WEIGHT LOSS MAINTENANCE TRIAL

超重/肥胖是美国的第二大死亡原因，并且正在以惊人的速度增长。 控制超重/肥胖症日益被视为国家的高度优先事项，因为它有助于 心血管疾病（CVD）的危险因素，并最终到CVD本身。行为干预的短期成功 体重减轻已被反复记录。不幸的是，由于体重重新增加是非常普遍的， 令人惊讶的是，只有很少一部分人能够长期控制体重。与之相关的因素 持续减肥，其中最重要的是与频繁接触的持续干预。我们提出了一个多- 中心、随机、对照试验[减肥维持试验（MAINTENANCE）]，以确定 两种创新的行为干预，每一种都旨在保持频繁的接触，与通常的护理控制相比， 组超重和肥胖个体（约60%女性，-40%非裔美国人）正在服用药物治疗 高血压、血脂异常和/或2型糖尿病将进入6个月的减肥计划。那些失败的人 然后将至少4 kg（N = 800）的受试者随机分为三组之一：个人接触（PC）干预， 每月提供与训练有素的干预人员的个人联系，主要通过电话;互动技术 (IT)干预，通过最先进的互动式网络计划提供频繁的接触， 通过其他通信技术;或医疗护理（UC）。主要结果将是体重变化， 从最初的减肥计划到30个月的体重维持干预期结束。其他成果 将包括亚组的体重变化，CVD危险因素的患病率，行为变化的测量，以及 实施.对于每种结局，将PC和IT干预与UC进行比较，如果与UC不同，则与 对方.为了成功地对抗肥胖症的流行，临床医生和卫生保健系统必须有选择， 有效和可行的，并且可以提供给大量的个人。这项建议的目的是 开发并测试两种这样的干预措施，如果有效，应该补充正在进行的遏制肥胖的努力。 并最终预防肥胖相关的CVD。

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 program. Those individuals who lose at least 4 kg (N = 800) will then be randomized into one of three groups: a Personal Contact (PC) Intervention that provides monthly personal contacts with a trained interventionist, primarily via telephone; an Interactive Technology (IT) Intervention that provides frequent contacts 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 intervention 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 successfully combat the obesity epidemic, clinicians and health care systems must have options 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.