Comparative effectiveness of three doses of weight-loss counseling: two-year findings from the rural LITE trial.
OBJECTIVE
To evaluate the effects and costs of three doses of behavioral weight-loss treatment delivered via Cooperative Extension Offices in rural communities.


METHODS
Obese adults (N = 612) were randomly assigned to low, moderate, or high doses of behavioral treatment (i.e., 16, 32, or 48 sessions over two years) or to a control condition that received nutrition education without instruction in behavior modification strategies.


RESULTS
Two-year mean reductions in initial body weight were 2.9% (95% Credible Interval = 1.7-4.3), 3.5% (2.0-4.8), 6.7% (5.3-7.9), and 6.8% (5.5-8.1) for the control, low-, moderate-, and high-dose conditions, respectively. The moderate-dose treatment produced weight losses similar to the high-dose condition and significantly larger than the low-dose and control conditions (posterior probability > 0.996). The percentages of participants who achieved weight reductions ≥ 5% at two years were significantly higher in the moderate-dose (58%) and high-dose (58%) conditions compared with low-dose (43%) and control (40%) conditions (posterior probability > 0.996). Cost-effectiveness analyses favored the moderate-dose treatment over all other conditions.


CONCLUSIONS
A moderate dose of behavioral treatment produced two-year weight reductions comparable to high-dose treatment but at a lower cost. These findings have important policy implications for the dissemination of weight-loss interventions into communities with limited resources.
Department of Clinical and Health Psychology, University of Florida College of Public Health and Health Professions, Gainesville, Florida, USA.
Michael G
MG
Perri
Marian C
MC
Limacher
Kristina
K
von Castel-Roberts
Michael J
MJ
Daniels
Patricia E
PE
Durning
David M
DM
Janicke
Linda B
LB
Bobroff
Tiffany A
TA
Radcliff
Vanessa A
VA
Milsom
Chanmin
C
Kim
A Daniel
AD
Martin
D000328:Adult; D000368:Aged; D001521:Behavior Therapy / Q000191:economics / Q000379:methods*; D003362:Cost-Benefit Analysis; D003376:Counseling / Q000191:economics / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000191:economics / Q000628:therapy*; D010353:Patient Education as Topic / Q000379:methods; D012424:Rural Population; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult