Using Partners to Enhance Long-Term Weight Loss

This study involves an evaluation of the role of domestic partner support in a comprehensive weight loss initiation and maintenance program.

Couples will be randomized to a comprehensive weight program directed at patients alone or involving their partners. In months 1-6, all patients will receive group-based weight loss program. In months 7-18, all patients will receive a telephone-based weight loss maintenance intervention. In the partner-assisted arm only, partners will participate in the intervention, learning and practicing communication skills and support strategies. In months 19-24, intervention will be withdrawn to examine sustainability of effects.

Due to COVID-19, option of doing screening and outcome assessment visits and attending the group classes (including exercise) remotely via a video conference may be available. COVID-19 survey will be administered every 3 month starting at screening/enrollment visit.

Eligibility Criteria:
Inclusion Criteria (patients):

* Aged 18-74 years
* BMI 27-29.9 kg/m2 plus at least one obesity-related comorbidity or BMI \>=30 kg/m2
* Cohabitating and at least daily contact with a spouse/domestic partner
* Access to reliable transportation
* Desire to lose weight
* Speak and read English
* Agree to attend visits per protocol
* Score of at least 4 out of 6 on Callahan cognitive screener
* Able to stand without assistance for weight measurements without assistance
* Possess individual email address
* Possess individual smart phone with data and texting plan
* Able to complete online screener without assistance
* Able to use a smartphone, tablet or computer with a video camera or webcam and microphone to download apps and to connect to a video conference call without assistance

Exclusion Criteria (patients):

* Currently or planning to become pregnant or breastfeeding in the study timeframe
* Weight loss ≥ 5 lb in the month prior to screening
* Currently enrolled, or enrolled in previous 3 months, in a clinical or research program focusing on lifestyle change that could affect weight
* Significant dementia, schizophrenia, psychosis, or drug or alcohol abuse
* Chronic or unstable illness that would limit ability to participate (e.g., recent hospitalization; unstable heart disease in the 6 months prior to screening, chronic kidney disease stage 4 or higher)
* Living a nursing home or receiving visits from a home health care agency
* Planning to relocate in the next 2.5 years
* Current use of prescription or over-the-counter weight loss medications
* History of bariatric surgery or planning to have bariatric surgery in the study timeframe
* Impaired hearing
* Currently receiving, or received in the past 6 months, treatment for cancer other than skin cancer
* Use of insulin, sulfonylureas, or meglinitides for diabetes
* High diuretic dose
* Exertional chest pain, dizziness, or lightheadedness
* Pain or other condition than prohibits mild-moderate exercise
* History of ascites requiring paracentesis

Inclusion criteria (partner):

* Aged 18 or older
* Willing to participate
* Access to reliable transportation
* Speak and read English
* Score of at least 4 out of 6 on Callahan cognitive screener
* Possess smart phone with data and texting plan (not shared with index patient)
* Possess email address (not shared with index patient)
* Able to complete online screener without assistance

Exclusion criteria (partner):

* BMI \<18.5 kg/m2
* Significant dementia, schizophrenia, psychosis, or drug or alcohol abuse
* Residing in a nursing home or receiving home health care
* Impaired hearing
* Currently receiving, or received in the past 6 months, treatment for cancer other than skin cancer
* Chronic or unstable illness that would limit ability to participate (e.g., recent hospitalization; unstable heart disease in the 6 months prior to screening)