Maintaining Weight Loss
Maintenance-focused interventions that modestly slow the rate of weight gain in obese adults who had lost weight are feasible and the tailoring of maintenance interventions to particular populations is examined.
Abstract
What is the problem and what is known about it so far? Weight loss interventions that target dietary change, physical activity, and behavioral strategies may lead to weight loss of at least 5%. After weight loss, most people tend to regain 1 to 2 kg (about 2 to 4.5 lb) per year, with faster rates of regain in the earlier years. Various strategies, including behavioral approaches, may help prevent weight regain. Behavioral approaches help people learn and habitualize behaviors for navigating situations that might lead to lapses and relapse. One such behavioral approach is learning maintenance-specific skills. Why did the researchers do this particular study? To establish the efficacy of a weight loss maintenance program compared with usual care in obese adults who had already lost weight. Who was studied? Obese adults from 3 primary care clinics at a Veterans Affairs Medical Center who had lost 4 kg (about 9 lb) or more during a 16-week, group-based, weight loss program. How was the study done? Researchers recruited 222 patients who had lost weight in the group-based program. The study participants were randomly assigned to receive usual care (112 patients), with no contact except for study measurements, or a maintenance intervention (110 patients), delivered primarily by telephone (that is, 3 group meetings and 8 telephone calls). The intervention addressed satisfaction with outcomes, relapse prevention techniques, self-monitoring, and social support. The primary outcome was mean weight regain at week 56. Other outcomes included self-reported calorie intake, walking, and moderate physical activity. Weight outcomes were assessed by a research associate who did not know whether patients were assigned to the intervention or usual care group. What did the researchers find? Most patients were middle-aged white men, and 85% of the participants completed study follow-up. Mean weight regain was statistically significantly lower in the intervention group (0.75 kg [about 1.5 lb]) than the usual care group (2.36 kg [about 5 lb]). No statistically significant differences were seen between the groups at 56 weeks for the secondary outcomes. No adverse events attributable to the intervention occurred. What were the limitations of the study? Dietary intake and physical activity were self-reported. Few women were studied. Follow-up duration was only 56 weeks. What are the implications of the study? Maintenance-focused interventions that modestly slow the rate of weight gain in obese adults who had lost weight are feasible. Future studies should examine the tailoring of maintenance interventions to particular populations, long-term durability of intervention effects, and optimal behavioral and implementation strategies.