Maintenance program associated with reduced weight regain after weight loss

1. After 56 weeks of a weight maintenance intervention program, researchers found that mean weight regain in the intervention group (0.75 kg) was lower than in the usual care group (2.36 kg) by a statistically significant amount.

2. This study suggests that a weight maintenance intervention program could help patients who have lost weight to slow weight regain.

Evidence Rating Level: 1 (Excellent) 

Study Rundown: After successfully losing weight, regaining weight over time is a common occurrence. In this study, patients who had participated in a 16-week weight loss program and had lost at least 4 kg were assigned at a random to either a maintenance group or a usual care group. Participants in the maintenance intervention group were contacted (usually by phone) with skills to help maintain weight loss. Contact was gradually reduced over the intervention period. Those in the usual care group received no contact other than for study measurements. After 56 weeks, researchers found that mean weight regain in the intervention group (0.75 kg) was lower than in the usual care group (2.36 kg) by a statistically significant amount. This study suggests that maintenance intervention could help patients who have lost weight to slow weight regain.

Strengths of the study include a high retention rate of 85%, regular assessments of fidelity, and a low cost intervention design that enables more resources to be used for the original weight loss than for maintenance. Limitations of the study include a study duration that was fairly brief and limits on generalizability.

Click to read the study, published today in Annals of Internal Medicine

Relevant Reading: Study design and protocol for a theory-based behavioral intervention focusing on maintenance of weight loss: The Maintenance After Initiation of Nutrition TrAINing (MAINTAIN) study

In-Depth [randomized controlled trial]: This study was conducted from August 2012 to December 2015 at 3 primary care clinics in Durham and Raleigh, North Carolina. In the initial 16-week weight loss program of 504 obese participants (body mass index ≥30 kg/m2), 222 lost 4 kg or more and were assigned at random to either a maintenance group (n = 110) or one receiving usual care (n = 112). Participants in the maintenance intervention group were contacted by group visits (weeks 2, 6, and 10) and individual phone calls (weeks 4, 8, 12, 16, 20, 24, 32, and 40). Topics that were addressed included outcomes satisfaction, self-monitoring, planning to prevent relapse, and social support. The 42-week intervention period was followed by a 14-week period of no contact. Those in the usual care group were contacted only for study measurements. Measurements included weight, height, dietary intake (via the Block Brief 2000 food frequency questionnaire) and the International Physical Activity Questionnaire. Most participants were male (84%), middle-aged (mean = 62 years), graduates of high school (98%), white (58%), and had previously tried to lose weight (82%). After 56 weeks, researchers found that mean weight regain in the intervention group (0.75 kg) was lower than in the usual care group (2.36 kg). The mean difference was 1.60 kg (95% CI, 0.07 kg to 3.13 kg; P = 0.040).

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