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Logo of nihpaAbout Author manuscriptsSubmit a manuscriptNIH Public Access; Author Manuscript; Accepted for publication in peer reviewed journal;
Am J Prev Med. Author manuscript; available in PMC 2009 August 1.
Published in final edited form as:
PMCID: PMC2515566
NIHMSID: NIHMS59421
Weight Loss During the Intensive Intervention Phase of the Weight-Loss Maintenance Trial
Jack F. Hollis, PhD, Christina M. Gullion, PhD, Victor J. Stevens, PhD, DR Phillip J. Brantley, DR Lawrence J. Appel, DR Jamy D. Ard, Catherine M. Champagne, PhD, RD, Arlene Dalcin, Thomas P. Erlinger, MD, MPH, Kristine Funk, MS, RD, MR Daniel Laferriere, Pao-Hwa Lin, PhD, Catherine M. Loria, PhD, Carmen Samuel-Hodge, PhD, RD, William M. Vollmer, PhD, Laura P. Svetkey, MD, and for the Weight Loss Maintenance Trial Research Group
From the Center for Health Research, Kaiser Permanente Northwest (Hollis, Gullion, Stevens, Funk, Laferriere, Vollmer), Portland, Oregon; Pennington Biomedical Research Center (Brantley, Champagne), Baton Rouge, Louisiana; Division of Clinical Nutrition and Dietetics, University of Alabama at Birmingham (Ard), Birmingham, Alabama; University of Texas Medical Branch (Erlinger), Austin, Texas; Johns Hopkins Medical Institutions (Appel, Dalcin), Baltimore, Maryland; Sarah W. Stedman Nutrition and Metabolism Center, Duke University Medical Center, (Lin, Svetkey), Durham, North Carolina; the Department of Nutrition, School of Public Health and School of Medicine University of North Carolina at Chapel Hill (Samuel-Hodge), Chapel Hill, North Carolina; and the National Heart, Lung, and Blood Institute (Loria), Bethesda, Maryland
Address correspondence and reprint requests to: Jack Hollis, PhD, Center for Health Research, Kaiser Permanente Northwest, 3800 N. Interstate Avenue, Portland OR 97227. E-mail: jack.hollis/at/kpchr.org
Abstract
Background
To improve methods for long-term weight management, the Weight Loss Maintenance (WLM) trial, a four-center randomized trial, was conducted to compare alternative strategies for maintaining weight loss over a 30-month period. This paper describes methods and results for the initial 6-month weight-loss program (Phase I).
Methods
Eligible adults were aged ≥25, overweight or obese (BMI=25–45 kg/m2), and on medications for hypertension and/or dyslipidemia. Anthropomorphic, demographic, and psychosocial measures were collected at baseline and 6 months. Participants (n=1685) attended 20 weekly group sessions to encourage calorie restriction, moderate-intensity physical activity, and the DASH (dietary approaches to stop hypertension) dietary pattern. Weight-loss predictors with missing data were replaced by multiple imputation.
Results
Participants were 44% African American and 67% women; 79% were obese (BMI≥30), 87% were taking anti-hypertensive medications, and 38% were taking antidyslipidemia medications. Participants attended an average of 72% of 20 group sessions. They self-reported 117 minutes of moderate-intensity physical activity per week, kept 3.7 daily food records per week, and consumed 2.9 servings of fruits and vegetables per day. The Phase-I follow-up rate was 92%. Mean (SD) weight change was −5.8 kg (4.4), and 69% lost at least 4 kg. All race–gender subgroups lost substantial weight: African-American men (−5.4 kg ± 7.7); African-American women (−4.1 kg ± 2.9); non–African-American men (−8.5 kg ± 12.9); and non–African-American women (−5.8 kg ± 6.1). Behavioral measures (e.g., diet records and physical activity) accounted for most of the weight-loss variation, although the association between behavioral measures and weight loss differed by race and gender groups.
Conclusions
The WLM behavioral intervention successfully achieved clinically significant short-term weight loss in a diverse population of high-risk patients.