title: Up to 7 Years of Sustained Weight Loss for Weight-Loss Program Completers.
abstract: BACKGROUND
  Two issues remain elusive in weight management programs: significant, long-term weight-loss maintenance and widely accessible programs that produce significant weight loss for reasonable costs. The purpose of this study is to determine the long-term weight loss of participants who consecutively renew their annual membership in Take Off Pounds Sensibly (TOPS), a national, nonprofit, low-cost, peer-led weight-loss program.
  
  
  METHODS
  This completers' analysis was a retrospective cohort study of overweight and obese men and women who joined TOPS in 2005-2011 and consecutively renewed their annual membership at least once. Data were analyzed from June to October 2013. TOPS participants' weights are sent to the national database when they join and at the time of their annual renewal; thus, follow-up weight is only available for those who renew their membership. Among 207,469 individuals who joined during the study period, 74,629 (35.9%) had at least one consecutive annual renewal and were included in the study.
  
  
  RESULTS
  Cumulative mean (95% CI) weight change as a percentage of initial weight ranged from -6.0% (-6.0%, -5.9%) for 74,629 participants who renewed at 1 year to -8.3% (-8.7%, -7.8%) for 2,289 participants with 7 years of consecutive annual renewal.
  
  
  CONCLUSIONS
  In the subset of individuals who choose to renew their program membership, TOPS can effectively promote maintenance of clinically significant weight loss for an extended period of time. RCTs are needed to further evaluate this low-cost, widely available program, which could be a viable option to treat overweight and obesity.
authors.affiliation: Division of General Internal Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado; Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, Colorado; Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado. Electronic address: nia.mitchell@ucdenver.edu.
authors.forename: Nia S
authors.initials: NS
authors.lastname: Mitchell
authors.affiliation: Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado; Barbara Davis Center for Childhood Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
authors.forename: Sarit
authors.initials: S
authors.lastname: Polsky
authors.affiliation: Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado; Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
authors.forename: Victoria A
authors.initials: VA
authors.lastname: Catenacci
authors.affiliation: Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
authors.forename: Anna L
authors.initials: AL
authors.lastname: Furniss
authors.affiliation: Division of General Internal Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado; Denver Veterans Administration Medical Center, Denver, Colorado.
authors.forename: Allan V
authors.initials: AV
authors.lastname: Prochazka
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000628:therapy*; D050177:Overweight / Q000628:therapy*; D012189:Retrospective Studies; D013997:Time Factors; D015431:Weight Loss; D061217:Weight Reduction Programs