A Three-Month RCT to Sustain Weight Loss Among Obese Persons through Tailored SMS

描述（由申请人提供）：重要性：超过67%的美国成年人肥胖或超重。这种健康流行病是昂贵的，并与多种慢性疾病，包括2型糖尿病，癌症和心血管疾病。许多减肥的人体重会反弹;这是由于个人未能自我调节和保持定期的身体活动，遵循低脂饮食和监测体重。虽然许多干预策略在开始体重控制行为时取得了成功，但它们往往无法促进行为的维持和防止体重增加的复发。关于如何维持减肥和控制体重的行为，从而防止复发的经验证据有限。体重增加的速度是最高的结构性减肥计划停止后立即。需要的是可以在结构化减肥计划之后使用的干预策略，这些策略可以促进减肥的可持续性，防止复发，并且易于使用和负担得起。 研究方法：一项为期三个月的随机对照设计研究将用于评估定制短信服务（SMS）（也称为短信）对减肥可持续性和复发的影响。将从杜克大学饮食和健身中心（DFC）招募60名体重减轻至少5%的肥胖（BMI>30）者（30名男性），他们进行为期四周的饮食和锻炼计划，其中人们平均减轻初始体重的5%。参与者将被随机分配到实验组或对照组。实验组（n=30）将收到短信，符合他们的监管重点方向（预防或促进重点）。对照组（n=30）将收到与其监管重点方向不匹配的SMS。这两个小组将在一个月内每天收到短信。信息内容将由DFC的研究人员、专家顾问和营养学家、运动生理学家和医生组成的团队构建。参与者将在基线和基线后3个月完成调查，评估BMI。四个焦点小组将进行抽样的参与者，以评估感知的有用性，态度和参与研究的经验。 公共卫生相关性：超过67%的美国成年人肥胖或超重。这种流行病代价高昂，并与许多慢性病有关。这包括2型糖尿病、癌症和心脏病。许多减肥的人体重又增加了。因此，需要采取干预措施来帮助维持体重减轻。通过持续减肥，可以防止体重增加的复发，并降低肥胖症的患病率。

DESCRIPTION (provided by applicant): Significance: Over 67% of American adults are obese or overweight. This health epidemic is costly and associated with multiple chronic illnesses including, type 2 diabetes, cancer, and cardiovascular diseases. Many people who lose weight gain it back; this is attributable to individuals' failure to self-regulate and maintain regular physical activity, follow a low-fat diet, and monitor body weight. While many intervention strategies succeed at initiation of weight-control behaviors, they often fail to facilitate behavior maintenance and prevent relapse of weight gain. Limited empirical evidence exists on how to sustain weight-loss and weight-control behaviors, and thus prevent relapse. The rate of weight gain is highest immediately after cessation of a structured weight-loss program. Needed are intervention strategies that can be used following a structured weight-loss program that promote sustainability of weight-loss, that prevent relapse, and that are easy and affordable to use. Methods: A three-month randomized controlled design study will be used to evaluate the effect of tailored short message service (SMS), also known as text messaging, on weight-loss sustainability and relapse. 60 obese (BMI>30) people (30 males), who have lost at least 5% of their body weight, will be recruited from the Duke University Diet and Fitness Center (DFC) following a four week diet and exercise program where people lose an average of 5% of initial weight. Participants will be randomized into an experimental or control group. The experimental group (n=30) will receive SMS that match their regulatory focus orientation (prevention or promotion focus). The control group (n=30) will receive SMS that do not match their regulatory focus orientation. Both groups will receive SMS daily for one month. Message content will be constructed by the researcher, an expert consultant, and a team of nutritionists, exercise physiologists, and physicians at the DFC. Participants will complete surveys at baseline and 3 months post-baseline assessing BMI. Four focus groups will be conducted from a sample of the participants to assess perceived usefulness, attitudes, and experiences of participating in the study. PUBLIC HEALTH RELEVANCE: Over 67% of American adults are obese or overweight. This health epidemic is costly and linked to many chronic illnesses. This includes type 2 diabetes, cancer, and heart disease. Many people who do lose weight gain the weight back. Thus, interventions are needed that help sustain weight loss. By sustaining weight loss, relapse of weight gain can be prevented and the prevalence of obesity reduced.