Case Series
Published: 13 April, 2026 | Volume 10 - Issue 1 | Pages: 017-025
Background: Obesity is one of the most pressing global health challenges, with over one billion people now living with the condition worldwide. In Southeast Asia, nearly 40% of the population is projected to be overweight or obese by 2035, with Thailand reporting prevalence exceeding 42%. Intensive Lifestyle Modification (ILM) combined with Meal Replacement (MR) has emerged as a promising strategy for achieving sustainable weight loss, supported by landmark trials including the Diabetes Prevention Program, Look AHEAD, and DiRECT.
Objective: To illustrate the clinical effectiveness of ILM combined with MR through detailed case presentations documenting anthropometric outcomes at baseline, 8 weeks, and 52 weeks, contextualized within international obesity management guidelines and comparative research across diverse populations. We hypothesized that selected participants undergoing the ILM+MR intervention would demonstrate clinically significant weight loss (≥5% of initial body weight) sustained through 52 weeks, with concurrent improvements in waist circumference indicating reduced central adiposity.
Methods: Twelve participants (9 female, 3 male) from the ILM+MR arm of a previously published retrospective cohort study (n = 702) were selected based on complete longitudinal data and representativeness. The intervention comprised structured nutritional counseling, soy-based MR (220 kcal per serving, twice daily for 8 weeks), behavioral modification with group therapy, and physical activity guidance aligned with the 2013 AHA/ACC/TOS guidelines. Body weight and waist circumference were measured at baseline, 8 weeks, and 52 weeks.
Results: Mean total weight loss was 38.2 kg (35.3% of initial body weight), with mean waist circumference reduction of 13.0 inches (33.0 cm) over 52 weeks. All 12 participants achieved clinically significant weight loss (>5%), substantially exceeding the 5–10% threshold recommended by international guidelines. Weight loss occurred in two phases: a rapid intensive phase (mean 14.0 kg during weeks 0–8) followed by continued loss during maintenance (mean 24.2 kg during weeks 8–52). All participants completed the 52-week follow-up.
Conclusion: This case series demonstrates the potential for substantial, sustained weight loss through ILM+MR intervention, supporting findings from the larger Thai cohort study and international research including the DiRECT trial and systematic meta-analyses. These results reaffirm the foundational role of comprehensive lifestyle programs and highlight their relevance as scalable, culturally adaptable interventions for obesity management across diverse populations.
Read Full Article HTML DOI: 10.29328/journal.acem.1001034 Cite this Article Read Full Article PDF
Obesity; Intensive lifestyle modification; Meal replacement; Weight loss; Case series; Body composition; Global health; Asia-Pacific
If you are already a member of our network and need to keep track of any developments regarding a question you have already submitted, click "take me to my Query."