Comparison of an alternative schedule of extended care contacts to a self-directed control: a randomized trial of weight loss maintenance
Abstract Background Behavioral interventions for obesity produce clinically meaningful weight loss, but weight regain following treatment is common. Extended care programs attenuate weight regain and improve weight loss maintenance. However, less is known about the most effective ways to deliver ext...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2017-08-01
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| Series: | International Journal of Behavioral Nutrition and Physical Activity |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12966-017-0564-1 |
| _version_ | 1818894015804735488 |
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| author | Gareth R. Dutton Marissa A. Gowey Fei Tan Dali Zhou Jamy Ard Michael G. Perri Cora E. Lewis |
| author_facet | Gareth R. Dutton Marissa A. Gowey Fei Tan Dali Zhou Jamy Ard Michael G. Perri Cora E. Lewis |
| author_sort | Gareth R. Dutton |
| collection | DOAJ |
| description | Abstract Background Behavioral interventions for obesity produce clinically meaningful weight loss, but weight regain following treatment is common. Extended care programs attenuate weight regain and improve weight loss maintenance. However, less is known about the most effective ways to deliver extended care, including contact schedules. Methods We compared the 12-month weight regain of an extended care program utilizing a non-conventional, clustered campaign treatment schedule and a self-directed program among individuals who previously achieved ≥5% weight reductions. Participants (N = 108; mean age = 51.6 years; mean weight = 92.6 kg; 52% African American; 95% female) who achieved ≥5% weight loss during an initial 16-week behavioral obesity treatment were randomized into a 2-arm, 12-month extended care trial. A clustered campaign condition included 12 group-based visits delivered in three, 4-week clusters. A self-directed condition included provision of the same printed intervention materials but no additional treatment visits. The study was conducted in a U.S. academic medical center from 2011 to 2015. Results Prior to randomization, participants lost an average of −7.55 ± 3.04 kg. Participants randomized to the 12-month clustered campaign program regained significantly less weight (0.35 ± 4.62 kg) than self-directed participants (2.40 ± 3.99 kg), which represented a significant between-group difference of 2.28 kg (p = 0.0154) after covariate adjustments. This corresponded to maintaining 87% and 64% of lost weight in the clustered campaign and self-directed conditions, respectively, which was a significant between-group difference of 29% maintenance of lost weight after covariate adjustments, p = 0.0396. Conclusions In this initial test of a clustered campaign treatment schedule, this novel approach effectively promoted 12-month maintenance of lost weight. Future trials should directly compare the clustered campaigns with conventional (e.g., monthly) extended care schedules. Trial registration Clinicaltrials.gov NCT02487121 . Registered 06/26/2015 (retrospectively registered) |
| first_indexed | 2024-12-19T18:21:47Z |
| format | Article |
| id | doaj.art-3b247e8d9dce4adb8afc9fde25bca7cf |
| institution | Directory Open Access Journal |
| issn | 1479-5868 |
| language | English |
| last_indexed | 2024-12-19T18:21:47Z |
| publishDate | 2017-08-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal of Behavioral Nutrition and Physical Activity |
| spelling | doaj.art-3b247e8d9dce4adb8afc9fde25bca7cf2022-12-21T20:10:58ZengBMCInternational Journal of Behavioral Nutrition and Physical Activity1479-58682017-08-0114111110.1186/s12966-017-0564-1Comparison of an alternative schedule of extended care contacts to a self-directed control: a randomized trial of weight loss maintenanceGareth R. Dutton0Marissa A. Gowey1Fei Tan2Dali Zhou3Jamy Ard4Michael G. Perri5Cora E. Lewis6Division of Preventive Medicine, Department of Medicine, University of Alabama at BirminghamDivision of Preventive Medicine, Department of Medicine, University of Alabama at BirminghamDepartment of Mathematical Sciences, Indiana University-Purdue University IndianapolisDepartment of Mathematical Sciences, Indiana University-Purdue University IndianapolisDepartment of Epidemiology and Prevention, Wake Forest University School of MedicineDepartment of Clinical and Health Psychology, University of FloridaDivision of Preventive Medicine, Department of Medicine, University of Alabama at BirminghamAbstract Background Behavioral interventions for obesity produce clinically meaningful weight loss, but weight regain following treatment is common. Extended care programs attenuate weight regain and improve weight loss maintenance. However, less is known about the most effective ways to deliver extended care, including contact schedules. Methods We compared the 12-month weight regain of an extended care program utilizing a non-conventional, clustered campaign treatment schedule and a self-directed program among individuals who previously achieved ≥5% weight reductions. Participants (N = 108; mean age = 51.6 years; mean weight = 92.6 kg; 52% African American; 95% female) who achieved ≥5% weight loss during an initial 16-week behavioral obesity treatment were randomized into a 2-arm, 12-month extended care trial. A clustered campaign condition included 12 group-based visits delivered in three, 4-week clusters. A self-directed condition included provision of the same printed intervention materials but no additional treatment visits. The study was conducted in a U.S. academic medical center from 2011 to 2015. Results Prior to randomization, participants lost an average of −7.55 ± 3.04 kg. Participants randomized to the 12-month clustered campaign program regained significantly less weight (0.35 ± 4.62 kg) than self-directed participants (2.40 ± 3.99 kg), which represented a significant between-group difference of 2.28 kg (p = 0.0154) after covariate adjustments. This corresponded to maintaining 87% and 64% of lost weight in the clustered campaign and self-directed conditions, respectively, which was a significant between-group difference of 29% maintenance of lost weight after covariate adjustments, p = 0.0396. Conclusions In this initial test of a clustered campaign treatment schedule, this novel approach effectively promoted 12-month maintenance of lost weight. Future trials should directly compare the clustered campaigns with conventional (e.g., monthly) extended care schedules. Trial registration Clinicaltrials.gov NCT02487121 . Registered 06/26/2015 (retrospectively registered)http://link.springer.com/article/10.1186/s12966-017-0564-1ObesityBehavioral treatmentExtended careWeight loss maintenanceWeight regainAdults |
| spellingShingle | Gareth R. Dutton Marissa A. Gowey Fei Tan Dali Zhou Jamy Ard Michael G. Perri Cora E. Lewis Comparison of an alternative schedule of extended care contacts to a self-directed control: a randomized trial of weight loss maintenance International Journal of Behavioral Nutrition and Physical Activity Obesity Behavioral treatment Extended care Weight loss maintenance Weight regain Adults |
| title | Comparison of an alternative schedule of extended care contacts to a self-directed control: a randomized trial of weight loss maintenance |
| title_full | Comparison of an alternative schedule of extended care contacts to a self-directed control: a randomized trial of weight loss maintenance |
| title_fullStr | Comparison of an alternative schedule of extended care contacts to a self-directed control: a randomized trial of weight loss maintenance |
| title_full_unstemmed | Comparison of an alternative schedule of extended care contacts to a self-directed control: a randomized trial of weight loss maintenance |
| title_short | Comparison of an alternative schedule of extended care contacts to a self-directed control: a randomized trial of weight loss maintenance |
| title_sort | comparison of an alternative schedule of extended care contacts to a self directed control a randomized trial of weight loss maintenance |
| topic | Obesity Behavioral treatment Extended care Weight loss maintenance Weight regain Adults |
| url | http://link.springer.com/article/10.1186/s12966-017-0564-1 |
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