Comparison of strategies for sustaining weight loss - The weight loss maintenance randomized controlled trial
Comparison of strategies for sustaining weight loss - The weight loss maintenance randomized controlled trial
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DOI：
10.1001/jama.299.10.1139
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发表时间：
2008-03-12
影响因子：
120.7
通讯作者：
Aicher, Kathleen
中科院分区：
文献类型：
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作者：
Svetkey, Laura P.;Stevens, Victor J.;Aicher, Kathleen
研究背景：行为性减肥干预能在短期内取得成功，但复发是很常见的。目的比较2种减肥维持干预措施与自我指导的对照组。设计、设置和参与者两阶段试验，其中1032名超重或肥胖的成年人(38%非裔美国人，63%女性)在为期6个月的减肥计划(第一阶段)中减重至少4公斤，随机进入减肥维持干预(第二阶段)。4个学术中心的入学时间为2003年8月至2004年7月，随机抽样时间为2004年2月至12月。数据收集于2007年6月完成。在第一阶段减肥计划结束后，参与者被随机分为以下组之一，为期30个月：每月个人接触、无限制地接受基于互动技术的干预或自我指导对照。随机结果显示体重的主要变化。在最初6个月的计划中，平均体重减轻了8.5公斤。随机分组后，体重回升。个人接触组的参与者恢复的体重(4.0公斤)低于自我指导组(5.5公斤；30个月时的平均差异，-1.5公斤；95%可信区间[CI]，-2.4至-0.6公斤；P=。001)。在30个月时，基于互动技术的组(5.2 kg)和自我指向组(5.5 kg；平均差异-0.3 kg；95%CI，-1.2至0.6 kg；P=。然而，18个月时，基于互动技术的组的体重恢复低于自我指导组(平均差异为-1.1公斤；95%可信区间为-1.9至-0.4公斤；P=。003)和24个月时(平均差异-0.9 kg；95%可信区间-1.7~-0.02 kg；P=。04)。在30个月时，个人接触组和基于互动技术的组之间的差异为-1.2 kg(95%CI-2.1到-0.3；P=。008)。性别、种族、年龄和体重指数亚组的影响没有显著差异。总体而言，71%的研究参与者的体重仍然低于初始体重。结论成功完成初始行为减肥计划的大多数人的体重保持在低于初始水平。每月短暂的个人接触在维持减肥方面提供了适度的好处，而基于技术的互动干预提供了早期但短暂的好处。政府标识：NCT00054925。
Context Behavioral weight loss interventions achieve short- term success, but regain is common.Objective To compare 2 weight loss maintenance interventions with a self- directed control group.Design, Setting, and Participants Two- phase trial in which 1032 overweight or obese adults ( 38% African American, 63% women) with hypertension, dyslipidemia, or both who had lost at least 4 kg during a 6- month weight loss program ( phase 1) were randomized to a weight- loss maintenance intervention ( phase 2). Enrollment at 4 academic centers occurred August 2003- July 2004 and randomization, February-December 2004. Data collection was completed in June 2007.Interventions After the phase 1 weight- loss program, participants were randomized to one of the following groups for 30 months: monthly personal contact, unlimited access to an interactive technology - based intervention, or self- directed control.Main Outcome Changes in weight from randomization.Results Mean entry weight was 96.7 kg. During the initial 6- month program, mean weight loss was 8.5 kg. After randomization, weight regain occurred. Participants in the personal- contact group regained less weight ( 4.0 kg) than those in the self- directed group ( 5.5 kg; mean difference at 30 months, - 1.5 kg; 95% confidence interval [ CI], - 2.4 to - 0.6 kg; P=. 001). At 30 months, weight regain did not differ between the interactive technology - based ( 5.2 kg) and self- directed groups ( 5.5 kg; mean difference - 0.3 kg; 95% CI, - 1.2 to 0.6 kg; P=. 51); however, weight regain was lower in the interactive technology - based than in the self- directed group at 18 months ( mean difference, - 1.1 kg; 95% CI, - 1.9 to - 0.4 kg; P=. 003) and at 24 months ( mean difference, - 0.9 kg; 95% CI, - 1.7 to - 0.02 kg; P=. 04). At 30 months, the difference between the personal-contact and interactive technology - based group was - 1.2 kg ( 95% CI - 2.1 to - 0.3; P=. 008). Effects did not differ significantly by sex, race, age, and body mass index subgroups. Overall, 71% of study participants remained below entry weight.Conclusions The majority of individuals who successfully completed an initial behavioral weight loss program maintained a weight below their initial level. Monthly brief personal contact provided modest benefit in sustaining weight loss, whereas an interactive techonology - based intervention provided early but transient benefit.Trial Registration clinicaltrials. gov Identifier: NCT00054925.