Long-Term Weight Maintenance after a 17-Week Weight Loss Intervention with or without a One-Year Maintenance Program: A Randomized Controlled Trial

Abstract

Background. Weight lost by obese patients is almost always regained over time. Extended treatment may improve maintenance, but solid evidence is lacking. Purpose. We determined effectiveness of maintenance therapy after a weight loss program. Methods. Together 201 patients (mean age 47 years and BMI 42 kg/m2, 71% women) were randomly assigned to either a 17-week weight loss program followed by a one-year maintenance program or to a weight loss program without subsequent maintenance intervention. The weight loss program included behavior modification and a very-low-calorie diet, and maintenance program behavior modification. The primary outcome measure was percentage of patients with 5% or more weight loss at the end of maintenance (week 69) and one year later (week 121). Secondary outcomes were weight related changes in lifestyle and quality of life. Results. At week 69, 52% of the patients with and 44% of those without maintenance program had lost weight ≥5%, P = 0.40, and, at week 121, 33% and 34%, P = 0.77, respectively. At week 121 secondary outcomes did not differ between the groups among those successfully followed up. Conclusions. This one-year maintenance program was not effective in preventing weight regain in severely obese patients. Trial Registration. This trial is registered under clinicaltrials.gov Identifier: NCT00590655.

Lifestyle intervention using the psychoeducational approach is associated with greater cardiometabolic benefits and retention of individuals with worse health status

“…Healthier behavior and a better clinical profile were harder to be maintained by participants of the traditional group. Difficulties sustaining weight loss among obese individuals have been frequently reported, particularly in some specific populations such as low-income groups (32,33).…”

Maintenance of Weight Loss After Initiation of Nutrition Training

“…Some trials evaluating maintenance skills did not have a specific weight loss requirement, so maintenance-specific skills could not be fully tested (9–13). One notable exception is the WLM (Weight Loss Maintenance) trial, in which participants who lost at least 4 kg were randomly assigned to an Internet, a personal contact, or a self-directed maintenance intervention (14).…”

Weight Regain Following Intentional Weight Loss in Older Adults

“…In a study of over 200 middle-aged severely obese adults who underwent a 17-week weight loss program using behavior modification and a very low calorie diet, a 1-year maintenance program which included behavioral sessions surrounding themes (such as eating at regular times, control of eating impulses, fat and energy density in food, lifestyle activity and related energy expenditure, monitoring exercise and obstacles to increase exercise, cooking/shopping, etc. ), did not prevent or delay weight regain compared to usual care [14]. Adults between 30 and 70 years of age underwent a 12-week weight loss program and were given the option to choose to continue with the same dietary intervention, either all meal provision or self-directed diet or change to the other diet for the next 12 weeks [15].…”