A randomized trial comparing two approaches to weight loss: Differences in weight loss maintenance (original) (raw)
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Transforming Your Life: An Environmental Modification Approach to Weight Loss
Journal of Health Psychology, 2011
This investigation compared a traditional behavioral weight loss program with a weight loss intervention emphasizing environmental modification and habit formation and disruption. Fifty-four overweight and obese adults (BMI ≥ 27 kg/m 2 ) were randomly assigned to either a 14-week LEARN or TYL intervention. Forty-two participants completed the six-month follow-up assessment. Treatment outcomes between LEARN and TYL participants were equivalent. During the six-month no-treatment follow-up period, participants evidenced a 3.3 lb (SD = 9.2) weight gain. The TYL intervention appears to represent an attractive option for individuals seeking an alternative to the traditional behavioral approach to weight loss.
Changing weight-loss expectations: A randomized pilot study
Eating Behaviors, 2005
Participants in weight-loss programs expect unreasonably large weight losses and believe that such reductions will produce dramatic improvements in their lives. The failure to achieve such benefits may contribute to poor maintenance of lost weight. This randomized pilot study investigated a new cognitive-behavioral intervention designed to modify unrealistic expectations regarding weight loss and its likely impact on appearance, attractiveness, and self-esteem. Twenty-eight overweight and obese young women who completed 10 sessions of standard behavioral weight-loss treatment were randomly assigned to 10 additional sessions of either standard behavioral (SB) treatment or a reformulated cognitive-behavioral (RCB) treatment. At posttreatment, the RCB intervention produced more realistic weight-loss expectations, decreased participants' motivation to lose weight as a means of improving self-confidence, and increased their overall self-esteem, compared with the SB condition (all p'sb.05). The mean posttreatment weight changes achieved in the SB (À6.2F4.5 kg) and RCB (À5.5F3.6 kg) conditions were equivalent, as were the amounts of weight regained during a 6-month follow-up (SB=2.3F2.7 kg; RCB=1.5F1.7 kg). Collectively, these findings indicate that the RCB intervention was effective in changing unrealistic weight-loss expectations, but it did not produce significantly better maintenance of lost weight than did the SB intervention.
Eating Behaviors, 2015
Objective: To investigate the change in eating behavior and the factors related with the change among successful dieters (maintained a weight loss of ≥5% of original weight). Methods: Obese adult subjects (21 male, 55 female) were randomized into three-year lifestyle intervention (n = 59) and control groups (n = 17). Eating behavior (cognitive restraint of eating, uncontrolled eating and emotional eating) was evaluated by the TFEQ-18 and motivation to lose weight and tolerance to problems by a separate questionnaire. Weight, height and body mass index were measured. Results: Weight decreased more in the intervention group than in the control group (5.0% vs 0.6%, p = 0.027). Cognitive restraint increased twice as much in the intervention group compared to the control group (16.0 vs. 7.0, p = 0.044). The increment in cognitive restraint was positively associated with weight loss and high baseline motivation and tolerance to problems. Cognitive restraint increased in both successful (n = 27) and unsuccessful dieters (n = 32), but only the successful dieters were able to decrease uncontrolled eating in the long term. Conclusions: Our results showed that intensive lifestyle counseling improved cognitive restraint which was associated with enhanced weight loss among obese adults. Successful dieters also showed a long-term improvement of uncontrolled eating. Eating behavior should be evaluated and followed before and during lifestyle interventions in order to support the change, e.g. by finding methods to control eating at risk situations and strengthening motivation and tolerance to problems.
Taking control of your personal eating and exercise environment: A weight maintenance program
Eating behaviors, 2008
The current investigation examined the impact of a weight maintenance intervention (MI) designed to empower people to create a personal healthy food and physical activity environment on weight loss treatment outcomes. It was hypothesized that behavioral weight loss program (BWLP) participants who received an additional MI would evidence superior weight loss maintenance compared to participants who received a BWLP alone (no contact [NC]). Fifty-one obese adults were randomly assigned to participate in a 16-week weight loss intervention followed by NC or a 6-week MI. Thirty-eight participants completed the sixmonth follow-up. Body weight, percent body fat, cardiorespiratory fitness, self-reported physical activity, and self-reported diet (i.e., calories, percent daily intake of fat, protein, and carbohydrates) were assessed. Participants significantly decreased their weight, increased physical activity/fitness, and improved dietary intake (ps b .05). MI participants had significantly greater weight loss maintenance than NC participants (ps b .05). Helping obese individuals to modify their personal eating and physical activity environment in order to reduce exposure to "obesogenic" cues may contribute to long-term weight loss maintenance.
The international journal of behavioral nutrition and physical activity, 2015
BackgroundProcess evaluation is important for improving theories of behavior change and behavioral intervention methods. The present study reports on the process outcomes of a pilot test of the theoretical model (the Process Model for Lifestyle Behavior Change; PMLBC) underpinning an evidence-informed, theory-driven, group-based intervention designed to promote healthy eating and physical activity for people with high cardiovascular risk.Methods108 people at high risk of diabetes or heart disease were randomized to a group-based weight management intervention targeting diet and physical activity, or to usual care. The intervention comprised nine group based sessions designed to promote motivation, social support, self-regulation and understanding of the behavior change process. Weight loss, diet, physical activity and theoretically defined mediators of change were measured pre-intervention, and after four and 12 months.ResultsThe intervention resulted in significant improvements in ...
Eight-year weight losses with an intensive lifestyle intervention: The look AHEAD study
Obesity, 2014
Objective: To evaluate 8-year weight losses achieved with intensive lifestyle intervention (ILI) in the Look AHEAD (Action for Health in Diabetes) study. Design and Methods: Look AHEAD assessed the effects of intentional weight loss on cardiovascular morbidity and mortality in 5,145 overweight/obese adults with type 2 diabetes, randomly assigned to ILI or usual care (i.e., diabetes support and education [DSE]). The ILI provided comprehensive behavioral weight loss counseling over 8 years; DSE participants received periodic group education only. Results: All participants had the opportunity to complete 8 years of intervention before Look AHEAD was halted in September 2012; 88% of both groups completed the 8-year outcomes assessment. ILI and DSE participants lost (mean 6 SE) 4.7% 6 0.2% and 2.1 6 0.2% of initial weight, respectively (P < 0.001) at year 8; 50.3% and 35.7%, respectively, lost 5% (P < 0.001), and 26.9% and 17.2%, respectively, lost 10% (P < 0.001). Across the 8 years ILI participants, compared with DSE, reported greater practice of several key weight-control behaviors. These behaviors also distinguished ILI participants who lost 10% and kept it off from those who lost but regained. Conclusions: Look AHEAD's ILI produced clinically meaningful weight loss (5%) at year 8 in 50% of patients with type 2 diabetes and can be used to manage other obesity-related co-morbid conditions.
Characteristics of Weight Loss Trajectories in a Comprehensive Lifestyle Intervention
Obesity (Silver Spring, Md.), 2017
Focusing on average weight loss (WL) from interventions provides useful efficacy data but masks large variability across patients. In this study, parameters of weight loss trajectories were determined that differentiated individuals during a 15-week clinical lifestyle intervention. Patients (n = 595) were in a fee-for-service WL lifestyle program with a partial meal replacement diet and lifestyle change counseling. Parameters used in latent class analyses were percent WL (%WL), weight nadir, number of weekly weight gains, maximum weekly percent weight gain, standard deviation of weekly weight changes, linear slope values, and change in slope. Average %WL was 9.73%. Latent class analyses revealed three groups with considerable overlap in %WL ranges but differing significantly on all trajectory parameters (Ps < 0.001). Group 1 had the most variable and least successful pattern of weight changes. Group 3 had the least variable and most successful pattern of weight changes. Group 2 f...
Continuous Engagement in a Weight-Loss Program Promotes Sustained Significant Weight Loss
PubMed, 2020
Background: Significant weight loss improves health but regain is common. Objective: The objective of the study was to determine if 2,346 members of Take Off Pounds Sensibly-a national, low-cost, peer-led weight-loss program-achieved and maintained significant weight loss with 7 consecutive annual renewals. Methods: This study was a retrospective cohort design. For each renewal, the cumulative change from baseline weight was calculated. Weight change was placed into 1 of 3 categories: significant weight loss, loss ≥ 5%; weight stable, loss of 0 to < 5%; or weight gain, any amount above baseline weight. Results: The cohort included 2,346 individuals. Fifty-one percent (n=740) of participants were in the significant weight-loss category all 7 years; 256 (18%) were in the significant weight-loss category at year 1 but moved into at least 1 other category during years 2 through 6; 359 (25%) were in the weight stable category at year 1; and 98 (7%) were in the weight gain category at year 1. Conclusions: Over 60% of the population achieved significant weight loss by year 7. Since continuous, long-term engagement in a weight-loss program can lead to significant weight loss, even if significant weight loss is not initially achieved, participation should be encouraged.