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How to Keep Lost Weight off? Try regular, short phone calls

Released: Wednesday, March 12, 2008

BATON ROUGE – We’ve all heard it’s easy to lose weight, but nearly impossible to keep those lost pounds off. One thing that might work is a regular, short phone call to a professional counselor. Researchers at the Pennington Biomedical Research Center (PBRC) conducted a weight-loss maintenance trial in which participants who had a brief, monthly personal contact intervention – most often a 10-15 minute personal phone conversation – regained less weight than participants who were in a Web-based intervention or self-directed program.

PBRC joined Duke University Medical Center, Johns Hopkins and Kaiser Health as one of four sites to conduct the study, which appears in the March 12 issue of JAMA.

Relatively short-term (4-6 months) behavioral interventions for adults can result in clinically significant weight loss, but regaining weight is common.

“Given the difficulty of keeping lost weight off, there is a critical need for practical, affordable strategies that effectively maintain weight loss,” Phillip Brantley, Ph.D., said, “Despite the potential for health benefits of maintaining a lower weight after loss, there is little evidence, particularly from clinical trials, on how to accomplish this objective.” Brantley, chief of the Behavioral Medicine Laboratory at PBRC, is a principal investigator of the study.

Led by Laura P. Svetkey, M.D., of Duke University Medical Center in Durham, N.C., the researchers have just completed the Weight Loss Maintenance (WLM) trial, a comparison of strategies for maintaining weight loss that consisted of two phases: a weight loss phase and a weight-loss maintenance phase. The researchers examined a large, diverse, adult population at high risk for cardiovascular disease by charting weight regain for 30 months following initial weight loss. The two-phases included 1,032 overweight or obese adults (38 percent African American, 63 percent women) with hypertension, dyslipidemia, or both who had lost at least 8.8 lbs. during a 6-month weight loss program (phase 1) and were randomized to a weight-loss maintenance intervention (phase 2).

The researchers compared three types of weight maintenance interventions: monthly contact with a professional counselor, unlimited access to an internet–based intervention, or self-direction. Monthly personal contact consisted of a case management approach with person-to-person guidance and support. Participants had telephone contact with an interventionist for 5 to 15 minutes each month, except for every 4th month when they had a 45- to 60-minute individual face-to-face contact. The internet–based intervention included unlimited access to a Web site designed to support weight loss maintenance, with interactive features allowing participants to set personal goals and action plans for the next week and to graph personal data over time. Self-directed participants received minimal intervention.

At the start of the study, participants, on average, weighed 213 lbs. The average weight loss in the first phase for all participants was 18.7 lbs. After the weight loss phase, all groups regained weight, but researchers saw a clear difference. The self-directed group gained an average of 12.1 lbs.; the interactive technology–based group an average of 11.5 lbs.; and in the personal-contact group, an average of 8.8 lbs. The average weight at 30 months remained lower in each group than average weight at entry into the study.

“Although weight regain with the personal-contact intervention was statistically less than weight regain in the self-directed control group, the average loss was a modest 3.3 lbs.” Brantley said.

However, the study researchers emphasized that even modest weight loss can improve cardiovascular risk factors. They stated that each kilogram (2.2 lbs.) of weight loss is associated with an average decrease in systolic blood pressure of 1.0 to 2.4 mm Hg and a reduction in incident diabetes of 16 percent.

“At the end of the study, more than 45 percent of those in the personal-contact intervention were still maintaining at least 8.8 lbs. of weight loss, an amount with clear clinical benefits,” Brantley said.

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The Pennington Biomedical Research Center is at the forefront of medical discovery as it relates to understanding the causes of obesity, diabetes, cardiovascular disease, cancer and dementia. Itis a campus of the Louisiana State University System and conducts basic, clinical and population research. The research enterprise at the Center includes approximately 80 faculty and more than 25 post-doctoral fellows who comprise a network of 50 laboratories supported by lab technicians, nurses, dieticians, and support personnel, and 19 highly specialized core service facilities.  The Center's more than 500 employees perform research activities in state-of-the-art facilities on the 234-acre campus located in Baton Rouge, Louisiana.