A comparison of a behavioral weight loss program to a stress management program: A pilot randomized controlled trial

Abstract

Background Effective non-surgical long-term weight loss solutions remain elusive. Objective To compare a behavioral weight loss program (BWL) with a stress management-based program (Emotional Brain Training, EBT) on weight loss, blood pressure, depression, perceived stress, diet and physical activity. Participants/setting Individuals with a body mass index (BMI) of ≥ 28 and ≤ 45 kg/m2 were recruited in Lexington, Kentucky in January 2014 and randomized to a behavioral weight loss program (BWL) or a stress management program (EBT) for a 20 week intervention. Of those recruited, 49 participants were randomized to EBT or BWL. Randomization and allocation to group were performed using SAS software (v 9.3, 2011, SAS Institute Inc.). Weight, blood pressure, depression, perceived stress, dietary intake and physical activity were measured at baseline, 10, and 20 weeks. Main outcome measures Weight and Body Mass Index (BMI) Statistical analyses Linear models for change over time were fit to calculate 95% confidence intervals of intervention effects. Results BWL produced greater changes in BMI than EBT at both 10(p=0.02) and 20 weeks (p=0.03). At 10 weeks, both EBT and BWL improved BMI, systolic blood pressure, depression and perceived stress (p<0.05). BWL also improved diastolic blood pressure (p=0.005). At 20 weeks, EBT maintained improvements in BMI, systolic blood pressure, depression, and perceived stress while BWL maintained improvements only in BMI and depression (p<0.05). Conclusions BWL produced greater weight loss than EBT; however, EBT produced sustained improvements in stress, depression, and systolic blood pressure. A combination of the two approaches should be explored.

Impact of adult weight management interventions on mental health: a systematic review and meta-analysis protocol

“…Research reports a bidirectional association between obesity and mental health, with those with overweight and obese more likely to have poor mental health and those with mental ill health at greater risk of weight gain, and consequently, obesity 6–10. Many researchers have reported improvements in mental health outcomes with weight loss,11–15 however, there has been concern expressed that weight management interventions advocating dietary restriction may contribute to disordered eating and worsen mental health 16 17. It is essential to better understand the impact of weight management interventions on mental health to optimise care and minimise risk of harm.…”

Short‐ and Long‐Term Changes in Health‐Related Quality of Life with Weight Loss: Results from a Randomized Controlled Trial

“…On the whole, weight loss is associated with improvements in physical HRQOL but little to no improvement in mental HRQOL, as assessed by the SF‐36 . Relatedly, studies have found small to minimal improvements in depressive symptoms and perceived stress following lifestyle intervention .…”

Programa nutricional, conductual y de actividad física para el abordaje de la obesidad tipo 1 y 2

“…Los resultados iniciales de ésta investigación muestran un incremento en el número de pasos y el gasto kilocalórico en todos los participantes, lo que sugiere un camino alentador en el desarrollo del ejercicio físico como hábito saludable, tal como lo encontrado por otros investigadores que han trabajado estrategias conductuales ( Donaldson & Normand, 2009;Valbuena, 2013;Webber, Casey, Mayes, Katsumata & Mellin, 2016 ).…”

“…En futuras investigaciones podría ser importante involucrar las mismas estrategias de autocontrol, tal como lo hicieron Webber, Casey, Mayes, Katsumata y Mellin (2016), quienes compararon dos tipos de programas para perder peso en personas con obesidad; uno conductual y otro enfocado en el manejo del estrés; en ambos programas las personas debían realizar 60 minutos de actividad física y una dieta saludable. Sin embargo, el grupo con el programa conductual tenían un entrenamiento en autocontrol para aumentar la actividad física y la reducción de 500 a 1000 kcal de su dieta; este último grupo produjo unas perdidas mayores de peso al final de la intervención.…”