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Weight Loss Maintenance in Primary Care

Weight Loss Maintenance in Primary Care: Rationale and Preliminary Findings Michael R. Lowe Department of Psychology Drexel University Philadelphia, PA. Weight Loss Maintenance in Primary Care. Acknowledgements Rachel Annunziato Meghan Butryn Yelena Chernyak Maria Coletta

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Weight Loss Maintenance in Primary Care

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  1. Weight Loss Maintenance in Primary Care: Rationale and Preliminary FindingsMichael R. LoweDepartment of PsychologyDrexel University Philadelphia, PA

  2. Weight Loss Maintenance in Primary Care Acknowledgements Rachel Annunziato Meghan Butryn Yelena Chernyak Maria Coletta Canice Crerand Liz Didie Tanja Kral Jessica Markowitz Chris Ochner Karyn Tappe Graham Thomas Supported by NIDDK grant DK066759

  3. Study Rationale • A variety of non-medical approaches to obesity treatment produce medically significant weight losses • However, relapse typically begins shortly after treatment ends • Nearly all weight lost is regained 5 years later

  4. Study Rationale cont. • Lifestyle change programs focus on making wide-ranging changes in participants’ eating behaviors, physical activity, cognitions, attitudes and relationships • Changes are numerous, complex and often distal from what and how much is actually eaten • Extensive research suggests that the availability, structure and composition of food may play an especially influential role in control of energy intake • Particularly for weight loss maintenance

  5. Study Rationale cont. • We studied effects on weight loss maintenance of: • Diet structure [provision of meal replacements (MRs)] • Diet composition [manualized treatment to reduce the energy density (ED) of the diet based on Roll’s Volumetrics] • Plus making modifications to energy density of foods at and away from home

  6. Study Design • Overweight (BMI > 30 or > 27 with comorbidities) primary care patients referred by their physicians • All treatment administered via 15 minute phone calls • Held weekly for 6 months and then less frequently to 1 year • Advanced clinical grad students and registered dieticians trained to administer interventions • Assessments at pretreatment, 12 weeks, 1, 2 and 3 years

  7. Study Design (cont) • All participants first lost weight for 12 weeks on same MR-supplemented, 1,100 kcal/day controlled diet • Then randomly assigned to MR and ED conditions for 9 more months • All participants administered lifestyle change advice aimed at maintenance

  8. Study Design • 2 X 2 design during maintenance: • MR- ED- • MR- ED+ • MR+ ED- • MR+ ED+

  9. Sample Characteristics n = 226 Attrition by week 12: ~40%

  10. Changes During Phase 1 – 12 Week Weight Loss Phase n = 108

  11. Changes During Phase 1 – 12 Week Weight Loss Phase (cont.) n = 108

  12. Changes During Phase 2 – 9 Month Weight Maintenance Phase n = 35

  13. Changes During Phase 2 – 9 Month Weight Maintenance Phase (cont.)

  14. Phase 2 (weight maintenance) Weight Change by ED and MR Condition

  15. Correlation Between Weight Losses in Phases 1 and 2

  16. Phase 2 (weight maintenance) Weight Change With Phase 1 Weight Losses Controlled

  17. A

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