The DOI matches its Crossref record; 28 of the 28 references it cites were found in a registry or an index.
Effect of a Stepped-Care Intervention Approach on Weight Loss in Adults: A Randomized Clinical Trial
Open accessAbstract
CONTEXT: Given the obesity epidemic, effective but resource-efficient weight loss treatments are needed. Stepped-treatment approaches customize interventions based on milestone completion and can be more effective while costing less to administer than conventional treatment approaches. OBJECTIVE: To determine whether a stepped-care weight loss intervention (STEP) compared with a standard behavioral weight loss intervention (SBWI) would result in greater weight loss. DESIGN, SETTING, AND PARTICIPANTS: A randomized clinical trial of 363 overweight and obese adults (body mass index: 25-<40; age: 18-55 years, 33% nonwhite, and 83% female) who were randomized to SBWI (n = 165) or STEP (n = 198) at 2 universities affiliated with academic medical centers in the United States (Step-Up Study). Participants were enrolled between May 2008 and February 2010 and data collection was completed by September 2011. INTERVENTIONS: All participants were placed on a low-calorie diet, prescribed increases in physical activity, and attended group counseling sessions ranging from weekly to monthly during an 18-month period. The SBWI group was assigned to a fixed program. Counseling frequency, type, and weight loss strategies could be modified every 3 months for the STEP group in response to observed weight loss as it related to weight loss goals. MAIN OUTCOME MEASURE: Mean change in weight over 18 months. Additional outcomes included resting heart rate and blood pressure, waist circumference, body composition, fitness, physical activity, dietary intake, and cost of the program. RESULTS: Of the 363 participants randomized, 260 (71.6%) provided a measure of mean change in weight over 18 months. The 18-month intervention resulted in weight decreasing from 93.1 kg (95% CI, 91.0 to 95.2 kg) to 85.6 kg (95% CI, 83.4 to 87.7 kg) (P < .001) in the SBWI group and from 92.7 kg (95% CI, 90.8 to 94.6 kg) to 86.4 kg (95% CI, 84.5 to 88.4 kg) in the STEP group (P < .001). The percentage change in weight from baseline to 18 months was -8.1% (95% CI, -9.4% to -6.9%) in the SBWI group (P < .001) compared with -6.9% (95% CI, -8.0% to -5.8%) in the STEP group (P < .001). Although the between-group difference in 18-month weight loss was not statistically different (-1.3 kg [95% CI, -2.8 to 0.2 kg]; P = .09), there was a significant group × time interaction effect (P = .03). The cost per participant was $1357 (95% CI, $1272 to $1442) for the SBWI group vs $785 (95% CI, $739 to $830) for the STEP group (P < .001). Both groups had significant and comparable improvements in resting heart rate, blood pressure level, and fitness. CONCLUSIONS: Among overweight and obese adults, the use of SBWI resulted in a greater mean weight loss than STEP over 18 months. Compared with SBWI, STEP resulted in clinically meaningful weight loss that cost less to implement. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00714168.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“The aim of this study was not to construct an adaptive intervention; rather, the aim was to evaluate the above-described intervention.”
From Introduction to SMART designs for the development of adaptive interventions: with application to weight loss research (2014) · cites this paper as [44]
In the citing paper
“In developing this AI prior to study, decisions were made (i) about the total number of decision stages, including when and how often they would occur (i.e., there was a step every 3 months over 18 months), (ii) to use one tailoring variable (i.e., weight loss), (iii) about the treatment options (i.e., group sessions, behavioral lessons, 1 vs 2 sessions of telephone counseling, individual sessions”
From Introduction to SMART designs for the development of adaptive interventions: with application to weight loss research (2014) · cites this paper as [44]
In the citing paper
“After these decisions were made, the investigators evaluated this adaptive intervention versus a standard behavioral weight loss intervention using a 2-arm RCT.”
From Introduction to SMART designs for the development of adaptive interventions: with application to weight loss research (2014) · cites this paper as [44]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin
(2002) · New England Journal of Medicine · doi:10.1056/nejmoa012512 · Cited by 19,011
(1998) · PsycEXTRA Dataset · doi:10.1037/e565682010-001 · Cited by 9,453
(2014) · Medical Entomology and Zoology · Cited by 9,400
Physical Activity, All-Cause Mortality, and Longevity of College Alumni
Paffenbarger, R. S., Hyde, R., Wing, A. L., & Hsieh, C.-C. (1986) · New England Journal of Medicine · doi:10.1056/nejm198603063141003 · Cited by 2,742
(1998) · PubMed · Cited by 2,737
A DATA-BASED APPROACH TO DIET QUESTIONNAIRE DESIGN AND TESTING
Block, G., Hartman, A. M., DRESSER, C. M., Carroll, M. D., Gannon, J. G., & Gardner, L. B. (1986) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a114416 · Cited by 2,150
Reduction in Weight and Cardiovascular Disease Risk Factors in Individuals With Type 2 Diabetes
The Look AHEAD Research Group (2007) · Diabetes Care · doi:10.2337/dc07-0048 · Cited by 1,522
Validation of a self-administered diet history questionnaire using multiple diet records
Block, G., Woods, M., Potosky, A., & Clifford, C. (1990) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(90)90099-b · Cited by 1,197
(2010) · Archives of Internal Medicine · doi:10.1001/archinternmed.2010.334 · Cited by 1,162
Jakicic, J. M., Marcus, B. H., Gallagher, K. I., Napolitano, M., & Lang, W. (2003) · JAMA · doi:10.1001/jama.290.10.1323 · Cited by 519
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Items 101–158 of 158
Khatib, R., Yusuf, S., Barzilay, J. I., Παπαϊωάννου, Α., Thabane, L., Gao, P., Joseph, P. G., Teo, K. K., & Mente, A. (2014) · Age and Ageing · doi:10.1093/ageing/afu009 · Cited by 12
Successful Medical Weight Loss in a Community Setting
Carney, D. M., Schultz, S., Lim, J. Y., & Walters, W. G. (2015) · Journal of Obesity & Weight loss Therapy · doi:10.4172/2165-7904.1000248 · Cited by 9
Carr, L. T. B., Samuel‐Hodge, C. D., Ward, D. S., Evenson, K. R., Bangdiwala, S. I., & Tate, D. F. (2019) · Women & Health · doi:10.1080/03630242.2019.1700585 · Cited by 9
Self-citationUnick, J. L., Walkup, M. P., Miller, M. E., Apolzan, J. W., Brubaker, P. H., Coday, M., Hill, J. O., Jakicic, J. M., Middelbeek, R. J. W., West, D. S., et al. (2020) · Journal of Physical Activity and Health · doi:10.1123/jpah.2020-0114 · Cited by 9
Self-citationNezami, B. T., Jakicic, J. M., Lang, W., Davis, K. K., & Tate, D. F. (2019) · Obesity Science & Practice · doi:10.1002/osp4.401 · Cited by 7
Self-citationPost, K. E., Heuer, L. B., Kamal, A. H., Kumar, P. P., Elyze, M., Griffith, S., Han, J., Friedman, F., Jackson, A., Trotter, C., et al. (2022) · BMJ Open · doi:10.1136/bmjopen-2021-057591 · Cited by 8
Comparative Effectiveness Research
Jakicic, J. M., Sox, H. C., Blair, S. N., Bensink, M. E., Johnson, W. G., King, A. C., Lee, I.-M. M., Nahum-Shani, I. B., Sallis, J. F., Sallis, R. E., et al. (2014) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000000590 · Cited by 8
Self-citationDiet and Exercise for Weight Loss
Bray, G. A. (2012) · JAMA · doi:10.1001/jama.2012.7263 · Cited by 8
Technology-Assisted Stepped-Care to Promote Adherence in Adolescents with Asthma: A Pilot Study
Ramsey, R. R., Plevinsky, J. M., Guilbert, T. W., Carmody, J. K., & Hommel, K. A. (2022) · Journal of Clinical Psychology in Medical Settings · doi:10.1007/s10880-022-09905-5 · Cited by 8
Do participants with children age 18 and under have suboptimal weight loss?
Rosenbaum, D. L., Remmert, J. E., Forman, E. M., & Butryn, M. L. (2018) · Eating Behaviors · doi:10.1016/j.eatbeh.2018.03.001 · Cited by 7
Gruchała‐Niedoszytko, M., Niedoszytko, P., Kaczkan, M., Pieszko, M., Gierat-Haponiuk, K., Śliwińska, A., Skotnicka, M., Szalewska, D., & Małgorzewicz, S. (2019) · Polskie Archiwum Medycyny Wewnętrznej · doi:10.20452/pamw.4480 · Cited by 7
DuBois, K., Delgado-Diaz, D. C., McGrievy, M. J., Valafar, H., Monroe, C. M., Wilcox, S., & Turner‐McGrievy, G. M. (2024) · Contemporary Clinical Trials · doi:10.1016/j.cct.2024.107735 · Cited by 7
Unick, J. L., Pellegrini, C. A., DUNSIGER, S. I., Demos, K. E., Thomas, J. G., Bond, D. S., Webster, J., & Wing, R. R. (2020) · Contemporary Clinical Trials · doi:10.1016/j.cct.2020.105953 · Cited by 7
Lim, R. S. M., Gardner, D. S. L., Bee, Y. M., Cheung, Y. B., Bairavi, J., Gandhi, M., Goh, S., Ho, E. T. L., Lin, X., Tan, N. C., et al. (2019) · Trials · doi:10.1186/s13063-019-3749-x · Cited by 6
Self-citationHafez, D., Lopez, K. S., Saslow, L. R., & Richardson, C. R. (2021) · Frontiers in Nutrition · doi:10.3389/fnut.2021.682137 · Cited by 6
Turner‐McGrievy, G. M., Wilcox, S., Boutté, A. K., Hutto, B., Singletary, C. R., Muth, E. R., & Hoover, A. W. (2017) · Obesity · doi:10.1002/oby.22076 · Cited by 6
Sridhar, S. B., Ferrara, A. M., Brown, S. D., Quesenberry, C. P., Xu, F., Liu, E., Sedgwick, T., Kissel, P., Bandera, H. S., Albright, C. L., et al. (2024) · Contemporary Clinical Trials · doi:10.1016/j.cct.2024.107781 · Cited by 5
Hurley, L., Nezami, B. T., Sciamanna, C., & Tate, D. F. (2024) · Digital Health · doi:10.1177/20552076241277351 · Cited by 4
Self-citationLeon, B. M., Miller, B. V., Zalos, G., Courville, A. B., Sumner, A. E., Powell‐Wiley, T. M., Walter, M. F., Waclawiw, M. A., & Cannon, R. O. (2014) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-014-0006-6 · Cited by 4
Healthy Weight Behaviors and Weight Change in Parents and Preschool-Aged Children
Nezami, B. T. (2019) · Carolina Digital Repository (University of North Carolina at Chapel Hill) · doi:10.17615/t2sf-5n50 · Cited by 4
Tabak, R. G., Morshed, A. B., Schwarz, C. D., & Haire-Joshu, D. L. (2019) · Obesity Science & Practice · doi:10.1002/osp4.369 · Cited by 2
Antonio‐Villa, N. E., Palma-Moreno, B. G., Rodríguez-Dávila, F. M., Gomez-Perez, F. J., Aguilar-Salinas, C. A., Hernández-Jiménez, S. C., García-Ulloa, A. C., & Almeda‐Valdés, P. (2020) · Primary care diabetes · doi:10.1016/j.pcd.2020.07.009 · Cited by 3
Wanik, J. A., Marcus, A. F., Radler, D. R., Byham-Gray, L. D., & Touger-Decker, R. E. (2016) · American Journal of Lifestyle Medicine · doi:10.1177/1559827615624420 · Cited by 3
Observations of a Commercial Weight Loss Program on Physical Function and Selected CVD Risk Factors
Rogers, R. J., Kovacs, S. J., Collins, K. A., Raybuck, S. D., Collins, A. M., Marcin, M. L., Foster, G. D., & Jakicic, J. M. (2020) · Translational Journal of the American College of Sports Medicine · doi:10.1249/tjx.0000000000000137 · Cited by 4
Self-citationAdaptive Mobile Health Intervention to Reduce Excess Gestational Weight Gain
Hedderson, M. M., Brown, S. D., Quesenberry, C. P., Xu, F., Liu, E. F., Li, K. L., Sridhar, S. B., Sedgwick, T., Kissel, P., Bandera, H. S., et al. (2026) · JAMA Network Open · doi:10.1001/jamanetworkopen.2026.8007 · Cited by 2
Liu, J., Godino, J., Norman, G. J., Hill, L. L., Calfas, K. J., Sallis, J. F., Arredondo, E. M., Rock, C. L., Criqui, M. H., Zhu, S., et al. (2018) · Preventive Medicine · doi:10.1016/j.ypmed.2018.07.015 · Cited by 2
Consistent weight loss linked to higher meal frequency
Peregrín-Alvarez, J. M. (2019) · Advances in Obesity Weight Management & Control · doi:10.15406/aowmc.2019.09.00267 · Cited by 2
Physical Activity Monitoring System for Manual Wheelchair Users
Hiremath, S. V. (2013) · D-Scholarship@Pitt (University of Pittsburgh) · Cited by 2
Dao, M. C., Das, S. K., Silver, R. E., & Roberts, S. B. (2020) · Obesity Research & Clinical Practice · doi:10.1016/j.orcp.2020.11.005 · Cited by 2
Rouleau, C. R., Moran, C., & Williamson, T. M. (2025) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2025.08.350 · Cited by 1
The Physiology Of the WEight Reduced State (POWERS) study: overview and study design
Belle, S. H., Gallagher, D., Roberts, S. B., Laughlin, M. R., Das, S. K., Whyte, K., King, W. C., Saks, R., Yanovski, S. Z., Fielding, R. A., et al. (2025) · International Journal of Obesity · doi:10.1038/s41366-025-01932-0 · Cited by 1
Self-citationDietary Self-monitoring in Patients with Obstructive Sleep Apnea
Hood, M. M., Nackers, L. M., Kleinman, B. M., Corsica, J. A., & Katterman, S. N. (2013) · Behavioral Medicine · doi:10.1080/08964289.2013.842534 · Cited by 1
Comparing Changes in Diet Quality Between Two Technology-Based Diet Tracking Devices
Boutté, A. K., Turner‐McGrievy, G. M., Wilcox, S., Hutto, B., Muth, E. R., & Hoover, A. W. (2018) · Journal of Technology in Behavioral Science · doi:10.1007/s41347-018-0075-1 · Cited by 1
Garcia, D. O. (2013) · D-Scholarship@Pitt (University of Pittsburgh) · Cited by 1
Effect of Daily Self-weighing on Weight Loss in Adults
Steinberg, D. (2019) · Carolina Digital Repository (University of North Carolina at Chapel Hill) · doi:10.17615/x2n6-9213 · Cited by 1
Pilot Feasibility Study of a Campaign Intervention for Weight Loss among Overweight and Obese Adults
Garcia, D. O., Jakicic, J. M., Davis, K. K., Gibbs, B. B., Burke, L. E., & Rickman, A. D. (2014) · Californian Journal of Health Promotion · doi:10.32398/cjhp.v12i3.1581 · Cited by 1
Self-citationEXAMINING THE EFFECTIVENESS OF BEHAVIORAL WEIGHT LOSS INTERVENTIONS AMONG AFRICAN AMERICAN WOMEN
Carr, L. T. B. (2017) · Cited by 1
Spark, L. C. (2015) · The University of Queensland · doi:10.14264/uql.2015.641
Patient-Centered Strategies for Effective Weight Management
Kolasa, K. M. (2014) · Springer eBooks · doi:10.1007/978-1-4939-0548-5_32
Awareness of Diabetes Risk Associated with Individuals 18 and Older
Boone, R. J. (2015) · ScholarWorks (Walden University)
Kossmann, B. (2014) · DuEPublico (University of Duisburg-Essen)
Dietitian Sex Differences Toward Adult Weight Loss Counseling
Bertrand, B. M., Pryor, J., Brinkley, J., Babatunde, O. T., & Harman, T. E. (2013) · Health care · doi:10.12966/hc.11.08.2013
Fernandes, S. P., Conterato, E. V., & de Mello, E. D. (2012)
McGrath, R. E., & O’Donohue, W. (2015) · Springer eBooks · doi:10.1007/978-3-319-19036-5_6
Creasy, S. A. (2016) · D-Scholarship@Pitt (University of Pittsburgh)
Behavioral and Psychological Approaches to Weight Management
Frutchey, R. A., & Carels, R. A. (2014) · Springer eBooks · doi:10.1007/978-1-4939-0548-5_16
Crane, M. M. (2019) · Carolina Digital Repository (University of North Carolina at Chapel Hill) · doi:10.17615/828s-0h30
Barriers to Weight Loss in a Stepped-Care Approach to Behavioral Weight Loss Treatment
Selensky, J. C. (2017) · The Scholarship East Carolina University's Institutional Repository (East Carolina University)
A revised cost-benefit analysis tool capable of analysing the effects of vocational rehabilitation
Brown, T. M. (2018) · University of Salford Institutional Repository (University of Salford)
Alick, C. L. (2019) · Carolina Digital Repository (University of North Carolina at Chapel Hill) · doi:10.17615/43gv-d160
Implicit Cognition and Understanding Unobserved Human Mind States by Machines
Ding, A. W. (2019) · Communications in computer and information science · doi:10.1007/978-981-15-1398-5_12
Lindeman, S., & Maragakis, A. (2018) · Springer eBooks · doi:10.1007/978-3-319-70539-2_24
Cedillo, M., Kukhareva, P., Larsen, S. M., McTigue, K. M., Bryce, C. L., Gibbs, B. B., Hess, R., Huber, K., & Conroy, M. B. (2022) · Obesity · doi:10.1002/oby.23595
The Language of Medical Terminology II
Erickson, S., & Sturdy, L. (2023) · doi:10.29173/oer43
Levesque, A., & Roy-Wsiaki, G. N. (2024) · Health Education · doi:10.1108/he-08-2023-0090
Optimizing the Postpartum Period to Support Lifelong Health for Women with Obesity
Hawley, N. L., Rossillo, M., Chundury, A., McElfish, P. A., Adrien, N., & Bengtson, A. M. (2026) · Current Obesity Reports · doi:10.1007/s13679-026-00748-x
Clarke, H., Lombardelli, C., Barrett, E., Wisely, J. A., Sellers, K., Issa, B. G., Howell, A., Crosbie, E. J., Howell, S. J., & Harvie, M. (2026) · BMJ Open · doi:10.1136/bmjopen-2026-119498
Metadata
- Authors
- Jakicic, J. M., Tate, D. F., Lang, W., Davis, K. K., Polzien, K., Rickman, A. D., Erickson, K., Neiberg, R. H., & Finkelstein, E. A.
- Affiliations
- University of Pittsburgh (US)
- University of North Carolina at Chapel Hill (US)
- Wake Forest University Health Sciences (US)
- National University of Singapore (SG)
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2012-06-27
- Volume
- 307
- Issue
- 24
- Pages
- 2617-26
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- PMC
- PMC4132634
- OpenAlex
- W2049460685
- Cited by
- 158
- References
- 28
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 7 · 2023: 1 · 2022: 8 · 2021: 7 · 2020: 10 · 2019: 23 · 2018: 12 · 2017: 18 · 2016: 12 · 2015: 16 · 2014: 22 · 2013: 12 · 2012: 3
- FWCI
- 16.35
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- National University of Singapore (submittedVersion)
- Funders
- National Heart, Lung, and Blood Institute (R01HL084400, HL084400)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity and Health Practices
- Health Sciences › Medicine › Pharmacology (medical) › Pharmacology and Obesity Treatment
- Keywords
- stepped-care intervention, weight loss, obesity, behavioral weight loss, hypocaloric diet, physical activity, group counseling, personalized treatment, cost-effectiveness, resting heart rate, blood pressure, waist circumference, body composition, adults with obesity, overweight adults, program costs, physical activity adherence, dietary intake, fitness, step-up
- MeSH terms
- Adolescent, Adult, Blood Pressure, Body Composition, Counseling, Diet, Reducing, Female, Heart Rate, Humans, Male, Middle Aged, Obesity, Physical Fitness, Weight Loss, Exercise, Body Mass Index, Treatment Outcome, Cost Savings, Overweight, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
