TY - JOUR
T1 - Comparison of strategies for sustaining weight loss
T2 - The weight loss maintenance randomized controlled trial
AU - Svetkey, Laura P.
AU - Stevens, Victor J.
AU - Brantley, Phillip J.
AU - Appel, Lawrence J.
AU - Hollis, Jack F.
AU - Loria, Catherine M.
AU - Vollmer, William M.
AU - Gullion, Christina M.
AU - Funk, Kristine
AU - Smith, Patti
AU - Samuel-Hodge, Carmen
AU - Myers, Valerie
AU - Lien, Lillian F.
AU - Laferriere, Daniel
AU - Kennedy, Betty
AU - Jerome, Gerald J.
AU - Heinith, Fran
AU - Harsha, David W.
AU - Evans, Pamela
AU - Erlinger, Thomas P.
AU - Dalcin, Arline T.
AU - Coughlin, Janelle
AU - Charleston, Jeanne
AU - Champagne, Catherine M.
AU - Bauck, Alan
AU - Ard, Jamy D.
AU - Aicher, Kathleen
PY - 2008/3/12
Y1 - 2008/3/12
N2 - Context: Behavioral weight loss interventions achieve short-term success, but regain is common. Objective: To compare 2 weight loss maintenance interventions with a self-directed control group. Design, Setting, and Participants: Two-phase trial in which 1032 overweight or obese adults (38% African American, 63% women) with hypertension, dyslipidemia, or both who had lost at least 4 kg during a 6-month weight loss program (phase 1) were randomized to a weight-loss maintenance intervention (phase 2). Enrollment at 4 academic centers occurred August 2003-July 2004 and randomization, February-December 2004. Data collection was completed in June 2007. Interventions: After the phase 1 weight-loss program, participants were randomized to one of the following groups for 30 months: monthly personal contact, unlimited access to an interactive technology-based intervention, or self-directed control. Main Outcome: Changes in weight from randomization. Results: Mean entry weight was 96.7 kg. During the initial 6-month program, mean weight loss was 8.5 kg. After randomization, weight regain occurred. Participants in the personal-contact group regained less weight (4.0 kg) than those in the self-directed group (5.5 kg; mean difference at 30 months, -1.5 kg; 95% confidence interval [CI], -2.4 to kg; P = .001). At 30 months, weight regain did not differ between the interactive technology-based (5.2 kg) and self-directed groups (5.5 kg; mean difference -0.3 kg; 95% CI, -1.2 to 0.6 kg; P = .51); however, weight regain was lower in the interactive technology-based than in the self-directed group at 18 months (mean difference, -1.1 kg; 95% CI, -1.9 to -0.4 kg; P = .003) and at 24 months (mean difference, -0.9 kg; 95% CI, -1.7 to -0.02 kg; P = .04). At 30 months, the difference between the personal-contact and interactive technology-based group was -1.2 kg (95% CI -2.1 to -0.3; P = .008). Effects did not differ significantly by sex, race, age, and body mass index subgroups. Overall, 71% of study participants remained below entry weight. Conclusions: The majority of individuals who successfully completed an initial behavioral weight loss program maintained a weight below their initial level. Monthly brief personal contact provided modest benefit in sustaining weight loss, whereas an interactive techonology-based intervention provided early but transient benefit. Trial Registration: clinicaltrials.gov Identifier: NCT00054925.
AB - Context: Behavioral weight loss interventions achieve short-term success, but regain is common. Objective: To compare 2 weight loss maintenance interventions with a self-directed control group. Design, Setting, and Participants: Two-phase trial in which 1032 overweight or obese adults (38% African American, 63% women) with hypertension, dyslipidemia, or both who had lost at least 4 kg during a 6-month weight loss program (phase 1) were randomized to a weight-loss maintenance intervention (phase 2). Enrollment at 4 academic centers occurred August 2003-July 2004 and randomization, February-December 2004. Data collection was completed in June 2007. Interventions: After the phase 1 weight-loss program, participants were randomized to one of the following groups for 30 months: monthly personal contact, unlimited access to an interactive technology-based intervention, or self-directed control. Main Outcome: Changes in weight from randomization. Results: Mean entry weight was 96.7 kg. During the initial 6-month program, mean weight loss was 8.5 kg. After randomization, weight regain occurred. Participants in the personal-contact group regained less weight (4.0 kg) than those in the self-directed group (5.5 kg; mean difference at 30 months, -1.5 kg; 95% confidence interval [CI], -2.4 to kg; P = .001). At 30 months, weight regain did not differ between the interactive technology-based (5.2 kg) and self-directed groups (5.5 kg; mean difference -0.3 kg; 95% CI, -1.2 to 0.6 kg; P = .51); however, weight regain was lower in the interactive technology-based than in the self-directed group at 18 months (mean difference, -1.1 kg; 95% CI, -1.9 to -0.4 kg; P = .003) and at 24 months (mean difference, -0.9 kg; 95% CI, -1.7 to -0.02 kg; P = .04). At 30 months, the difference between the personal-contact and interactive technology-based group was -1.2 kg (95% CI -2.1 to -0.3; P = .008). Effects did not differ significantly by sex, race, age, and body mass index subgroups. Overall, 71% of study participants remained below entry weight. Conclusions: The majority of individuals who successfully completed an initial behavioral weight loss program maintained a weight below their initial level. Monthly brief personal contact provided modest benefit in sustaining weight loss, whereas an interactive techonology-based intervention provided early but transient benefit. Trial Registration: clinicaltrials.gov Identifier: NCT00054925.
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U2 - 10.1001/jama.299.10.1139
DO - 10.1001/jama.299.10.1139
M3 - Article
C2 - 18334689
AN - SCOPUS:40749141596
VL - 299
SP - 1139
EP - 1148
JO - JAMA - Journal of the American Medical Association
JF - JAMA - Journal of the American Medical Association
SN - 0098-7484
IS - 10
ER -