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The impact of continued intervention on weight: Five-year results from the weight loss maintenance trial.

ABSTRACT: In the Weight Loss Maintenance (WLM) Trial, a personal contact (PC) intervention sustained greater weight loss relative to a self-directed (SD) group over 30 months. This study investigated the effects of continued intervention over an additional 30 months and overall weight change across the entire WLM Trial.WLM had 3 phases. Phase 1 was a 6-month weight loss program. In Phase 2, those who lost ?4 kg were randomized to a 30-month maintenance trial. In Phase 3, PC participants (n?=?196, three sites) were re-randomized to no further intervention (PC-Control) or continued intervention (PC-Active) for 30 more months; 218 SD participants were also followed.During Phase 3, weight increased 1.0 kg in PC-Active and 0.5 kg in PC-Control (mean difference 0.6 kg; 95% CI:-1.4 to 2.7; P?=?0.54). Mean weight change over the entire study was -3.2 kg in those originally assigned to PC (PC-Combined) and -1.6 kg in SD (mean difference -1.6 kg; 95% CI:-3.0 to -0.1; P?=?0.04).After 30 months of the PC maintenance intervention, continuation for another 30 months provided no additional benefit. However, across the entire study, weight loss was slightly greater in those originally assigned to PC.

SUBMITTER: Coughlin JW

PROVIDER: S-EPMC4896740 | biostudies-literature | 2016 May

REPOSITORIES: biostudies-literature

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The impact of continued intervention on weight: Five-year results from the weight loss maintenance trial.

Coughlin Janelle W JW Brantley Phillip J PJ Champagne Catherine M CM Vollmer William M WM Stevens Victor J VJ Funk Kristine K Dalcin Arlene T AT Jerome Gerald J GJ Myers Valerie H VH Tyson Crystal C Batch Bryan C BC Charleston Jeanne J Loria Catherine M CM Bauck Alan A Hollis Jack F JF Svetkey Laura P LP Appel Lawrence J LJ

Obesity (Silver Spring, Md.) 20160315 5

<h4>Objective</h4>In the Weight Loss Maintenance (WLM) Trial, a personal contact (PC) intervention sustained greater weight loss relative to a self-directed (SD) group over 30 months. This study investigated the effects of continued intervention over an additional 30 months and overall weight change across the entire WLM Trial.<h4>Methods</h4>WLM had 3 phases. Phase 1 was a 6-month weight loss program. In Phase 2, those who lost ≥4 kg were randomized to a 30-month maintenance trial. In Phase 3, ...[more]

PMID: 26991814

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Project description:BackgroundDigital health promotion programs tailored to the individual are a potential cost-effective and scalable solution to enable self-management and provide support to people with excess body weight. However, solutions that are widely accessible, personalized, and theory- and evidence-based are still limited.ObjectiveThis study aimed to develop a digital behavior change program, Choosing Health, that could identify modifiable predictors of weight loss and maintenance for each individual and use these to provide tailored support.MethodsWe applied an Intervention Mapping protocol to design the program. This systematic approach to develop theory- and evidence-based health promotion programs consisted of 6 steps: development of a logic model of the problem, a model of change, intervention design and intervention production, the implementation plan, and the evaluation plan. The decisions made during the Intervention Mapping process were guided by theory, existing evidence, and our own research-including 4 focus groups (n=40), expert consultations (n=12), and interviews (n=11). The stakeholders included researchers, public representatives (including individuals with overweight and obesity), and experts from a variety of relevant backgrounds (including nutrition, physical activity, and the health care sector).ResultsFollowing a structured process, we developed a tailored intervention that has the potential to reduce excess body weight and support behavior changes in people with overweight and obesity. The Choosing Health intervention consists of tailored, personalized text messages and email support that correspond with theoretical domains potentially predictive of weight outcomes for each participant. The intervention content includes behavior change techniques to support motivation maintenance, self-regulation, habit formation, environmental restructuring, social support, and addressing physical and psychological resources.ConclusionsThe use of an Intervention Mapping protocol enabled the systematic development of the Choosing Health intervention and guided the implementation and evaluation of the program. Through the involvement of different stakeholders, including representatives of the general public, we were able to map out program facilitators and barriers while increasing the ecological validity of the program to ensure that we build an intervention that is useful, user-friendly, and informative. We also summarized the lessons learned for the Choosing Health intervention development and for other health promotion programs.International registered report identifier (irrid)RR2-10.1136/bmjopen-2020-040183.

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The impact of continued intervention on weight: Five-year results from the weight loss maintenance trial.

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The impact of continued intervention on weight: Five-year results from the weight loss maintenance trial.

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