title: Weight loss during the intensive intervention phase of the weight-loss maintenance trial.
abstract: 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.
authors.affiliation: Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon 97227, USA. jack.hollis@kpchr.org
authors.forename: Jack F
authors.initials: JF
authors.lastname: Hollis
authors.forename: Christina M
authors.initials: CM
authors.lastname: Gullion
authors.forename: Victor J
authors.initials: VJ
authors.lastname: Stevens
authors.forename: Phillip J
authors.initials: PJ
authors.lastname: Brantley
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Appel
authors.forename: Jamy D
authors.initials: JD
authors.lastname: Ard
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Champagne
authors.forename: Arlene
authors.initials: A
authors.lastname: Dalcin
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Erlinger
authors.forename: Kristine
authors.initials: K
authors.lastname: Funk
authors.forename: Daniel
authors.initials: D
authors.lastname: Laferriere
authors.forename: Pao-Hwa
authors.initials: PH
authors.lastname: Lin
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Loria
authors.forename: Carmen
authors.initials: C
authors.lastname: Samuel-Hodge
authors.forename: William M
authors.initials: WM
authors.lastname: Vollmer
authors.forename: Laura P
authors.initials: LP
authors.lastname: Svetkey
mesh_terms: 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