Evaluating home-delivered meal service programs for obesity: a randomized controlled approach

Abstract

Background: Though a healthy diet is the most effective solution for obesity, it is hindered by two main barri-
ers: difficulty in accessing or preparing healthy meals and lack of portion control knowledge.

Objective: This study compared two different medical nutrition therapies (home-delivered diet meal service
[HDMS] combined with dietary counseling and dietary counseling solely) in terms of anthropometric mea-
surements, biochemical parameters and eating behaviors in women with overweight or obesity who partici-
pated in a weight loss program.

Design: A non-randomized, controlled, parallel-group intervention study was conducted with 60 women aged
25–45 years, having a Body Mass Index (BMI) of 25–35 kg/m², representing individuals with overweight
and class I obesity. Participants were divided into two groups: an intervention group receiving HDMS com-
bined with dietary counseling (n = 30) and a control group receiving dietary counseling solely (n = 30).
Anthropometric measurements, bioelectrical impedance analysis (BIA), and dietary and physical activ-
ity records were monitored throughout the 8-week intervention, while comprehensive assessments includ-
ing biochemical parameters (fasting blood glucose, homeostatic model assessment for insulin resistance
(HOMA-IR), lipid profile), resting metabolic rate (RMR) (FITMATE), and eating behaviors assessed using
the Three-Factor Eating Questionnaire (TFEQ) were conducted at baseline, week 4, and week 8.

Results: Both groups showed significant reductions over time in body weight, BMI, waist circumference,
hip circumference, body fat percentage, RMR, blood glucose, lipid parameters, and blood pressure values
(P < 0.001). Although greater reductions were observed in the HDMS group, the differences between groups
were not statistically significant (P > 0.05). When considering the group-time interaction, changes in waist
circumference (P < 0.001), hip circumference (P < 0.05), RMR (P < 0.05), fasting blood glucose (P < 0.05),
low-density lipoprotein (LDL), cholesterol (P < 0.05), and systolic blood pressure (P < 0.05) were found
to be significant in the HDMS group. In addition, when examining eating behaviors, statistically significant
changes were observed in the intervention group for both time effects and behavior outcomes. Uncontrolled
eating and emotional eating behaviors decreased, while cognitive restraint increased (P < 0.001).

Conclusion: Both interventions improved anthropometric and metabolic parameters, with greater reductions observed in the HDMS group; however, the differences between groups were not statistically significant. HDMS may be considered a practical approach to support weight management.