title: The effect of training in reduced energy density eating and food self-monitoring accuracy on weight loss maintenance.
abstract: BACKGROUND
  Failure to maintain weight losses in lifestyle change programs continues to be a major problem and warrants investigation of innovative approaches to weight control.
  
  
  OBJECTIVE
  The goal of this study was to compare two novel group interventions, both aimed at improving weight loss maintenance, with a control group.
  
  
  METHODS
  A total of 103 women lost weight on a meal replacement-supplemented diet and were then randomized to one of three conditions for the 14-week maintenance phase: cognitive-behavioral treatment (CBT); CBT with an enhanced food monitoring accuracy (EFMA) program; or these two interventions plus a reduced energy density eating (REDE) program. Assessments were conducted periodically through an 18-month postintervention. Outcome measures included weight and self-reported dietary intake. Data were analyzed using completers only as well as baseline-carried-forward imputation.
  
  
  RESULTS
  Participants lost an average of 7.6 +/- 2.6 kg during the weight loss phase and 1.8 +/- 2.3 kg during the maintenance phase. Results do not suggest that the EFMA intervention was successful in improving food monitoring accuracy. The REDE group decreased the energy density (ED) of their diets more so than the other two groups. However, neither the REDE nor the EFMA condition showed any advantage in weight loss maintenance. All groups regained weight between 6- and 18-month follow-ups.
  
  
  CONCLUSIONS
  Although no incremental weight maintenance benefit was observed in the EFMA or EFMA + REDE groups, the improvement in the ED of the REDE group's diet, if shown to be sustainable in future studies, could have weight maintenance benefits.
authors.affiliation: Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA. lowe@drexel.edu
authors.forename: Michael R
authors.initials: MR
authors.lastname: Lowe
authors.forename: Karyn A
authors.initials: KA
authors.lastname: Tappe
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Annunziato
authors.forename: Lynnette J
authors.initials: LJ
authors.lastname: Riddell
authors.forename: Maria C
authors.initials: MC
authors.lastname: Coletta
authors.forename: Canice E
authors.initials: CE
authors.lastname: Crerand
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Didie
authors.forename: Christopher N
authors.initials: CN
authors.lastname: Ochner
authors.forename: Shortie
authors.initials: S
authors.lastname: McKinney
mesh_terms: D000328:Adult; D001521:Behavior Therapy / Q000379:methods*; D001835:Body Weight; D002784:Cholesterol / Q000097:blood; D015930:Diet Records; D004038:Diet, Reducing / Q000379:methods*; D004435:Eating / Q000502:physiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D015999:Multivariate Analysis; D014280:Triglycerides / Q000097:blood; D015431:Weight Loss / Q000502:physiology*
chemical_list: D014280:Triglycerides; D002784:Cholesterol