A comparison of maintenance-tailored therapy (MTT) and standard behavior therapy (SBT) for the treatment of obesity

Jeffery, Robert W.; Levy, Rona L.; Langer, Shelby L.; Welsh, Ericka M.; Flood, Andrew; Jaeb, Melanie A.; Laqua, Patricia S.; Hotop, Annie M.; Finch, Emily

doi:10.1016/j.ypmed.2009.08.004

Cited by 37 publications

(70 citation statements)

References 30 publications

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“…For 7 of these studies, the percentage of weight loss could not be calculated, but a significant absolute weight loss-weight maintenance was reported Itoh et al 2001;Jeffery et al 2009;Kuller et al 2006Kuller et al , 2007Kuller et al , 2012Leermakers et al 1999;Tanumihardjo et al 2009;Wolfson et al 2010;Yankura et al 2008;Yatsuya et al 2011) and thus, these studies were retained. The majority of retained studies (n = 20) reported that participant weight was measured by study staff.…”

Section: Weight-loss and Weight-maintenance Combined Studies (N = 24)mentioning

confidence: 99%

“…The lengths of the interventions were found to be variable among studies: 15 weeks ), 18 weeks (McLaughlin et al 2008, 21 weeks (Christiansen et al 2007), 3 months Ditschuneit and Flechtner-Mors 2001;Ditschuneit et al 1999Ditschuneit et al , 2002Flechtner-Mors et al 2000;Foreyt et al 1993;Itoh et al 2001;Morgan et al 2009Morgan et al , 2011Tanumihardjo et al 2009), 4 months Layman et al 2009;Thorpe et al 2008), 6 months (Gold et al 2007;Jeffery et al 2009;Krukowski et al 2008;Kuller et al 2006Kuller et al , 2007Kuller et al , 2012Leermakers et al 1999;Matvienko and Hoehns 2009;Rock et al 2007;Rolls et al 2005;West et al 2011;Wing et al 2010;Wolfson et al 2010;Yankura et al 2008;Yatsuya et al 2011), and 12 months Burke et al 2008;Teixeira et al 2010). These time periods were considered to reflect the weight-loss phase, because the intervention either ended or was reduced considerably.…”

Section: Weight-loss and Weight-maintenance Combined Studies (N = 24)mentioning

confidence: 99%

“…Studies rated as moderate quality Foreyt et al 1993;Jeffery et al 2009;Krukowski et al 2008;Kuller et al 2006Kuller et al , 2007Layman et al 2009;Matsuo et al 2010;Rolls et al 2005;Teixeira et al 2010;West et al 2011;Wing et al 2010;Wolfson et al 2010;Yankura et al 2008;Yatsuya et al 2011) all used some form of calorie restriction, except for 1 Internet-based program that focused on self-monitoring, individual feedback, and social support .…”

Section: Energy and Macronutrientsmentioning

confidence: 99%

“…The fibre recommendations among successful studies were varied and included 17 g·day −1 , 20 g·day −1 , 17 g·1000 kcal −1 ), and 5-10 g of soluble fibre·day −1 Yankura et al 2008), as well as a general recommendation that fibre be increased . Other successful adjunct strategies included education programs Morgan et al 2009Morgan et al , 2011, increased meal frequency (3 meals and 2 snacks) (Christiansen et al 2007;Cussler et al 2008;Ditschuneit and Flechtner-Mors 2001;Ditschuneit et al 1999Ditschuneit et al , 2002Flechtner-Mors et al 2000), portion control , liquid meal-replacement products Ditschuneit and Flechtner-Mors 2001;Ditschuneit et al 1999Ditschuneit et al , 2002Flechtner-Mors et al 2000;Jeffery et al 2009;West et al 2011;Wing et al 2010;Yatsuya et al 2011), prepackaged foods and (or) food provision (Rock et al 2007;Tanumihardjo et al 2009), food groups and (or) food exchange systems Matsuo et al 2010;Rolls et al 2005;Yatsuya et al 2011), increased dairy foods West et al 2011;Wing et al 2010 increased water , increased fruits and vegetables Wolfson et al 2010;Yankura et al 2008), and increased functional foods (soy, stanols, omega 3 fatty acids) Yankura et al 2008).…”

Section: Other Diet Strategiesmentioning

confidence: 99%

See 3 more Smart Citations

Healthy strategies for successful weight loss and weight maintenance: a systematic review

Ramage

Farmer

Eccles

et al. 2014

Appl. Physiol. Nutr. Metab.

157

132

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The rates of overweight and obesity are rising in Canada and worldwide, and there is a need for effective methods for weight loss and weight maintenance to empower individuals to make changes. The purpose of this systematic review was to examine the evidence available for successful diet strategies for weight loss and weight maintenance among adults. A search was conducted of the following databases: CAB Abstracts, Central Register of Controlled Trials, EMBASE, MEDLINE, Food Science and Technology Abstracts, and Web of Knowledge. The studies investigated had participants who were overweight or obese and between 18 and 65 years of age. A successful study was defined as one that reported an intervention that created ≥5% weight loss from baseline and a maintenance phase during which the ≥5% weight loss was maintained from baseline to 12 months. After exclusions, the search resulted in 67 papers. Overall, for significant safe weight loss, an energy deficit was required, which was commonly achieved by reduced fat intake. Increased dietary fibre was also a component of 21% of successful interventions. Physical activity was included in 88% of successful interventions, and behaviour training such as self-monitoring was part of 92% of successful interventions. The same combination of energy and fat restriction, regular physical activity, and behavioural strategies was also required for successful weight maintenance. This review confirmed previous knowledge about weight loss and weight maintenance in adults. A comprehensive approach, including reduced dietary intake, regular physical activity, and behavioural strategies, is warranted and is supported by the research evidence.

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Section: Weight-loss and Weight-maintenance Combined Studies (N = 24)mentioning

confidence: 99%

Section: Weight-loss and Weight-maintenance Combined Studies (N = 24)mentioning

confidence: 99%

Section: Energy and Macronutrientsmentioning

confidence: 99%

Section: Other Diet Strategiesmentioning

confidence: 99%

See 2 more Smart Citations

Healthy strategies for successful weight loss and weight maintenance: a systematic review

Ramage

Farmer

Eccles

et al. 2014

Appl. Physiol. Nutr. Metab.

157

132

View full text Add to dashboard Cite

show abstract

“…Individual; Groups and Families) typically taught in MSW programs. The current preferred treatment for obesity is behavior therapy (Jeffery et al, 2009) that includes frequent monitoring of diet and exercise and outlines specific weight loss goals. In utilizing obesity-focused case situations social worker students can learn the behavioral strategies of weight loss programs (including long term follow up and support) while applying the basic techniques of behavioral therapy.…”

Section: Practice Sequencementioning

confidence: 99%

Obesity Related Stigma as a Form of Oppression: Implications for Social Work Education

Lawrence

Hazlett

Abel

2012

Social Work Education

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Obesity is a growing health problem in the US. In addition to the health problems associated with being grossly overweight, obese individuals also must confront stigma and social exclusion. Weight bias and negative attitudes towards the obese have been widely confirmed in numerous professions. The purpose of this article is two-fold: (1) to discuss the implications of weight-related stigma on obese clients; and (2) to offer pedagogical approaches for reducing discriminatory attitudes against overweight individuals, among MSW students, so that they may provide more effective clinical services to clients struggling with obesity.

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Pragmatic Implementation of Online Obesity Treatment and Maintenance Interventions in Primary Care

Thomas,

Panza,

Goldstein

et al. 2024

JAMA Intern Med

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ImportanceBehavioral weight loss interventions have achieved success in primary care; however, to our knowledge, pragmatic implementation of a fully automated treatment that requires little researcher oversight has not been tested. Moreover, weight loss maintenance remains a challenge.ObjectiveTo evaluate the long-term effectiveness of an automated, online, behavioral obesity treatment program (Rx Weight Loss [RxWL]) at 12 months (primary end point) and 24 months when delivered pragmatically in primary care and to compare the effectiveness of 3 weight loss maintenance approaches.Design, Setting, and ParticipantsThis randomized clinical trial of RxWL, an online weight loss program, recruited patients from a Rhode Island primary care network with approximately 60 practices and 100 physicians. Eligible participants were primary care patients aged 18 to 75 years with overweight or obesity who were referred by their nurse care manager and enrolled between 2018 and 2020. All participants were included in the intention-to-treat analysis, whereas only those who engaged with maintenance intervention were included in the per-protocol analysis. Data were analyzed from August 2022 to September 2023.InterventionsAll participants were offered the same 3-month weight loss program, with randomization to one of three 9-month maintenance programs: control intervention (monthly online newsletters), monthly intervention (9 monthly video lessons and 1 week of self-monitoring per month), or refresher intervention (an introductory session and two 4-week periods of lessons and self-monitoring at 7 and 10 months).Main Outcomes and MeasuresThe primary outcome was weight change at 12 months using height and weight data collected from electronic medical records through 24 months.ResultsAmong the 540 participants (mean [SD] age, 52.8 [13.4] years; 384 females [71.1%]) in the intention-to-treat analysis, mean estimated 3-month weight loss was 3.60 (95% CI, −4.32 to −2.88) kg. At the 12-month primary end point, the amount of weight regained in the monthly (0.37 [95% CI, −0.06 to 0.81] kg) and refresher (0.45 [95% CI, 0.27 to 0.87] kg) maintenance groups was significantly less than that in the newsletter control maintenance group (1.28 [95% CI, 0.85 to 1.71] kg; P = .004). The difference in weight regain between the monthly and refresher maintenance groups was not statistically significant. This pattern persisted at 24 months. In the per-protocol analysis of 253 participants, mean weight loss at the end of the initial 3-month intervention was 6.19 (95% CI, −7.25 to −5.13) kg. Similarly, at 12 months there was less weight regain in the monthly (0.61 kg) and refresher (0.96 kg) maintenance groups than in the newsletter control maintenance group (1.86 kg).Conclusions and RelevanceResults of this randomized clinical trial indicate that pragmatic implementation of a 12-month automated, online, behavioral obesity treatment that includes 9 months of active maintenance produces clinically significant weight loss over 2 years in primary care patients with overweight or obesity. These findings underscore the importance of providing ongoing maintenance intervention to prevent weight regain.Trial RegistrationClinicalTrials.gov Identifier: NCT03488212

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A comparison of maintenance-tailored therapy (MTT) and standard behavior therapy (SBT) for the treatment of obesity

Cited by 37 publications

References 30 publications

Healthy strategies for successful weight loss and weight maintenance: a systematic review

Healthy strategies for successful weight loss and weight maintenance: a systematic review

Obesity Related Stigma as a Form of Oppression: Implications for Social Work Education

Pragmatic Implementation of Online Obesity Treatment and Maintenance Interventions in Primary Care

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