The problem of overweight and obesity has reached epidemic proportions in the U.S. and globally, and the high prevalence is due in part to the recidivism associated with weight-loss treatment. Approximately one third of lost weight is often regained in the first year after treatment and, at times, continues. Because a plethora of co-morbid diseases are associated with obesity, in particular, cardiovascular disease, hypertension and hyperlipidemia, clinicians and researchers have attempted to find useful strategies for maintaining weight loss. This review presents the findings from 42 randomized clinical trials of weight-loss maintenance from 1984 through 2007 utilizing interventions that include 1) the Internet, 2) strategies after a very-low-calorie diet, 3) pharmacotherapy, 4) behavioral strategies, 5) physical activity, and 6) alternative strategies. The results of the reviewed trials revealed that treatment with orlistat or sibutramine combined with dietary modification, caffeine or protein supplementation, consuming a diet lower in fat, adherence to physical activity routines, prolonged contact with participants, problem-solving therapy and the alternative treatment acupressure were efficacious in reducing weight regain after weight-loss treatment. The limitations of some studies may reduce the robustness of their findings, and future studies are necessary to replicate and support these results so that individuals are able to maintain weight loss and retain the health benefits associated with a lower weight. Keywords NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptOverweight and obesity are worldwide, chronic health problems that are associated with heart disease and stroke, 1 and 66.3% of the U.S. population falls into one of these two weight categories. 2 Overweight and obesity are measured by body mass index (BMI), i.e., weight in kilograms divided by height in meters squared. Overweight is defined as a BMI between 25.0 kg/m 2 and 29.9 kg/m 2 and obesity as a BMI > 30 kg/m 2 . Obesity is categorized further by obesity I (BMI between 30.0 kg/m 2 and 34.9 kg/m 2 ), obesity II (35.0 kg/m 2 to 39.9 kg/m 2 ), and a BMI greater than 40.0 kg/m 2 is obesity III or extreme obesity. 3 With increasing levels of BMI, the associated level of risk for cardiovascular disease (CVD) and development of type 2 diabetes increases; a BMI ≥ 30 kg/m 2 is an independent risk factor for CVD. 4 Moreover, central adiposity, mainly visceral fat, is a strong risk factor for hypertension, dyslipidemia, and insulin resistance. 5The usual course of weight-loss therapy shows that weight is lost quickly at first, and the point of greatest loss occurs 6 months after beginning treatment; then weight is slowly regained until weight returns near the original level. 6 Often, 30-35% of the weight a person loses is regained during the first year after treatment, 7 and weight gain frequently persists with an average loss of about 1.8 kg remaining at four years after treatment. 8 Approximately 20% of individuals ...

Introduction Weight loss has been associated with higher physical activity (PA) levels and frequent dietary self-monitoring. Less is known about how PA self-monitoring affects adherence to PA goals, PA levels and weight change. Methods The SMART Trial is a clinical weight loss trial in which 210 overweight adults were randomized equally to one of three arms: 1) paper record (PR); 2) personal digital assistant with self-monitoring software (PDA); and 3) PDA with daily tailored feedback message (PDA+FB). PA self-monitoring and adherence to PA goals were based on entries in weekly submitted diaries. PA levels were measured via self-report by the past 6 month Modifiable Activity Questionnaire at baseline and 6 months. Results Data are presented on 189 participants with complete 6-month PA data [84% female, 77% White, mean age: 47.3 ± 8.8 years, mean BMI: 34.1 ± 4.5 kg/m2]. Median PA level was 7.96 MET-hr-wk−1 at baseline and 13.4 MET-hr-wk−1 at 6 months, with significant PA increases in all three arms. PDA+FB arm had a higher mean number of weekly self-monitoring entries than the PR arm (3.4 vs. 2.4; p=0.003) and were more likely to maintain high (i.e., 100%) adherence to PA goals over time than the PDA (p=0.02) or PR arms (p=0.0003). Both PA self-monitoring and adherence to PA goals were related to higher PA levels at 6 months. A higher mean rate of PA self-monitoring was associated with a greater percentage of weight decrease (rho=−0.49; p<0.0001) at 6 months. Conclusions PA self-monitoring and adherence to PA goals were more likely in participants in the PDA+FB arm and in turn predicted higher PA levels and weight loss.

Yoga, a form of physical activity, is rapidly gaining in popularity and has many health benefits. Yet healthcare providers have been slow to recognize yoga for its ability to improve health conditions, and few interventions have been developed that take full advantage of its benefits. The purpose of this article is to review published studies using yoga programs and to determine the effect of yoga interventions on common risk factors of chronic diseases (overweight, hypertension, high glucose level and high cholesterol). A systematic search yielded 32 articles published between 1980 and April 2007. The studies found that yoga interventions are generally effective in reducing body weight, blood pressure, glucose level and high cholesterol, but only a few studies examined long-term adherence. Additionally, not enough studies included diverse populations at high risk for diabetes and its related common health problems.

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