Both diet groups (D and D + E) lost significantly (P < .001) more weight than the E group (Table 2). The D group lost8.9kg (9.5%) over 18 months; the mean loss in the D + E group was 10.6 kg (11.4%). Neither group regressed toward baseline values (eFigure in the Supplement). The E group lost 1.8 kg, or 2.0% of baseline body weight. At baseline, 79.3% of all participants had a BMI of 30 or greater. At 18 months, this was reduced to 55.5%, including 69.0% in the E group, 54.6% in the D group, and 43.3% D + E participants.
Total fat mass was significantly less in both diet groups relative to the E group after 18 months (P < .001). Fat mass remained essentially unchanged (−0.4 kg) in the E group, while decreasing 6.5 kg (18%) and 4.8 kg (13%) at 18 months in the D + E and D groups, respectively. The D + E and D groups lost significantly more lean mass than the E group (P < .001), but the percentage of lean mass at 18 months did not differ among the 3 groups.