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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:BACKGROUND/OBJECTIVE:Financial incentives can improve initial weight loss; we examined whether financial incentives can improve weight loss maintenance. SUBJECTS/METHODS:Participants aged 30-80 years who lost at least 5 kg during the first 4-6 months in a nationally available commercial weight loss program were recruited via the internet into a three-arm randomized trial of two types of financial incentives versus active control during months 1-6 (Phase I) followed by passive monitoring during months 7-12 (Phase II). Interventions were daily self-weighing and text messaging feedback alone (control) or combined with a lottery-based incentive or a direct incentive. The primary outcome was weight change 6 months after initial weight loss. Secondary outcomes included weight change 12 months after initial weight loss (6 months after cessation of maintenance intervention), and self-reported physical activity and eating behaviors. RESULTS:Of 191 participants randomized, the mean age was 49.0 (SD = 10.5) years and weight loss prior to randomization was 11.4 (4.7) kg; 92% were women and 89% were White. Mean weight changes during the next 6 months (Phase I) were: lottery -3.0 (5.8) kg; direct -2.8 (5.8) kg; and control -1.4 (5.8) kg (all pairwise comparisons p > 0.1). Weight changes through the end of 12 months post-weight loss (Phase II) were: lottery -1.8 (10.5) kg; direct -0.7 (10.7) kg; and control -0.3 (9.4) kg (all pairwise comparisons p > 0.1). The percentages of participants who maintained their weight loss (defined as gaining ≤1.36 kg) were: lottery 79%, direct 76%, and control 67% at 6 months and lottery 66%, direct 62%, and control 59% at 12 months (all pairwise comparisons p > 0.1). At 6 and 12 months after initial weight loss, changes in self-reported physical activity or eating behaviors did not differ across arms. CONCLUSIONS:Compared with the active control of daily texting based on daily home weighing, lottery-based and direct monetary incentives provided no additional benefit for weight loss maintenance.

Dataset Information

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

Publications

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

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