Small changes approach promotes initial and continued weight loss with a phone-based follow-up: nine-month outcomes from ASPIRES II

Abstract

Purpose: To examine the impact of a small-changes weight loss program across a 3-month intervention followed by a 6-month follow-up program.

Design: A one-group pre-post intervention study.

Setting: Medium-sized Southwestern university.

Participants: Twenty-five obese adult women (mean body mass index [BMI] = 31.8 kg/m(2), standard deviation [SD] = 4.9).

Intervention: Participants were asked to choose and adopt small changes in their diet and physical activity relative to baseline during weekly group-based meetings over 3 months. Participants then received bi-weekly phone calls across a 6-month follow-up period.

Measures: Weight change was the primary outcome. Secondary outcomes included waist circumference, daily step count, and caloric intake.

Analyses: Intention-to-treat analysis of change from baseline and completers-only analysis (n = 22) for secondary outcomes.

Results: Participants achieved clinically significant weight loss (mean [M] = -3.2 kg, standard error [SE] = .47 kg, p < .001) across the initial small changes treatment program. Moreover, participants continued to lose weight across the 6-month phone-based follow-up program (M = -2.1 kg, SE = .83 kg, p < .017), totaling >5% weight loss across the 9-month program (M = 5.3 kg, SE = 1.1 kg, p < .001).

Conclusion: Using a small changes approach, participants achieved weight loss in an initial group-based program, which continued with minimal phone-based follow-up. Larger randomized studies comparing a small changes approach to traditional obesity treatment are warranted.