- pregnancy or lactating women, impaired renal function with serum creatinine ≧ 1.5 mg/dl, abnormal liver function [alanine aminotransferase (ALT), aspartate aminotransferase (AST), ≧ 3 times the normal upper limit) or liver cirrhosis, significant heart diseases (unstable angina, unstable heart failure), frequent gout attacks (≧ 3 times/year), participation in other weight loss programs or the use of weight-reducing drugs, eating disorders and those who could not complete the questionnaire or who had a poor compliance to protocol.