title: Maintenance of Weight Loss After Initiation of Nutrition Training: A Randomized Trial.
abstract: BACKGROUND
  Weight regain after successful weight loss interventions is common.
  
  
  OBJECTIVE
  To establish the efficacy of a weight loss maintenance program compared with usual care in obese adults.
  
  
  METHODS
  2-group, parallel, randomized trial stratified by initial weight loss (<10 kg vs. ≥10 kg), conducted from 20 August 2012 to 18 December 2015. Outcome assessors were blinded to treatment assignment. (ClinicalTrials.gov: NCT01357551).
  
  
  METHODS
  3 primary care clinics at the Veterans Affairs Medical Center in Durham and Raleigh, North Carolina.
  
  
  METHODS
  Obese outpatients (body mass index ≥30 kg/m2) who lost 4 kg or more of body weight during a 16-week, group-based weight loss program.
  
  
  METHODS
  The maintenance intervention, delivered primarily by telephone, addressed satisfaction with outcomes, relapse-prevention planning, self-monitoring, and social support. Usual care involved no contact except for study measurements.
  
  
  METHODS
  Primary outcome was mean weight regain at week 56. Secondary outcomes included self-reported caloric intake, walking, and moderate physical activity.
  
  
  RESULTS
  Of 504 patients in the initial program, 222 lost at least 4 kg of body weight and were randomly assigned to maintenance (n = 110) or usual care (n = 112). Retention was 85%. Most patients were middle-aged white men. Mean weight loss during initiation was 7.2 kg (SD, 3.1); mean weight at randomization was 103.6 kg (SD, 20.4). Estimated mean weight regain was statistically significantly lower in the intervention (0.75 kg) than the usual care (2.36 kg) group (estimated mean difference, 1.60 kg [95% CI, 0.07 to 3.13 kg]; P = 0.040). No statistically significant differences in secondary outcomes were seen at 56 weeks. No adverse events directly attributable to the intervention were observed.
  
  
  CONCLUSIONS
  Results may not generalize to other settings or populations. Dietary intake and physical activity were self-reported. Duration was limited to 56 weeks.
  
  
  CONCLUSIONS
  An intervention focused on maintenance-specific strategies and delivered in a resource-conserving way modestly slowed the rate of weight regain in obese adults.
  
  
  BACKGROUND
  Veterans Affairs Health Services Research and Development Service.
authors.affiliation: From Durham Veterans Affairs Medical Center, Duke University Medical Center, and Duke University Diet and Fitness Center, Durham, North Carolina.
authors.forename: Corrine I
authors.initials: CI
authors.lastname: Voils
authors.affiliation: From Durham Veterans Affairs Medical Center, Duke University Medical Center, and Duke University Diet and Fitness Center, Durham, North Carolina.
authors.forename: Maren K
authors.initials: MK
authors.lastname: Olsen
authors.affiliation: From Durham Veterans Affairs Medical Center, Duke University Medical Center, and Duke University Diet and Fitness Center, Durham, North Carolina.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Gierisch
authors.affiliation: From Durham Veterans Affairs Medical Center, Duke University Medical Center, and Duke University Diet and Fitness Center, Durham, North Carolina.
authors.forename: Megan A
authors.initials: MA
authors.lastname: McVay
authors.affiliation: From Durham Veterans Affairs Medical Center, Duke University Medical Center, and Duke University Diet and Fitness Center, Durham, North Carolina.
authors.forename: Janet M
authors.initials: JM
authors.lastname: Grubber
authors.affiliation: From Durham Veterans Affairs Medical Center, Duke University Medical Center, and Duke University Diet and Fitness Center, Durham, North Carolina.
authors.forename: Leslie
authors.initials: L
authors.lastname: Gaillard
authors.affiliation: From Durham Veterans Affairs Medical Center, Duke University Medical Center, and Duke University Diet and Fitness Center, Durham, North Carolina.
authors.forename: Jamiyla
authors.initials: J
authors.lastname: Bolton
authors.affiliation: From Durham Veterans Affairs Medical Center, Duke University Medical Center, and Duke University Diet and Fitness Center, Durham, North Carolina.
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Maciejewski
authors.affiliation: From Durham Veterans Affairs Medical Center, Duke University Medical Center, and Duke University Diet and Fitness Center, Durham, North Carolina.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Strawbridge
authors.affiliation: From Durham Veterans Affairs Medical Center, Duke University Medical Center, and Duke University Diet and Fitness Center, Durham, North Carolina.
authors.forename: William S
authors.initials: WS
authors.lastname: Yancy
mesh_terms: D037001:Directive Counseling; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs; D005102:Health Expenditures; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000628:therapy*; D017060:Patient Satisfaction; D055502:Secondary Prevention; D012944:Social Support; D016896:Treatment Outcome; D015431:Weight Loss; D061217:Weight Reduction Programs / Q000191:economics / Q000379:methods