline body composition parameters, there was no significant increase in percentage weight loss compared to dietary therapy, especially those on a low-carbohydrate diet. On the contrary, patients on a low-carbohydrate diet achieved greater magnitude of weight loss at 1 month. At 2 months, those taking anti-obesity medication lost similar weight compared with those on a low-carbohydrate diet, but more than those in the balanced dietary guidance group. When carbohydrates account for less than 40% of calories, the diet provides less energy, which promotes fat tissue metabolism and weight loss.\u0026nbsp;\u003csup\u003e27\u003c/sup\u003e Medications, however, can easily cause gastrointestinal adverse events such as nausea, dizziness, and diarrhea, leading to lower energy intake for patients. Anti-obesity medication can also delay food absorption.\u003csup\u003e24\u003c/sup\u003e These factors may result in more rapid weight loss compared to patients who only follow balanced dietary guidance. However, at 3 months, there were no significant differences in the percentage of weight loss among different therapies. This may be related to the relatively small number of patients who completed a 3-month follow-up.\u003c/p\u003e\n\u003cp\u003eThe univariate analysis revealed that gender, therapeutic methods, baseline body composition, and obesity-related complications played a crucial role in significant weight loss at 1 month and 2 months, but not at 3 months. Multiple logistic regression analyses further indicated that the low-carbohydrate diet was an independent predictor of percentage weight loss of \u0026ge;3% and \u0026ge;5% after adjusting for baseline characteristics. However, therapeutic methods and baseline characteristics had no impact on significant weight loss at 2 and 3 months. These findings align with reports that low-carbohydrate diets result in more effective body weight reduction in the short term but not in the long term.\u003csup\u003e28\u003c/sup\u003e A randomized trial also suggested that patients with obesity on a low-carbohydrate diet lost more percentage of body weight than those on a conventional diet in the short term. This could be attributed to factors such as a single diet, changes in plasma or central satiety factors,\u0026nbsp;or other factors that affect appetite and dietary adherence. However, as the body gradually adapts to this dietary pattern over the long term, these factors weaken, and the magnitude of weight loss becomes similar to other interventions.\u003csup\u003e20\u003c/sup\u003e The findings emphasize that energy intake, rather than nutrient composition, determines weight loss.\u003csup\u003e29\u003c/sup\u003e\u003csup\u003e,\u003c/sup\u003e\u003csup\u003e30\u003c/sup\u003e For long-term weight control, a trained interventionist or nutrition professional is essential, regardless of whether lifestyle intervention is used alone or in combination with adjunctive therapies such as medications.\u003csup\u003e12,21\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThis study has several limitations that must be acknowledged. Firstly, as a retrospective study, we did not have access to detailed records of patients\u0026apos; calorie intake and physical exercise levels, which could have introduced bias into the results. Secondly, we excluded patients who were not followed up monthly, which may have led to an overestimation of the effectiveness of weight loss. Additionally, there was a possibility of recall bias because the dosage and duration of medication were provided by patients during their communication with dieticians and may not have been accurate. Furthermore, the number of patients followed up for 3 months was relatively small, which may have limited the accuracy of the results. Our analyses only examined the effects within three months and did not consider the longer-term effects of weight loss. Finally, our analysis was incomplete due to the absence of laboratory indicators related to metabolic syndrome, which made it challenging to establish the connection between weight loss and changes in the risk factors for metabolic syndrome.\u003c/p\u003e\n\u003cp\u003eIn conclusion, this retrospective study showed that a low-carbohydrate diet was an effective weight loss strategy in the short term (1 month). However, its long-term effects (2 and 3 months) were comparable to those observed with balanced dietary guidance and pharmacotherapy. Therefore, it is important to consider individual patient characteristics and long-term outcomes when selecting appropriate weight loss strategies. Future research should focus on longer-term follow-up and include more comprehensive assessments of patient lifestyle factors to better understand the impact of different dietary interventions on weight loss and metabolic health.\u0026nbsp;\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eIQR: Interquartile Range; \u003cstrong\u003eSD: standard deviation;\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eMAFLD\u003cstrong\u003e:\u003c/strong\u003e metabolic associated\u003cstrong\u003e\u0026nbsp;fatty liver disease;\u0026nbsp;\u003c/strong\u003eBMI: body mass index; VFA: visceral fat area; SMM: skeletal muscle mass; BFM: body fat mass; PBF: percent body fat; WHR: wait-hip ratio；B: Coefficient; S.E.: std error; OR: odds ratio; CI: confidence interval.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eConflict of interest:\u0026nbsp;\u003c/strong\u003eThe authors declare that they have no conflicts of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contributions:\u0026nbsp;\u003c/strong\u003eLei-lei Wang designed the study and collected the data. Hui-hui Yan contributed to the technical assistance. Ling-ling Wang, Xiao-chen Liu, Hai-ying Hu, Hong-xia Li,\u0026nbsp;Wei Wei\u0026nbsp;and Qin Du were major contributors to research and academic guidance. All authors contributed to the writing and revision of the manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments:\u0026nbsp;\u003c/strong\u003eNone\u003c/p\u003e\n\u003cp\u003eApproval for human experiments：We Confirm that all experiments were performed in accordance with relevant named guidelines and regulations. This study was a retrospective study, ethics committee was in favor of informed consent exemption.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e The study was supported by Zhejiang Provincial Natural Science Foundation of China (LY22H160002)\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eBray, G. A., Kim, K. K. \u0026amp; Wilding, J. P. H. Obesity: a chronic relapsing progressive disease process. A position statement of the World Obesity Federation. \u003cem\u003eObesity reviews : an official journal of the International Association for the Study of Obesity\u003c/em\u003e \u003cstrong\u003e18\u003c/strong\u003e, 715-723, doi:10.1111/obr.12551 (2017).\u003c/li\u003e\n\u003cli\u003eBl\u0026uuml;her, M. Obesity: global epidemiology and pathogenesis. \u003cem\u003eNat Rev Endocrinol\u003c/em\u003e \u003cstrong\u003e15\u003c/strong\u003e, 288-298, doi:10.1038/s41574-019-0176-8 (2019).\u003c/li\u003e\n\u003cli\u003ethe World Health Organization(WHO). obesity and overweight. \u003cem\u003ehttps://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight\u003c/em\u003e (2021).\u003c/li\u003e\n\u003cli\u003ePan, X. F., Wang, L. \u0026amp; Pan, A. Epidemiology and determinants of obesity in China. \u003cem\u003eThe lancet. 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D.\u003cem\u003e et al.\u003c/em\u003e A randomized trial of a low-carbohydrate diet for obesity. \u003cem\u003eThe New England journal of medicine\u003c/em\u003e \u003cstrong\u003e348\u003c/strong\u003e, 2082-2090, doi:10.1056/NEJMoa022207 (2003).\u003c/li\u003e\n\u003cli\u003eYork, L. W., Puthalapattu, S. \u0026amp; Wu, G. Y. Nonalcoholic fatty liver disease and low-carbohydrate diets. \u003cem\u003eAnnual review of nutrition\u003c/em\u003e \u003cstrong\u003e29\u003c/strong\u003e, 365-379, doi:10.1146/annurev-nutr-070208-114232 (2009).\u003c/li\u003e\n\u003cli\u003eElmaleh-Sachs A, Schwartz JL, Bramante CT, Nicklas JM, Gudzune KA, Jay M. Obesity Management in Adults: A Review. \u003cem\u003eJama\u003c/em\u003e 2023; \u003cstrong\u003e330\u003c/strong\u003e(20): 2000-15, doi: 10.1001/jama.2023.19897 (2023).\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Overweight, Obesity, Low-carbohydrate diet, Balanced dietary guidance, Pharmacotherapy","lastPublishedDoi":"10.21203/rs.3.rs-4485017/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4485017/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjective\u003c/h2\u003e \u003cp\u003eThis study aims to evaluate the impact of low-carbohydrate diet, balanced dietary guidance, and pharmacotherapy on weight loss among individuals with overweight or obesity over a period of three months.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThe study involves 339 individuals with overweight or obesity and received weight loss treatment at the Department of Clinical Nutrition at the Second Affiliated Hospital of Zhejiang University, School of Medicine, between January 1st, 2020 and December 31st, 2023. The primary outcome is the percentage weight loss.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eAmong the studied patients, the majority chose low-carbohydrate diet as their primary treatment (168 [49.56%]), followed by balanced dietary guidance (139[41.00%]) and pharmacotherapy (32 [9.44%]). The total percentage weight loss for patients who were followed up for 1 month, 2 months, and 3 months was 4.98 (3.04,6.29) %,7.93 (5.42, 7.93) % and 10.71 (7.74,13.83) %, respectively. Multivariable logistic regression analysis identified low-carbohydrate diet as an independent factor associated with percentage weight loss of \u0026ge;\u0026thinsp;3% and \u0026ge;\u0026thinsp;5% at 1 month (\u003cem\u003eOR [\u003c/em\u003eodds ratio\u003cem\u003e]\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.461, \u003cem\u003eP\u003c/em\u003e\u0026lt;0.05; \u003cem\u003eOR\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.349, \u003cem\u003eP\u003c/em\u003e\u0026lt;0.001).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThe results showed that a low-carbohydrate diet was an effective weight loss strategy in the short term. However, its long-term effects were comparable to those observed with balanced dietary guidance and pharmacotherapy.\u003c/p\u003e","manuscriptTitle":"Comparison of Weight Loss Induced by Dietary and Pharmaceuticals in Individuals with Overweight and Obesity: A Case Control Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-06-12 19:22:47","doi":"10.21203/rs.3.rs-4485017/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"665c8635-592e-441c-a9cb-fe6c6106ccfa","owner":[],"postedDate":"June 12th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":33068042,"name":"Health sciences/Diseases/Metabolic disorders"},{"id":33068043,"name":"Health sciences/Diseases/Nutrition disorders"}],"tags":[],"updatedAt":"2024-06-18T05:24:58+00:00","versionOfRecord":[],"versionCreatedAt":"2024-06-12 19:22:47","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4485017","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4485017","identity":"rs-4485017","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}