Maintenance After Initiation of Nutrition TrAINing
Condition: Obesity
MeSH terms: Obesity
Study type: Interventional

Summary: 
      Obesity is the second leading cause of preventable deaths in the United States and is
      associated with a wide range of diseases. In people who are obese, weight loss improves blood
      pressure, dyslipidemia, glycemia, and arthritis symptoms; reduces medication use for several
      disease processes; increases physical functioning; and enhances health-related quality of
      life. The current study evaluated a theoretically informed maintenance intervention. If
      effective, this intervention could reduce the need for future clinic visits to treat obesity
      and its many associated illnesses.
    

Detailed description: 
      Obesity is the second leading cause of preventable deaths in the United States and is
      associated with a wide range of diseases. In people who are obese, weight loss improves blood
      pressure, dyslipidemia, glycemia, and arthritis symptoms; reduces medication use for several
      disease processes; increases physical functioning; and enhances health-related quality of
      life. Despite these benefits, most patients who achieve weight loss regain much of this
      weight within a year, and few effective behavioral weight maintenance interventions have been
      identified. Thus, there is a dire need for effective interventions that can promote weight
      loss maintenance. Theoretical and empirical studies indicate that behavior maintenance is a
      distinct state that involves different psychological processes and behavioral skills than
      initial behavior change. The few trials that have tested weight loss maintenance
      interventions have not taken this distinction into account, which may partially explain their
      modest findings. The current study evaluated the efficacy of a theoretically informed
      maintenance intervention compared to usual care. If efficacious, this intervention could
      reduce the need for future clinic visits to treat obesity and its many associated illnesses
      and could serve as a model for redesigning the MOVE! program. This 3.5-year study involved a
      two-arm, randomized, controlled trial. During the run-in phase, Veterans with BMI 30 kg/m2
      participated in a 4-month, intensive, group-based weight loss program. Participants who lost
      at least 4 kg by the end of 4 months (n=222) were randomized to receive (a) usual care
      (n=112) for 56 weeks or (b) a theoretically-informed maintenance intervention (n=110) for 42
      weeks months, followed by 14 weeks of no intervention contact to examine sustainability. The
      maintenance intervention involved in-person group visits that transition to individualized
      telephone calls, and the frequency of contact with the interventionist gradually tapered over
      time. Outcomes were assessed at randomization and at weeks 14, 26, 42, and 56
      post-randomization. The hypotheses are that the maintenance intervention will result in at
      least 3.5 kg greater weight loss and greater improvements in caloric intake and physical
      activity over the study period, and that it will be cost-effective, compared to usual care.
    

Intervention name(s): Maintenance intervention
Intervention type(s): Behavioral
Intervention description(s): Theoretically-informed maintenance intervention that involves in-person group visits that transition to individualized telephone calls, and the frequency of contact gradually decreases over time.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: obesity; intervention studies; patient adherence