title: Sustainability of health and lifestyle improvements following a non-dieting randomised trial in overweight women.
abstract: OBJECTIVE
  To compare three non-dieting interventions that focused on lifestyle change rather than weight loss, in terms of the sustainability of improvements in lifestyle behaviors, psychological well-being and medical symptoms at 2 years.
  
  
  METHODS
  In Dunedin, New Zealand in 2002/2003, 225 obese/overweight women (BMI > or = 28; 25-68 years) participated in a randomised, intention-to-treat trial comparing two group programs (P1, P2) and a self-guided mail-delivered program (P3). Only P1 included intensive relaxation response training. All three non-dieting interventions involved a 10-week program, followed by an eight-month support phase. Participants completed baseline, 1-year and 2-year assessments. Outcomes included behavioral, psychological and medical symptom measures and a composite success score.
  
  
  RESULTS
  118 participants completed the 2-year follow-up. Only among P1 participants were the reductions in psychological distress and medical symptoms achieved at 1 year, also maintained at 2 years. At 2 years, P1 participants had significantly greater increases in stress management behaviors than those in P2 (p<0.05), and significantly greater success scores than those in P3 (p<0.05). In all three programs, mean weight was unchanged at 2 years.
  
  
  CONCLUSIONS
  Inclusion of relaxation response training in a healthy lifestyle program facilitates long-term maintenance of psychological and medical symptom improvements even in the absence of weight loss.
authors.affiliation: Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
authors.forename: Greer
authors.initials: G
authors.lastname: Hawley
authors.forename: Caroline
authors.initials: C
authors.lastname: Horwath
authors.forename: Andrew
authors.initials: A
authors.lastname: Gray
authors.forename: Alison
authors.initials: A
authors.lastname: Bradshaw
authors.forename: Lisa
authors.initials: L
authors.lastname: Katzer
authors.forename: Janine
authors.initials: J
authors.lastname: Joyce
authors.forename: Sue
authors.initials: S
authors.lastname: O'Brien
mesh_terms: D000328:Adult; D000368:Aged; D004435:Eating / Q000523:psychology*; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D009520:New Zealand; D009765:Obesity / Q000628:therapy*; D050177:Overweight / Q000628:therapy*; D012064:Relaxation Therapy; D013315:Stress, Psychological / Q000523:psychology*