Janelle W Coughlin1,2, Phillip J Brantley3, Catherine M Champagne3, William M Vollmer4, Victor J Stevens4, Kristine Funk4, Arlene T Dalcin2, Gerald J Jerome5,6, Valerie H Myers7, Crystal Tyson8,9, Bryan C Batch9, Jeanne Charleston2, Catherine M Loria10, Alan Bauck4, Jack F Hollis4, Laura P Svetkey8,9, Lawrence J Appel2,5. 1. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. 2. Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA. 3. Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA. 4. The Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA. 5. Division of General Internal Medicine, Johns Hopkins University, Baltimore, Maryland, USA. 6. Department of Kinesiology, Towson University, Towson, Maryland, USA. 7. Klein Buendel, Inc, Golden, Colorado, USA. 8. Division of Nephrology/Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA. 9. Duke Hypertension Center and Sarah W. Stedman Nutrition and Metabolism Center, Duke University Medical Center, Durham, North Carolina, USA. 10. National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA.
Abstract
OBJECTIVE: In the Weight Loss Maintenance (WLM) Trial, a personal contact (PC) intervention sustained greater weight loss relative to a self-directed (SD) group over 30 months. This study investigated the effects of continued intervention over an additional 30 months and overall weight change across the entire WLM Trial. METHODS: WLM had 3 phases. Phase 1 was a 6-month weight loss program. In Phase 2, those who lost ≥4 kg were randomized to a 30-month maintenance trial. In Phase 3, PC participants (n = 196, three sites) were re-randomized tono further intervention (PC-Control) or continued intervention (PC-Active) for 30 more months; 218 SD participants were also followed. RESULTS: During Phase 3, weight increased 1.0 kg in PC-Active and 0.5 kg in PC-Control (mean difference 0.6 kg; 95% CI:-1.4 to 2.7; P = 0.54). Mean weight change over the entire study was -3.2 kg in those originally assigned to PC (PC-Combined) and -1.6 kg in SD (mean difference -1.6 kg; 95% CI:-3.0 to -0.1; P = 0.04). CONCLUSIONS: After 30 months of the PC maintenance intervention, continuation for another 30 months provided no additional benefit. However, across the entire study, weight loss was slightly greater in those originally assigned to PC.
RCT Entities:
OBJECTIVE: In the Weight Loss Maintenance (WLM) Trial, a personal contact (PC) intervention sustained greater weight loss relative to a self-directed (SD) group over 30 months. This study investigated the effects of continued intervention over an additional 30 months and overall weight change across the entire WLM Trial. METHODS: WLM had 3 phases. Phase 1 was a 6-month weight loss program. In Phase 2, those who lost ≥4 kg were randomized to a 30-month maintenance trial. In Phase 3, PCparticipants (n = 196, three sites) were re-randomized to no further intervention (PC-Control) or continued intervention (PC-Active) for 30 more months; 218 SDparticipants were also followed. RESULTS: During Phase 3, weight increased 1.0 kg in PC-Active and 0.5 kg in PC-Control (mean difference 0.6 kg; 95% CI:-1.4 to 2.7; P = 0.54). Mean weight change over the entire study was -3.2 kg in those originally assigned to PC (PC-Combined) and -1.6 kg in SD (mean difference -1.6 kg; 95% CI:-3.0 to -0.1; P = 0.04). CONCLUSIONS: After 30 months of the PC maintenance intervention, continuation for another 30 months provided no additional benefit. However, across the entire study, weight loss was slightly greater in those originally assigned to PC.
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