***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Some investigators fear that dieting may precipitate binge eating and other adverse behavioral consequences . OBJECTIVE The objective of the study was to examine whether dieting would elicit binge eating and mood disturbance in individuals free of these complications before treatment . DESIGN A total of 123 obese women were r and omly assigned to 1 ) a 1000 kcal/d diet that included 4 servings/d of a liquid meal replacement ( MR ) ; 2 ) a 1200 - 1500 kcal/d balanced deficit diet ( BDD ) of conventional foods ; or 3 ) a nondieting ( ND ) approach that discouraged energy restriction . All women attended weekly group sessions for 20 wk and biweekly sessions from week 20 to week 40 . RESULTS At week 20 , participants in the MR , BDD , and ND groups lost 12.1 + /- 6.7 % , 7.8 + /- 6.0 % , and 0.1 + /- 2.4 % of initial weight , respectively ( P < 0.001 ) . During the first 20 wk , there were no significant differences among groups in the number of persons who had objective binge episodes or in reports of hunger or dietary disinhibition . Symptoms of depression decreased significantly more ( P < 0.001 ) in the MR and BDD groups than in ND participants . At week 28 , significantly more ( P < 0.003 ) cases of binge eating were observed in MR participants than in the 2 other groups . No differences , however , were observed between groups at weeks 40 or 65 ( a follow-up visit ) . At no time did any participant meet criteria for binge-eating disorder . CONCLUSION Concerns about possible adverse behavioral consequences of dieting should not dissuade primary care providers from recommending modest energy restriction to obese individuals Noncompliance with therapeutic diets remains a major obstacle to achieving improvements in cardiovascular disease ( CVD ) morbidity and mortality . This study compared dietary compliance and CVD risk factor response to two dietary interventions design ed to treat hypertension , dyslipidemia , and diabetes mellitus . In a multicenter trial , 560 adults were r and omly assigned to either a self-selected , mixed-food plan ( n = 277 ) , or a nutrient-fortified prepared meal plan ( n = 283 ) ; each was design ed to provide 15 - 20 % of energy from fat , 55 - 60 % from carbohydrate , and 15 - 20 % from protein . Nutrient intake was estimated from 3-d food records collected biweekly throughout the 10-wk intervention . Compliance was determined by evaluating the participants ' ability to meet specific criteria for energy intake [ + /-420 kJ ( 100 kcal ) from the midpoint of the prescribed energy range ] , fat intake ( < 20 % , < 25 % , or < 30 % of energy from total fat ) , and the National Cholesterol Education Program/American Heart Association Step 1 and 2 diet recommendations . Compliance with energy , fat , and Step 1 and 2 criteria was better in participants who followed the prepared meal plan than in those who followed the self-selected diet ( P < 0.0001 ) . Compliant participants in both groups achieved greater reductions in body weight , systolic and diastolic blood pressure , and total and low-density-lipoprotein cholesterol than noncompliant participants ( P < 0.05 ) . In general , better endpoint responses were observed with lower fat intakes regardless of group assignment . The prepared meal plan is a simple and effective strategy for meeting the many nutrient recommendations for CVD risk reduction and improving dietary compliance and CVD endpoints OBJECTIVE This study tested a secondary hypothesis of the CALERIE trial ( Heilbronn et al. , 2006 ) that a 12-month period of intentional dietary restriction would be associated with an increase in eating disorder symptoms . DESIGN To test this hypothesis , 48 overweight adults were r and omly assigned to four treatment arms in a 12-month study : ( 1 ) 25 % calorie restriction , ( 2 ) 12.5 % calorie restriction and 12.5 % increased energy expenditure by structured exercise , ( 3 ) low-calorie diet , and ( 4 ) healthy diet ( no-calorie restriction ) . MAIN OUTCOME MEASURES Primary outcome measures for the study were changes in : eating disorder symptoms , mood , dietary restraint , body weight , and energy balance . RESULTS All three dietary restriction arms were associated with increased dietary restraint and negative energy balance , but not with increased ED symptoms or other harmful psychological effects . Participants in the three calorie restriction arms lost significant amounts of body weight . The psychological and behavioral effects were maintained during a 6-month follow-up period . CONCLUSION These results did not support the hypothesis that caloric restriction causes increased eating disorder symptoms in overweight adults . In general , caloric restriction had either benign or beneficial psychological and behavioral effects In order to examine the concurrent and criterion validity of the question naire version of the Eating Disorders Examination ( EDE-Q ) , self-report and interview formats were administered to a community sample of women aged 18 - 45 ( n = 208 ) . Correlations between EDE-Q and EDE subscales ranged from 0.68 for Eating Concern to 0.78 for Shape Concern . Scores on the EDE-Q were significantly higher than those of the EDE for all subscales , with the mean difference ranging from 0.25 for Restraint to 0.85 for Shape Concern . Frequency of both objective bulimic episodes ( OBEs ) and subjective bulimic episodes ( SBEs ) was significantly correlated between measures . Chance-corrected agreement between EDE-Q and EDE ratings of the presence of OBEs was fair , while that for SBEs was poor . Receiver operating characteristic ( ROC ) analysis , based on a sample of 13 cases , indicated that a score of 2.3 on the global scale of the EDE-Q in conjunction with the occurrence of any OBEs and /or use of exercise as a means of weight control , yielded optimal validity coefficients ( sensitivity = 0.83 , specificity = 0.96 , positive predictive value = 0.56 ) . A stepwise discriminant function analysis yielded eight  EDE-Q items which best distinguished cases from non-cases , including frequency of OBEs , use of exercise as a means of weight control , use of self-induced vomiting , use of laxatives and guilt about eating . The EDE-Q has good concurrent validity and acceptable criterion validity . The measure appears well-suited to use in prospect i ve epidemiological studies OBJECTIVE This study examined the factors associated with the diagnostic outcome of obese individuals with and without binge eating disorder ( BED ) 1 year after completing a very low calorie diet ( VLCD ) program .  METHOD Participants included 63 individuals with BED , 36 individuals with subthreshold BED , and 29 individuals with no binge eating symptoms . Diagnoses before and after VLCD were obtained using the Structured Clinical Interview for DSM-IV ( SCID ) interviews . The severity of psychiatric symptoms were assessed using various rating scales . RESULTS Fifty-six percent ( n = 36 ) of the participants who met criteria for BED at baseline did not meet diagnostic criteria 1 year later . None of the baseline factors were statistically associated with outcome . DISCUSSION Although the main hypothesis was not supported , absence of a BED diagnosis at 12-month follow-up after a VLCD diet appears to be associated with less weight gain at 1-year follow-up regardless of baseline diagnosis OBJECTIVE : To test the feasibility of creating a valid and reliable checklist with the following features : appropriate for assessing both r and omised and non-r and omised studies ; provision of both an overall score for study quality and a profile of scores not only for the quality of reporting , internal validity ( bias and confounding ) and power , but also for external validity . DESIGN : A pilot version was first developed , based on epidemiological principles , review s , and existing checklists for r and omised studies . Face and content validity were assessed by three experienced review ers and reliability was determined using two raters assessing 10 r and omised and 10 non-r and omised studies . Using different raters , the checklist was revised and tested for internal consistency ( Kuder-Richardson 20 ) , test-retest and inter-rater reliability ( Spearman correlation coefficient and sign rank test ; kappa statistics ) , criterion validity , and respondent burden . MAIN RESULTS : The performance of the checklist improved considerably after revision of a pilot version . The Quality Index had high internal consistency ( KR-20 : 0.89 ) as did the subscales apart from external validity ( KR-20 : 0.54 ) . Test-retest ( r 0.88 ) and inter-rater ( r 0.75 ) reliability of the Quality Index were good . Reliability of the subscales varied from good ( bias ) to poor ( external validity ) . The Quality Index correlated highly with an existing , established instrument for assessing r and omised studies ( r 0.90 ) . There was little difference between its performance with non-r and omised and with r and omised studies . Raters took about 20 minutes to assess each paper ( range 10 to 45 minutes ) . CONCLUSIONS : This study has shown that it is feasible to develop a checklist that can be used to assess the method ological quality not only of r and omised controlled trials but also non-r and omised studies . It has also shown that it is possible to produce a checklist that provides a profile of the paper , alerting review ers to its particular method ological strengths and weaknesses . Further work is required to improve the checklist and the training of raters in the assessment of external validity BACKGROUND Very-low-energy diets ( VLEDs ) together with behavior therapy ( BT ) are widely used in the treatment of morbid obesity , but there is no evidence of their long-term effectiveness as compared with behavior therapy alone . METHODS Fifty-nine morbidly obese patients ( 25 men and 34 women ; mean weight , 132.8 + /- 20.7 kg ; mean age , 43.1 + /- 9.2 years ) were treated with combined therapy of VLED and BT or BT alone . No maintenance program was used . Eighty-seven percent of eligible patients were contacted 4.8 to 6.2 years after the program . RESULTS During treatment , 56 % of patients dropped out of the VLED + BT group and 28 % from the BT group ( P = .03 ) . High scores on the Symptom Checklist-90R before treatment predicted dropout from the VLED+BT group , but not from BT . At the end of therapy , mean weight change was -22.9 kg in the VLED+BT group and -8.9 kg in the BT group ( P < .001 ) . The overall weight change from pretreatment to the 5-year follow-up was greater in the VLED+BT group than in the BT group ( -16.9 kg vs -4.9 kg , respectively ; P = .03 ) . Men succeeded better in the VLED+BT group than in BT . Among the dropouts , the mean weight change from baseline was + 5.2 kg in the VLED+BT group and + 13.0 kg in the BT group . CONCLUSIONS Our data suggest that in the treatment of morbid obesity , VLED combined with BT may produce a better 5-year maintenance than BT alone , especially among men . A satisfactory weight loss can be achieved without a maintenance program The purpose of the present study was to examine the relationship between patterns of meal replacement ( MR ) adherence and changes in outcomes during a behaviorally-oriented weight loss program . Data from the present study are based on sixty female participants ( age : 29 - 62 years , BMI : 27.99 - 37.50 kg/m(2 ) ) . Participants were r and omized into either a control or experimental condition , which tested the use of MRs during weight loss maintenance . Outcome measures included body weight , depression , physical activity , cognitive restraint , disinhibition , hunger , and binge eating collected at four assessment points . Within the experimental condition , we further examined adherence to MRs and its relationship with the outcome measures . We found evidence of differences at baseline on some measures ( e.g. , weight , physical activity and depression ) while on others ( cognitive restraint , disinhibition , and hunger ) , differences that emerged over the course of treatment . Further research is necessary to determine if there are measures associated with successful MR use that can be detected at baseline and if MR adherence itself leads to changes in eating behavior There is no consensus on whether ‘ very low‐energy diets ’ ( VLED ; < 800 kcal d−1 ) cause greater weight loss in obese individuals  than ‘ low‐energy diets ’ ( LED ; 800–1200 kcal d−1 ) . The objective was to determine whether a very low‐energy formula diet would cause greater weight loss than a formula 810 kcal d−1 LED in older sedentary individuals . This is a pragmatic r and omized controlled trial . Inclusion criteria : obesity ( body mass index [ BMI ] > 30 ) ; age > 50 years , with knee osteoarthritis . Participants were r and omized to VLED ( 420–554 kcal d−1 ) or LED ( 810 kcal d−1 ) for 8 weeks , followed by a fixed‐energy ( 1200 kcal d−1 ) diet with food and two diet products daily for 8 weeks . In all , 192 participants were r and omized . Mean age was 63 years ( st and ard deviation : 6 ) , mean 
    Output:
    
Among individuals with clinical ly relevant pre-treatment binge eating disorder , severe dietary energy restriction significantly decreased binge eating in all four interventions involving this population , at least during the weight loss programme .
We conclude that clinical ly supervised severe dietary energy restriction appears safe and beneficial for overweight or obese individuals with pre-treatment binge eating disorder , and does not necessarily trigger binge eating in those without binge eating disorder