title: The impact of continued intervention on weight: Five-year results from the weight loss maintenance trial.
abstract: In the Weight Loss Maintenance (WLM) Trial, a personal contact (PC) intervention sustained greater weight loss relative to a self-directed (SD) group over 30 months. This study investigated the effects of continued intervention over an additional 30 months and overall weight change across the entire WLM Trial.
  
  
  
  WLM had 3 phases. Phase 1 was a 6-month weight loss program. In Phase 2, those who lost ≥4 kg were randomized to a 30-month maintenance trial. In Phase 3, PC participants (n = 196, three sites) were re-randomized to no further intervention (PC-Control) or continued intervention (PC-Active) for 30 more months; 218 SD participants were also followed.
  
  
  
  During Phase 3, weight increased 1.0 kg in PC-Active and 0.5 kg in PC-Control (mean difference 0.6 kg; 95% CI:-1.4 to 2.7; P = 0.54). Mean weight change over the entire study was -3.2 kg in those originally assigned to PC (PC-Combined) and -1.6 kg in SD (mean difference -1.6 kg; 95% CI:-3.0 to -0.1; P = 0.04).
  
  
  
  After 30 months of the PC maintenance intervention, continuation for another 30 months provided no additional benefit. However, across the entire study, weight loss was slightly greater in those originally assigned to PC.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.|Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Janelle W
authors.initials: JW
authors.lastname: Coughlin
authors.affiliation: Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA.
authors.forename: Phillip J
authors.initials: PJ
authors.lastname: Brantley
authors.affiliation: Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Champagne
authors.affiliation: The Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA.
authors.forename: William M
authors.initials: WM
authors.lastname: Vollmer
authors.affiliation: The Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA.
authors.forename: Victor J
authors.initials: VJ
authors.lastname: Stevens
authors.affiliation: The Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA.
authors.forename: Kristine
authors.initials: K
authors.lastname: Funk
authors.affiliation: Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Arlene T
authors.initials: AT
authors.lastname: Dalcin
authors.affiliation: Division of General Internal Medicine, Johns Hopkins University, Baltimore, Maryland, USA.|Department of Kinesiology, Towson University, Towson, Maryland, USA.
authors.forename: Gerald J
authors.initials: GJ
authors.lastname: Jerome
authors.affiliation: Klein Buendel, Inc, Golden, Colorado, USA.
authors.forename: Valerie H
authors.initials: VH
authors.lastname: Myers
authors.affiliation: Division of Nephrology/Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA.|Duke Hypertension Center and Sarah W. Stedman Nutrition and Metabolism Center, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Crystal
authors.initials: C
authors.lastname: Tyson
authors.affiliation: Duke Hypertension Center and Sarah W. Stedman Nutrition and Metabolism Center, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Bryan C
authors.initials: BC
authors.lastname: Batch
authors.affiliation: Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Jeanne
authors.initials: J
authors.lastname: Charleston
authors.affiliation: National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Loria
authors.affiliation: The Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA.
authors.forename: Alan
authors.initials: A
authors.lastname: Bauck
authors.affiliation: The Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA.
authors.forename: Jack F
authors.initials: JF
authors.lastname: Hollis
authors.affiliation: Division of Nephrology/Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA.|Duke Hypertension Center and Sarah W. Stedman Nutrition and Metabolism Center, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Laura P
authors.initials: LP
authors.lastname: Svetkey
authors.affiliation: Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA.|Division of General Internal Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Appel
mesh_terms: D000328:Adult; D001521:Behavior Therapy / Q000379:methods; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000628:therapy; D015431:Weight Loss; D061217:Weight Reduction Programs / Q000379:methods*