Comparative effectiveness of weight-loss interventions in clinical practice

Lawrence Appel, Jeanne Clark, Hsin Chieh Yeh, Nae Yuh Wang, Janelle Coughlin, Gail L Daumit, Edgar R Miller, Arlene Dalcin, Gerald J. Jerome, Steven Geller, Gary Noronha, Thomas Pozefsky, Jeanne B Charleston, Jeffrey B. Reynolds, Nowella Durkin, Richard R. Rubin, Thomas Louis, Frederick L. Brancati

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Obesity and its cardiovascular complications are extremely common medical problems, but evidence on how to accomplish weight loss in clinical practice is sparse. METHODS: We conducted a randomized, controlled trial to examine the effects of two behavioral weight-loss interventions in 415 obese patients with at least one cardiovascular risk factor. Participants were recruited from six primary care practices; 63.6% were women, 41.0% were black, and the mean age was 54.0 years. One intervention provided patients with weight-loss support remotely - through the telephone, a study-specific Web site, and e-mail. The other intervention provided in-person support during group and individual sessions, along with the three remote means of support. There was also a control group in which weight loss was self-directed. Outcomes were compared between each intervention group and the control group and between the two intervention groups. For both interventions, primary care providers reinforced participation at routinely scheduled visits. The trial duration was 24 months. RESULTS: At baseline, the mean body-mass index (the weight in kilograms divided by the square of the height in meters) for all participants was 36.6, and the mean weight was 103.8 kg. At 24 months, the mean change in weight from baseline was -0.8 kg in the control group, -4.6 kg in the group receiving remote support only (P

Original languageEnglish (US)
Pages (from-to)1959-1968
Number of pages10
JournalNew England Journal of Medicine
Volume365
Issue number21
StatePublished - Nov 24 2011

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Weight Loss
Weights and Measures
Control Groups
Primary Health Care
Postal Service
Telephone
Body Mass Index
Randomized Controlled Trials
Obesity

ASJC Scopus subject areas

  • Medicine(all)

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Comparative effectiveness of weight-loss interventions in clinical practice. / Appel, Lawrence; Clark, Jeanne; Yeh, Hsin Chieh; Wang, Nae Yuh; Coughlin, Janelle; Daumit, Gail L; Miller, Edgar R; Dalcin, Arlene; Jerome, Gerald J.; Geller, Steven; Noronha, Gary; Pozefsky, Thomas; Charleston, Jeanne B; Reynolds, Jeffrey B.; Durkin, Nowella; Rubin, Richard R.; Louis, Thomas; Brancati, Frederick L.

In: New England Journal of Medicine, Vol. 365, No. 21, 24.11.2011, p. 1959-1968.

Research output: Contribution to journalArticle

Appel, Lawrence ; Clark, Jeanne ; Yeh, Hsin Chieh ; Wang, Nae Yuh ; Coughlin, Janelle ; Daumit, Gail L ; Miller, Edgar R ; Dalcin, Arlene ; Jerome, Gerald J. ; Geller, Steven ; Noronha, Gary ; Pozefsky, Thomas ; Charleston, Jeanne B ; Reynolds, Jeffrey B. ; Durkin, Nowella ; Rubin, Richard R. ; Louis, Thomas ; Brancati, Frederick L. / Comparative effectiveness of weight-loss interventions in clinical practice. In: New England Journal of Medicine. 2011 ; Vol. 365, No. 21. pp. 1959-1968.
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