Low-cost intervention limits weight regain
medwireNews: A randomized trial published in the Annals of Internal Medicine demonstrates the success of switching patients to an intervention designed to promote a stable weight, after initial weight loss.
All 222 participants undertook an initial weight loss program, losing an average of 7.2 kg from a baseline of 110.8 kg (average body mass index=36.3 kg/m2) over a 16-week intervention focusing on calorie and fat restriction.
After the initial intervention, the participants were stratified according to the extent of weight loss and randomly assigned to usual care or to an intervention to promote weight maintenance, which Corrine Voils (Duke University, Durham, North Carolina, USA) and study co-authors describe as “the holy grail of weight loss research.”
The weight loss intervention was based on face-to-face group meetings every 2 weeks, but the weight maintenance intervention transitioned participants to individual telephone calls at decreasing intervals. The telephone calls focused on satisfaction with weight loss outcomes, relapse-prevention planning, self-monitoring, and social support.
After 42 weeks of the weight maintenance intervention, followed by 14 weeks of no contact, the 88 participants remaining in the intervention group had regained an average of 0.75 kg, which was significantly less than the 2.36 kg regained by the 101 remaining in the usual care group.
In the maintenance group, 57.8% retained a weight that was at least 5% lower than their starting (pre-weight loss) weight, compared with 34.3% of participants in the usual care group.
Despite the difference in weight regain, there was no difference in the self-reported calorie intake between the groups at 56 weeks. The researchers say this could be because of the inherent unreliability of self-report, or because patients varied as to whether they planned to target calorie control or physical activity as their primary means of weight maintenance.
Voils and researchers note that the maintenance phase was relatively low cost, allowing most resources to be spent on the weight loss phase. “By incorporating a weight maintenance intervention into clinical or commercial weight loss programs, the effect of efficacious weight loss programs may be increased,” they conclude.
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