Evaluating a Small Change Approach to Preventing Long Term Weight Gain in Overweight and Obese Adults
Condition: Obesity; Prevention of Weight Gain
MeSH terms: Overweight; Body Weight; Weight Gain
Study type: Interventional

Summary: 
      Obesity is a major risk factor for disease and a public health problem. Recent information
      suggests that while it is possible for most overweight adults to lose a substantial amount of
      weight, maintaining the weight loss for any extended time (2 to 3 years) is very difficult.
      This is because trying to maintain big changes in exercise and/or eating behaviour is very
      difficult in today's environment that makes sustain big changes in behaviour (Example: eat
      allot less or exercise allot more) very hard. In fact at this time health professionals are
      unsure of how best to help overweight adults maintain big behavioral changes for long periods
      of time. In response, we propose that making smaller changes in eating and exercise habits
      every day may be possible in today's environment and if so, small weight changes may be
      possible to maintain for long periods of time. This study is designed to assess whether
      making small changes in eating and exercise behavior will be associated with sustained weight
      loss over three (3) years. The results of the study may have important implications for
      development of public health messages and clinical guidelines for prevention and treatment of
      obesity through small changes in both exercise and eating habits.
    

Detailed description: 
      The prevalence of obesity and associated morbidity among Canadian adults is already high and
      increasing. Prevalence estimates for overweight determined from measured height and weight
      now exceeds 62 % in Canadian adults1; approximately 15.5 million Canadian adults are now
      overweight and obese1. Obesity is associated with a wide range of health outcomes from
      co-morbidities including type 2 diabetes, cardiovascular disease and certain cancers, to
      psychiatric disorders such as depression1. Direct costs attributed to obesity in Canada range
      from 4.6 to 7.1 billion dollars annually1. Despite agreement concerning the urgent need to
      address the obesity problem; few strategies have been successful on a wide scale basis. Past
      efforts to achieve and sustain weight loss have not been particularly successful. We3 and
      others4 have repeatedly demonstrated in randomized controlled trials that most adults are not
      able to sustain the major changes in behaviour that are required to maintain weight loss long
      term. Thus, although it is an admirable goal to substantially reduce the number of overweight
      or obese Canadians, this goal may be totally out of reach in the short term. The question
      then is what can be done to address the obesity problem now? We propose that a reasonable
      start point in addressing the obesity problem is to develop behavioural goals for prevention
      of weight gain. This strategy can at least keep the problem from getting worse and at best,
      can reduce obesity rates over time.
    

Intervention name(s): Control group; Lifestyle counselling
Intervention type(s): Behavioral; Behavioral
Intervention description(s): No prescribed intervention/ Participants asked to follow normal initiatives to engage in physical activity a healthful diet behaviors for the duration of the intervention; Participants will follow a prescribed behavioral intervention program seeking small changes in both physical activity and diet for the duration of the intervention.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: physical activity; diet; small change; behavior change