Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2020 May 11;20(1):652.
doi: 10.1186/s12889-020-08796-1.

The transtheoretical model is an effective weight management intervention: a randomized controlled trial

Patrícia Pinheiro de Freitas  1 , Mariana Carvalho de Menezes  1 , Luana Caroline Dos Santos  1   2 , Adriano Marçal Pimenta  1   3 , Adaliene Versiani Matos Ferreira  1   2 , Aline Cristine Souza Lopes  4   5
Affiliations
Randomized Controlled Trial

The transtheoretical model is an effective weight management intervention: a randomized controlled trial

Patrícia Pinheiro de Freitas et al. BMC Public Health. .

Abstract

Background: Given the current worldwide epidemic of obesity, there is a demand for interventions with higher impact, such as those carried out in the primary health care (PHC) setting. Here we evaluate the effect of intervention performed according to the stages of change of the transtheoretical model (TTM) for weight management.

Methods: This randomized controlled trial in Brazilian PHC offered free physical exercise and nutrition education. The participants were women, aged 20 years or older who were obese or overweight, users in PHC service. The intervention group (IG, n = 51) received the same orientation as the comparison group (CG, n = 35) plus individual health counseling based on the TTM aimed at weight loss, which lasted 6 months. The outcome measures were anthropometric, food, and nutrient profiles. Inflammatory parameters were evaluated in a random subsample. The inter-group and intra-group differences were evaluated using interntion-to-treat analysis, and analysis of covariance (ANCOVA) used to assess intervention effectiveness.

Results: There was a difference between groups of - 1.4 kg (CI95%: - 2.5; - 0.3) in body weight after the intervention. About 97% of women in the IG reported benefits of the intervention and presented positive changes in diet, biochemical markers, and anthropometry. The IG showed better body mass index, resistine, and blood glucose results compared to the CG during follow-up.

Conclusion: The individualized TTM-based intervention, combined with usual care, was an effective strategy in PHC. These results should encourage the use of interdisciplinary practices; nevertheless, research to identify additional strategies is needed to address barriers to weight maintenance among obese low-income women.

Trial registration: The trial is registered with Brazilian clinical trials under the code: RBR-8t7ssv, Registration date: 12/12/2017 (retrospectively registered).

Keywords: Feeding behavior; Intervention studies; Obesity; Primary health care; Theoretical models.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Participant flow
See this image and copyright information in PMC

References

    1. World Health Organization (WHO). Obesity and overweight. http://www.who.int/mediacentre/factsheets/fs311/en/. Accessed 28 Oct 2017.
    1. Stenholm S, Head J, Aalto V, Kivimäki M, Kawachi I, Zins M, et al. Body mass index as a predictor of healthy and disease-free life expectancy between ages 50 and 75: a multicohort study. Int J Obes. 2017;41(5):769–775. doi: 10.1038/ijo.2017.29. - DOI - PMC - PubMed
    1. Dansinger ML, Gleason JA, Griffith JL, Selker HP, Schaefer EJ. Comparison of the Atkins, Ornish, weight watchers, and zone diets for weight loss and heart disease risk reduction: a randomized trial. JAMA. 2005;293:43–53. doi: 10.1001/jama.293.1.43. - DOI - PubMed
    1. Raynor HA, Champagne CM. Position of the academy of nutrition and dietetics: interventions for the treatment of overweight and obesity in adults. J Acad Nutr Diet. 2016;116:129–147. doi: 10.1016/j.jand.2015.10.031. - DOI - PubMed
    1. Sutton K, Logue E, Jarjoura D, Baughman K, Smucker W, Capers C. Assessing dietary and exercise stage of change to optimize weight loss interventions. Obes Res. 2003;11:641–652. doi: 10.1038/oby.2003.92. - DOI - PubMed

Publication types

MeSH terms