Figure 1.

The diet consisted initially of 3 very low energy meals per day, reducing to 2 meals per day, and then provided as only breakfast as subjects were educated on the replacement of these meals with low-calorie home-prepared meals. The exercise program consisted of both resistance and aerobic training, a minimum of 5 sessions per week. Initially, 3 of these sessions were supervised in the hospital gymnasium; the number of supervised sessions was gradually reduced as subjects were educated about exercise in the community.