Weight Loss With Self-help Compared With a Structured Commercial Program

Heshka, Stanley; Anderson, James W.; Atkinson, Richard L.; Greenway, Frank L.; Hill, James O.; Phinney, Stephen D.; Kolotkin, Ronette L.; Miller-Kovach, Karen; Pi‐Sunyer, F. Xavier

doi:10.1001/jama.289.14.1792

Cited by 426 publications

(359 citation statements)

References 26 publications

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“…Participants in the structured weight loss arm received incentives in the form of vouchers for the cost of the commercial programme and had contact with the researchers every 1-2 weeks over the 2-year period. 15 In our study, there was no significant difference in weight loss between the two intervention groups over the 12 months. There was a trend however for the FBI group to maintain weight loss compared to the other two groups.…”

Section: Discussioncontrasting

confidence: 49%

“…That is, minimal inclusion and exclusion criteria were applied, incentives were not provided and dietetic staff provided the interventions within normal workplace requirements. This is in contrast to previous studies, which have provided participants with enticing incentives to maintain involvement 15 or applied stringent eligibility criteria, 16,28 which limit generalisability of the results.…”

Section: Discussionmentioning

confidence: 68%

“…14 Studies demonstrating success in weight loss are usually conducted in tightly controlled clinical trial settings. Most have invested large resources in the form of financial incentives for attending programmes, 15 for meal replacements 16 or for medications in drug trials. 17 When these methods are translated to real practice settings the results are often disappointing, calling experts to recommend more 'effectiveness' rather than 'efficacy'-based research.…”

Section: Introductionmentioning

confidence: 99%

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A randomised control trial comparing lifestyle groups, individual counselling and written information in the management of weight and health outcomes over 12 months

et al. 2006

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Objective: To investigate the effect of an 8-week group-based cognitive behaviour therapy lifestyle intervention with monthly follow-up to 6 months and further follow up at 12 months on change in weight and other weight-related variables, change in physical activity and change in health and well being compared to individualised dietetic treatment or giving an information booklet only (BO). Design: A randomised controlled trial of two intervention groups, a group-based cognitive behaviour therapy lifestyle intervention, Fat Booters Incorporated -(FBI) and individualised dietetic treatment (IDT) and control group receiving an information booklet only (BO). The intervention groups involved weekly contact for 8 weeks with monthly follow-up to 6 months and further follow-up at 12 months, conducted in real practice setting. Subjects: A total of 176 adults with body mass index (BMI)427 kg/m 2 , mean (7s.d.) age 48713 years, mean BMI 3475.5 kg/m 2 . Main outcome measures: Weight, percent body fat, waist circumference, physical activity, health status, self-efficacy and satisfaction with life were measured at baseline, 3, 6 and 12 months. Results: A statistically significant difference between groups was observed for weight change over time (P ¼ 0.05). The change in weight (mean7s.e.) for the FBI group was significantly greater than the BO group at 3 and 12 months (À2.870.7 compared to À1.070.6 kg, Po0.05 and À2.970.9 compared to þ 0.570.9 kg, Po0.005, respectively). Change in weight in the IDT group did not differ from the FBI group at any time point. For all groups, waist circumference was significantly less than baseline at all time points (Po0.001). Significant differences in self-efficacy were observed over time (P ¼ 0.02), with both intervention groups having greater self-efficacy than the BO group. Significant drop-outs occurred over time for all three groups. Conclusions: A cognitive behaviour-based lifestyle intervention was more effective than providing an information booklet alone and as effective as intensive individualised dietetic intervention in weight loss and improvements in self-efficacy. International Journal of Obesity (2006) IntroductionOverweight and obesity have grown to be one of the major public health problems of the 21st century, both in developed and developing countries. 1 Recent national data indicate that approximately 60% of the adult Australian population is overweight or obese. 2 Obesity per se has now been recognised as an independent chronic condition, which contributes over 4% to the burden of disease in Australia. 3 Combined with lack of physical activity, which contributes 7%, this is an overall contribution of 11%. The true cost of this burden of disease has been estimated at A$680-1239m from the impact of obesity and overweight alone. 4 Received 25 International Journal of Obesity (2006) 30, 1557-1564 & 2006 Nature Publishing Group All rights reserved 0307-0565/06 $30.00 www.nature. com/ijoIntervention studies for the management of overweight and obesity have shown disappointing ...

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Section: Discussioncontrasting

confidence: 49%

Section: Discussionmentioning

confidence: 68%

Section: Introductionmentioning

confidence: 99%

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A randomised control trial comparing lifestyle groups, individual counselling and written information in the management of weight and health outcomes over 12 months

et al. 2006

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“…These investigators concluded that adherence was a stronger predictor of weight loss success than diet group assignment, but the 12-month dropout rates of 35-50% among their four diet groups present a limitation. Heshka et al 17 reported a significant association between adherence to the Weight Watcher program and weight loss success but adherence was assessed by self-reported attendance. Finally, Knauper et al 15 examined the relationship between adhering to self-set dieting rules and weight loss and concluded that adherence was associated with weight loss success.…”

Section: Discussionmentioning

confidence: 99%

“…Even the few studies that have examined the associations between dietary adherence and weight loss were constrained by a number of limitations such as self-reported measure of adherence measure, small sample sizes, low retention rate and short study follow-up period. 10,[15][16][17] Therefore, to address some of the potential limitations of previous work, we performed the present analyses to determine the level of adherence from a 1-year randomized clinical trial comparing the effectiveness of four popular diets in overweight/obese women using carefully measured diet data and to examine the association between the dietary adherence and magnitude of weight loss.…”

Section: Introductionmentioning

confidence: 99%

Dietary adherence and weight loss success among overweight women: results from the A TO Z weight loss study

et al. 2008

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Background: Dietary adherence has been implicated as an important factor in the success of dieting strategies; however, studies assessing and investigating its association with weight loss success are scarce. Objective: We aimed to document the level of dietary adherence using measured diet data and to examine its association with weight loss success. Design: Secondary analysis was performed using data from 181 free-living overweight/obese women (mean ± s.d. age ¼ 43 ± 5 years, body mass index ¼ 31 ± 4 kg m À2 ) participating in a 1-year randomized clinical trial (the A TO Z study) comparing popular weight loss diets (Atkins, Zone and Ornish). Participants' dietary adherence was assessed as the difference between their respective assigned diet's recommended macronutrient goals and their self-reported intake. Association between dietary adherence and 12-month weight change was computed using Spearman's correlations. Differences in baseline characteristics and macronutrient intake between the most and least adherent tertiles for diet groups were compared using t-tests. Results: Within each diet group, adherence score was significantly correlated with 12-month weight change (Atkins, r s ¼ 0.42, P ¼ 0.0003; Zone, r s ¼ 0.34, P ¼ 0.009 and Ornish, r s ¼ 0.38, P ¼ 0.004). Twelve-month weight change in the most vs least adherent tertiles, respectively, was À8.3±5.6 vs À1.9±5.8 kg, P ¼ 0.0006 (Atkins); À3.7±6.3 vs À0.4±6.8 kg, P ¼ 0.12 (Zone) and À6.5 ± 6.8 vs À1.7 ± 7.9 kg, P ¼ 0.06 (Ornish). Conclusions: Regardless of assigned diet groups, 12-month weight change was greater in the most adherent compared to the least adherent tertiles. These results suggest that strategies to increase adherence may deserve more emphasis than the specific macronutrient composition of the weight loss diet itself in supporting successful weight loss.

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Impact of a Weight Management Program on Health-Related Quality of Life in Overweight Adults With Type 2 Diabetes

Williamson¹

2009

Arch Intern Med

213

135

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Context Inconsistent findings have been reported regarding improved health-related quality of life (HRQOL) following weight loss. Objective To test the efficacy of a weight management program for improving HRQOL in overweight/obese adults diagnosed with type 2 diabetes. Design Randomized multi-site clinical trial with two treatment arms and blinded measurements at baseline and end of Year 1. Setting Study was conducted at 16 outpatient research centers. Participants Total of 5,145 participants (mean age = 58.7±6.9 yr; mean BMI = 36.0±5.9; % women = 59.5%; % white = 63.3%) were randomized to two treatment arms. Intervention The two treatment arms were: Intensive Lifestyle Intervention 1 and Diabetes Support and Education (DSE). Main Outcome Measures SF-36, physical (PCS) and mental health (MCS) summary scores, and Beck Depression Inventory-II (BDI-II) scores. Baseline means were: PCS = 47.9±7.9; MCS = 54.0±8.1; and BDI-II = 5.7±5.0. Results HRQOL, as measured by PCS and BDI-II scores, improved (p<0.001) in the ILI arm compared to the DSE arm. The largest effect was observed for PCS (difference = −2.91, 99% CI: −3.44 ~ −2.37). HRQOL improved greatest in participants with the lowest baseline levels of quality of life. Changes in weight (ILI = −8.77±8.2 kg; DSE = −0.86±5.0 kg), improved fitness, and improved physical complaints mediated treatment effects associated with BDI-II and PCS. Conclusions HRQOL was significantly improved in overweight adults diagnosed with type 2 diabetes by enrollment in a weight management program that yielded significant weight loss, improved physical fitness, and reduced physical complaints. Trial Registration: NCT00017953

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Weight Loss With Self-help Compared With a Structured Commercial Program

Cited by 426 publications

References 26 publications

A randomised control trial comparing lifestyle groups, individual counselling and written information in the management of weight and health outcomes over 12 months

A randomised control trial comparing lifestyle groups, individual counselling and written information in the management of weight and health outcomes over 12 months

Dietary adherence and weight loss success among overweight women: results from the A TO Z weight loss study

Impact of a Weight Management Program on Health-Related Quality of Life in Overweight Adults With Type 2 Diabetes

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