Weight loss during the intensive intervention phase of the weight-loss maintenance trial - PubMed (original) (raw)

Clinical Trial

doi: 10.1016/j.amepre.2008.04.013.

Christina M Gullion, Victor J Stevens, Phillip J Brantley, Lawrence J Appel, Jamy D Ard, Catherine M Champagne, Arlene Dalcin, Thomas P Erlinger, Kristine Funk, Daniel Laferriere, Pao-Hwa Lin, Catherine M Loria, Carmen Samuel-Hodge, William M Vollmer, Laura P Svetkey; Weight Loss Maintenance Trial Research Group

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Clinical Trial

Weight loss during the intensive intervention phase of the weight-loss maintenance trial

Jack F Hollis et al. Am J Prev Med. 2008 Aug.

Abstract

Background: To improve methods for long-term weight management, the Weight Loss Maintenance (WLM) trial, a four-center randomized trial, was conducted to compare alternative strategies for maintaining weight loss over a 30-month period. This paper describes methods and results for the initial 6-month weight-loss program (Phase I).

Methods: Eligible adults were aged > or =25, overweight or obese (BMI=25-45 kg/m2), and on medications for hypertension and/or dyslipidemia. Anthropomorphic, demographic, and psychosocial measures were collected at baseline and 6 months. Participants (n=1685) attended 20 weekly group sessions to encourage calorie restriction, moderate-intensity physical activity, and the DASH (dietary approaches to stop hypertension) dietary pattern. Weight-loss predictors with missing data were replaced by multiple imputation.

Results: Participants were 44% African American and 67% women; 79% were obese (BMI> or =30), 87% were taking anti-hypertensive medications, and 38% were taking antidyslipidemia medications. Participants attended an average of 72% of 20 group sessions. They self-reported 117 minutes of moderate-intensity physical activity per week, kept 3.7 daily food records per week, and consumed 2.9 servings of fruits and vegetables per day. The Phase-I follow-up rate was 92%. Mean (SD) weight change was -5.8 kg (4.4), and 69% lost at least 4 kg. All race-gender subgroups lost substantial weight: African-American men (-5.4 kg +/- 7.7); African-American women (-4.1 kg +/- 2.9); non-African-American men (-8.5 kg +/- 12.9); and non-African-American women (-5.8 kg +/- 6.1). Behavioral measures (e.g., diet records and physical activity) accounted for most of the weight-loss variation, although the association between behavioral measures and weight loss differed by race and gender groups.

Conclusions: The WLM behavioral intervention successfully achieved clinically significant short-term weight loss in a diverse population of high-risk patients.

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Figures

Figure 1

Figure 1

Flow diagram.

Figure 2

Figure 2

Mean weight loss during Phase I by race–gender subgroups for participants with at least one weight measurement in every month.

Figure 3

Figure 3. Estimated effect of physical activity on weight change, by gender and race

a Model evaluated at the overall mean of 3.7 food records per week.

Figure 4

Figure 4. Estimated effect of number of food records kept per week on weight change, by gender and race

a Evaluated at the overall mean of 117 minutes per week of moderate-intensity physical activity.

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