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Randomized Controlled Trial
. 2013 Dec;46(3):369-81.
doi: 10.1007/s12160-013-9517-3.

Behavioral mediators of treatment effects in the weight loss maintenance trial

J W Coughlin  1 , C M Gullion, P J Brantley, V J Stevens, A Bauck, C M Champagne, A T Dalcin, K L Funk, J F Hollis, G J Jerome, L F Lien, C M Loria, V H Myers, L J Appel
Affiliations
Randomized Controlled Trial

Behavioral mediators of treatment effects in the weight loss maintenance trial

J W Coughlin et al. Ann Behav Med. 2013 Dec.

Abstract

Background: The Weight Loss Maintenance Trial tested strategies for maintenance of weight loss. Personal contact was superior to interactive technology and self-directed conditions.

Purpose: We aimed to identify behavioral mediators of the superior effect of personal contact vs. interactive technology and of personal contact vs. self-directed arms.

Methods: Overweight/obese adults at risk for cardiovascular disease (n = 1,032) who lost at least 4 kg were randomized to personal contact, interactive technology, or self-directed. After 30 months, 880 participants had data on weight and behavioral strategies.

Results: Reported increase of intake of fruits and vegetables and physical activity and more frequent self-weighing met criteria as mediators of the better outcome of personal contact vs. interactive technology. Increased intake of fruits and vegetables, more frequent self-weighing, and decreased dessert consumption were mediators of the difference between personal contact vs. self-directed.

Conclusion: Inducing changes in the identified behaviors might yield better outcomes in future weight loss maintenance trials.

Trial registration: ClinicalTrials.gov NCT00054925.

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Conflict of interest statement

Conflict of interest statements: Four of the study authors (JWC, LJA, GJJ, and ATD) have a financial relationship with Healthways, Inc., a company with whom we partnered for the POWER Trial (Appel et al., 2011), which occurred after the Weight Loss Maintenance Trial was complete. This relationship presents no conflicts of interest with the organization that sponsored the research (NIH). Appel L.J., Clark J.M., Yeh H.C., Wang N.Y., Coughlin J.W., Daumit G., Miller E.R., Dalcin A., Jerome G.J., Geller S., Noronha G., Pozefsky T., Charleston J., Reynolds J.B., Durkin N., Rubin R.R., Louis T.A., and Brancati F.L. (2011). Comparative effectiveness of weight-loss interventions in clinical practice. N Engl J Med. 365 [20]. doi: 10.1056/NEJMoa1108660, PMID:22085317.

Figures

Fig. 1
Fig. 1
Decision flow chart for classifying the role of postintervention measures in an experimental study
Fig. 2
Fig. 2
Relationship between frequency of weighing and weight change over 30 months in the personal contact vs. interactive technology comparison
Fig. 3
Fig. 3
Treatment moderates the relationship between cutting back portions and weight outcomes in the personal contact vs. self-directed comparison
See this image and copyright information in PMC

References

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    1. Brantley PJ, Appel LJ, Hollis JF, et al. Design considerations and rationale of a multi-center trial to sustain weight loss: The weight loss maintenance trial. Clinical Trials. 2008;5:546–556. - PMC - PubMed
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