WEIGHT LOSS MAINTENANCE TRIAL

超重/肥胖是美国的第二大死亡原因， 惊人的速度。控制超重/肥胖越来越被认为是国家的一项重要优先事项， 它对心血管（CVD）风险因素的贡献，并最终对CVD本身。短期 减肥行为干预的成功已被反复记录。不幸的是， 因为体重再增加是非常普遍的，一个令人不安的小比例的个人实现 长期控制体重。在与持续减肥相关的因素中，最重要的因素之一是 重要的是通过经常接触继续进行干预。我们提出了一个多中心，随机， 对照试验[减肥维持试验（维持）]，以确定两种 创新的行为干预，每一个旨在保持频繁的接触，相比之下， 护理对照组。超重和肥胖个体（约60%女性，约40%非裔美国人）， 服用高血压、血脂异常和/或2型糖尿病药物将进入6个月的体重减轻期 3rogram。然后，体重减轻至少4 kg的个体（N = 800）将被随机分配到三个 iroups：一种个人接触（PC）干预，每月提供与训练有素的 “干预者，主要通过电话;一种互动技术（IT）干预，提供频繁的 通过最先进的基于网络的交互式程序， 技术;或医疗保健（UC）。主要结局将是体重较初始治疗结束时的变化。 减肥计划到30个月的体重维持期结束。其他成果将包括 亚组的体重变化、CVD危险因素的患病率、行为改变的测量以及 实施.对于每种结局，将PC和IT干预与UC进行比较，如果不同， 从UC到彼此为了对抗肥胖症的流行，临床医生和卫生保健系统必须 有效和可行的洗剂，并且可以提供给大量的个体。的 本建议的目的是制定和测试两项此类干预措施，如果有效，应 补充正在进行的努力，以遏制肥胖症的流行，并最终预防肥胖相关的心血管疾病。

Overweight/obesity is the second leading cause of death in the US, and is growing in prevalence at an alarming rate. Control of overweight/obesity is increasingly recognized as a high national priority because of its contribution to cardiovascular (CVD) risk factors and ultimately to CVD itself. The short-term success of behavioral interventions for weight loss has been repeatedly documented. Unfortunately, because weight re-gain is extremely common, a disappointingly small proportion of individuals achieve long-term weight control. Of the factors that are associated with sustained weight loss, one of the most important is continued intervention with frequent contacts. We propose a multi-center, randomized, controlled trial [Weight Loss Maintenance Trial (MAINTENANCE)] to determine the effects of two innovative behavioral interventions, each designed to maintain frequent contacts, compared to a usual care control group. Overweight and obese individuals (~60% women, ~40% African Americans) who are taking medication for hypertension, dyslipidemia and/or type 2 diabetes will enter a 6 month weight loss 3rogram. Those individuals who lose at least 4 kg (N = 800) will then be randomized into one of three iroups: a Personal Contact (PC) Intervention that provides monthly personal contacts with a trained "lterventionist, primarily via telephone; an Interactive Technology (IT) Intervention that provides frequent ',ontacts through a state-of-the-art interactive web-based program supplemented by other communication technologies; or Usual Care (UC). The primary outcome will be weight change from the end of the initial weight loss program to the end of the 30-month weight maintenance period. Other outcomes will include weight change in subgroups, prevalence of CVD risk factors, measures of behavior change, and cost of implementation. For each outcome, the PC and IT interventions will be compared to UC, and if different from UC, to each other. To combat the obesity epidemic, clinicians and health care systems must have loptions that are effective and feasible, and that can be provided to large numbers of individuals. The purpose of this proposal is to develop and test two such interventions, which, if effective, should complement ongoing efforts to stem the obesity epidemic and ultimately prevent obesity-related CVD.