Weight loss during the intensive intervention phase of the weight-loss maintenance trial.
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 > or =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> or =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.
Hollis
Jack F
JF
Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon 97227, USA. jack.hollis@kpchr.org
Gullion
Christina M
CM
Stevens
Victor J
VJ
Brantley
Phillip J
PJ
Appel
Lawrence J
LJ
Ard
Jamy D
JD
Champagne
Catherine M
CM
Dalcin
Arlene
A
Erlinger
Thomas P
TP
Funk
Kristine
K
Laferriere
Daniel
D
Lin
Pao-Hwa
PH
Loria
Catherine M
CM
Samuel-Hodge
Carmen
C
Vollmer
William M
WM
Svetkey
Laura P
LP
D000328:Adult; D003131:Combined Modality Therapy; D004032:Diet; D015930:Diet Records; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy* / Q000628:therapy; D050177:Overweight / Q000178:diet therapy* / Q000628:therapy; D010349:Patient Compliance / Q000706:statistics & numerical data*; D015431:Weight Loss