The DOI matches its Crossref record; 39 of the 39 references it cites were found in a registry or an index; none of the 27 sources its claims cite is checked for support yet.
A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice
Open accessAbstract
BACKGROUND: Calls for primary care providers (PCPs) to offer obese patients behavioral weight-loss counseling have not been accompanied by adequate guidance on how such care could be delivered. This randomized trial compared weight loss during a 2-year period in response to three lifestyle interventions, all delivered by PCPs in collaboration with auxiliary health professionals (lifestyle coaches) in their practices. METHODS: We randomly assigned 390 obese adults in six primary care practices to one of three types of intervention: usual care, consisting of quarterly PCP visits that included education about weight management; brief lifestyle counseling, consisting of quarterly PCP visits combined with brief monthly sessions with lifestyle coaches who instructed participants about behavioral weight control; or enhanced brief lifestyle counseling, which provided the same care as described for the previous intervention but included meal replacements or weight-loss medication (orlistat or sibutramine), chosen by the participants in consultation with the PCPs, to potentially increase weight loss. RESULTS: Of the 390 participants, 86% completed the 2-year trial, at which time, the mean (±SE) weight loss with usual care, brief lifestyle counseling, and enhanced brief lifestyle counseling was 1.7±0.7, 2.9±0.7, and 4.6±0.7 kg, respectively. Initial weight decreased at least 5% in 21.5%, 26.0%, and 34.9% of the participants in the three groups, respectively. Enhanced lifestyle counseling was superior to usual care on both these measures of success (P=0.003 and P=0.02, respectively), with no other significant differences among the groups. The benefits of enhanced lifestyle counseling remained even after participants given sibutramine were excluded from the analyses. There were no significant differences between the intervention groups in the occurrence of serious adverse events. CONCLUSIONS: Enhanced weight-loss counseling helps about one third of obese patients achieve long-term, clinically meaningful weight loss. (Funded by the National Heart, Lung, and Blood Institute; POWER-UP ClinicalTrials.gov number, NCT00826774.).
Overview
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TL;DR
In a two-year randomized trial in six primary care practices, enhanced brief lifestyle counseling—quarterly PCP visits, monthly lifestyle-coach sessions, plus meal replacements or weight-loss medication—produced greater weight loss than usual care in obese adults. Brief lifestyle counseling alone did not significantly outperform usual care.
Key findings
- At 24 months, mean (±SE) weight loss was 1.7±0.7 kg with usual care, 2.9±0.7 kg with brief lifestyle counseling, and 4.6±0.7 kg with enhanced brief lifestyle counseling.
- Initial weight decreased by at least 5% in 21.5%, 26.0%, and 34.9% of participants in the three groups, respectively.
- Enhanced lifestyle counseling was superior to usual care on both weight loss and ≥5% weight loss (P=0.003 and P=0.02, respectively), with no other significant differences among groups.
- There were no significant differences between intervention groups in serious adverse events; 73 hospitalizations occurred, with no deaths.
Methods
- Randomized trial of 390 obese adults in six primary care practices; participants were ≥21 years old, had BMI 30 to 50, and had at least two of five metabolic syndrome components.
- Participants were assigned to usual care (quarterly PCP visits), brief lifestyle counseling (quarterly PCP visits plus monthly lifestyle-coach sessions), or enhanced brief lifestyle counseling (same as brief counseling plus meal replacements, orlistat, or sibutramine chosen with the PCP).
- Primary outcome was 24-month weight change; intention-to-treat analyses used repeated-measures linear mixed-effects models and generalized-estimating-equation models, controlling for initial weight, age, sex, race or ethnic group, and study site. The trial had 80% power to detect a 2.75-kg difference at month 24.
Limitations
- The paper states that limitations included provision of free treatment enhancements, which may limit generalizability; need for longer follow-up; and withdrawal of sibutramine from the market, which clouded interpretation of findings for the enhanced-counseling group.
- The text also makes evident that attendance declined from year 1 to year 2, brief lifestyle counseling did not significantly increase weight loss versus usual care, and the usual-care group lost more than expected, possibly because it received more weight-management support than typical primary care.
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Claims the paper makes
33 Own result · 13 Not checked yet · 13 Own method · 6 Own interpretation · 2 No basis given · 1 Sources not found
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Initial weight decreased at least 5% in 21.5%, 26.0%, and 34.9% of the participants in the three groups, respectively.”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > Abstract > RESULTS
plainn = 390- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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In the paper
“with no other significant differences among the groups.”
- Also stated in: § WEIGHT LOSS · plain
“whereas other between-group differences were not significant.”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > Abstract > RESULTS
plainn = 390- Asserted: passes — The authors put it forward as true.
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- Also stated in: § WEIGHT LOSS · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, this group had significantly smaller reductions in LDL cholesterol levels at month 24.”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > RESULTS > CHANGES IN CARDIOVASCULAR RISK FACTORS
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Figure 3 in the Supplementary Appendix shows that for each intervention group, higher attendance generally was associated with greater weight loss.”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > RESULTS > ATTENDANCE AT SCHEDULED VISITS
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The principal finding of this study was that PCPs, collaborating with medical assistants, helped one group of their obese patients lose an average of 4.7% of their initial weight at 24 months.”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > DISCUSSION
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“brief counseling without enhancement did not result in the 4-kg weight loss expected in light of the results of the pilot study.9”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > DISCUSSION
What the sources say
- Not checked yetcites [9] Tsai AG Wadden TA Rogers MA Day SC Moore RH Islam BJ A primary care intervention for weight loss: results of a randomized controlled pilot study Obesity (Silver Spring) 2010 18 1614 1618 20019680 source
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Attendance was higher in the enhanced-lifestyle-counseling group than in the lifestyle-counseling group (P = 0.01)”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > RESULTS > ATTENDANCE AT SCHEDULED VISITS
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The frequency of attendance (across groups) declined from year 1 (81.7±24.9%) to year 2 (61.0±39.2%) (P<0.001).”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > RESULTS > ATTENDANCE AT SCHEDULED VISITS
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Participants in the usual-care, lifestyle-counseling, and enhanced-lifestyle-counseling groups attended 71.8±28.6%, 69.0±29.1%, and 76.7±27.4% of the 8 scheduled PCP visits, respectively.”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > RESULTS > ATTENDANCE AT SCHEDULED VISITS
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There were no deaths.”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > RESULTS > ADVERSE EVENTS
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The benefits of enhanced lifestyle counseling remained even after participants given sibutramine were excluded from the analyses.”
- Also stated in: § WEIGHT LOSS · plain
“The remaining 85 participants lost a mean of 4.3±0.8 kg at month 24, which was significantly greater than the loss for those who received usual care (1.7±0.7 kg) but did not differ significantly from the weight loss for those who received brief lifestyle counseling (2.9±0.7 kg).”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > Abstract > RESULTS
plaindirectn = 85- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § WEIGHT LOSS · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Enhanced lifestyle counseling was superior to usual care on both these measures of success (P = 0.003 and P = 0.02, respectively)”
- Also stated in: § CATEGORICAL WEIGHT LOSS · plain
“All categorical weight losses at 12 and 24 months were significantly greater in the group that received enhanced lifestyle counseling than in the group that received usual care.”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > Abstract > RESULTS
plaindirectn = 390- Asserted: passes — The authors put it forward as true.
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- Also stated in: § CATEGORICAL WEIGHT LOSS · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and declined across both groups from year 1 (72.1±25.4%) to year 2 (45.6±35.2%) (P<0.001).”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > RESULTS > ATTENDANCE AT SCHEDULED VISITS
plaincorrelational- Asserted: passes — The authors put it forward as true.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Blood pressure was essentially unchanged from normal baseline values.”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > RESULTS > CHANGES IN CARDIOVASCULAR RISK FACTORS
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Participants who received enhanced lifestyle counseling weighed significantly less than those who received usual care (P = 0.02)”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > RESULTS > BASELINE CHARACTERISTICS OF THE STUDY PARTICIPANTS
plaincorrelational- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and the maximum weight loss was generally reached at month 12 (Table 2).”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > RESULTS > WEIGHT LOSS
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Thirty-five percent of the participants assigned to this intervention lost 5% or more of their initial weight”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There were no significant differences between the intervention groups in the occurrence of serious adverse events.”
- Also stated in: § ADVERSE EVENTS · plain
“with no significant differences between groups (P = 0.556).”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > Abstract > RESULTS
plainn = 390- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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- Also stated in: § ADVERSE EVENTS · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Only three events — two cholecystectomies and one case of syncope — were judged by the study physicians to be related to the intervention.”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > RESULTS > ADVERSE EVENTS
plaindirectn = 2- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“All categorical weight losses at 12 and 24 months were significantly greater in the group that received enhanced lifestyle counseling than in the group that received usual care.”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > RESULTS > CATEGORICAL WEIGHT LOSS
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Enhanced lifestyle counseling was superior to usual care on both these measures of success (P = 0.003 and P = 0.02, respectively)”
- Also stated in: § WEIGHT LOSS · plain
“Enhanced lifestyle counseling resulted in significantly greater weight loss than did usual care (Table 2)”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > Abstract > RESULTS
plaindirectn = 390- Asserted: passes — The authors put it forward as true.
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- Also stated in: § WEIGHT LOSS · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Weight losses in all three groups differed significantly from one another at month 6”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > RESULTS > WEIGHT LOSS
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“A total of 73 hospitalizations for serious adverse events were reported by participants during the 2-year trial.”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > RESULTS > ADVERSE EVENTS
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Our study shows that combining quarterly PCP visits with brief monthly lifestyle coaching provided by medical assistants does not significantly increase weight loss, as compared with PCP visits alone.”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“In contrast, participants who received the usual care lost more than the expected 1 kg”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“The study also confirmed the problem of weight regain despite ongoing counseling for weight-loss maintenance.34”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > DISCUSSION
What the sources say
- Not checked yetcites [34] Sacks FM Bray GA Carey VJ Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates N Engl J Med 2009 360 859 873 19246357 PMC2763382 source
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Participants who received the brief lifestyle counseling attended significantly fewer coaching sessions than did those who received the enhanced counseling, despite the fact that the same personnel delivered both interventions.”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > DISCUSSION
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Given the demands on providers’ time, an increase in the frequency of PCP counseling does not appear to be feasible.8”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > Abstract > CONCLUSIONS
What the sources say
- Not checked yetcites [8] Kushner RF Barriers to providing nutrition counseling by physicians: a survey of primary care practitioners Prev Med 1995 24 546 552 8610076 source
hedged- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Enhanced weight-loss counseling helps about one third of obese patients achieve long-term, clinically meaningful weight loss.”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > Abstract > CONCLUSIONS
plaindirect- Asserted: passes — The authors put it forward as true.
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- Rests on an assumption: The trial participants are representative of obese adults in primary care practice.
None of the sources cited for this claim have been checked yet.
In the paper
“and the same is true for the addition of meal replacements to lifestyle modification.15,16”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > Abstract > CONCLUSIONS
What the sources say
- Not checked yetcites [15] Ashley JM St Jeor ST Schrage JP Weight control in the physician’s office Arch Intern Med 2001 161 1599 1604 11434791 source
- Not checked yetcites [16] Heymsfield SB van Mierlo CA van der Knaap HC Heo M Frier HI Weight management using a meal replacement strategy: meta and pooling analysis from six studies Int J Obes Relat Metab Disord 2003 27 537 549 12704397 source
plaindirect- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Enhanced lifestyle counseling offers a model for treating obesity in primary care practices with the help of regular staff members (PCPs and medical assistants).”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > DISCUSSION
plaindirect- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“Trials in which primary care providers (PCPs) offer counseling about diet and activity (i.e., lifestyle counseling) have led to weight loss of 2.5 kg or less over study periods ranging from 6 to 18 months.5–7”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > Abstract > CONCLUSIONS
What the sources say
- Not checked yetcites [5] Martin PD Dutton GR Rhode PC Horswell RL Ryan DH Brantley PJ Weight loss maintenance following a primary care intervention for low-income minority women Obesity (Silver Spring) 2008 16 2462 2467 18787526 PMC2753427 source
- Not checked yetcites [6] Christian JG Bessesen DH Byers TE Christian KK Goldstein MG Bock BC Clinic-based support to help overweight patients with type 2 diabetes increase physical activity and lose weight Arch Intern Med 2008 168 141 146 18227359 source
- Not checked yetcites [7] Ockene IS Hebert JR Ockene JK Effect of physician-delivered nutrition counseling training and an office-support program on saturated fat intake, weight, and serum lipid measurements in a hyperlipidemic population: Worcester Area Trial for Counseling in Hyperlipidemia (WATCH) Arch Intern Med 1999 159 725 731 10218753 source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Limited treatment contact is probably responsible for this modest degree of weight loss.1”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > Abstract > CONCLUSIONS
What the sources say
- Not checked yetcites [1] Preventive Services Task Force Screening for obesity in adults: recommendations and rationale Ann Intern Med 2003 139 930 932 14644896 source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“(Sensitivity analyses, in which multiple imputation was used to assess the effects of missing data, yielded similar results.)”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > RESULTS > WEIGHT LOSS
plain- Asserted: passes — The authors put it forward as true.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Delivery of the interventions was standardized across sites with the use of detailed protocols.”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > METHODS > PCPs AND LIFESTYLE COACHES
plain- Asserted: passes — The authors put it forward as true.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“the provision of interventions by primary care personnel who treated obese patients in their local practices (rather than the provision of interventions by specialized personnel to highly selected volunteer subjects)”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“probably because the weight-management support they were given (quarterly PCP visits, a calorie book, and a pedometer) to encourage them to remain in the study was greater than the support that would typically be provided in the primary care setting.”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > DISCUSSION
hedgedconditional- Asserted: passes — The authors put it forward as true.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“the withdrawal of sibutramine from the market, which clouded interpretation of the findings for the group of participants who received enhanced brief lifestyle counseling.”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > DISCUSSION
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“as suggested by our attendance data, participants might not be willing to make additional office visits.”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > DISCUSSION
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“and the high rate of study completion by participants (86%).”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Our findings suggest that PCPs may be able to assist one fifth of their obese patients in losing 5% or more of body weight by providing educational materials and briefly discussing weight management at quarterly visits.”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > DISCUSSION
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: The trial participants are representative of obese adults in primary care practice.
None of the sources cited for this claim have been checked yet.
In the paper
“By providing enhanced lifestyle counseling, as described here, PCPs could help a considerable minority of obese persons achieve clinically meaningful weight loss,11,29 which they might not achieve if they were simply told to reduce their weight on their own.”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > DISCUSSION
What the sources say
- Not checked yetcites [11] National Heart Lung and Blood Institute (NHLBI) Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: the evidence report: National Institutes of Health Obes Res 1998 6 Suppl 2 51S 209S [Erratum, Obes Res 1998;6:464.] 9813653
- Not checked yetcites [29] Wing RR Lang W Wadden TA Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes Diabetes Care 2011 34 1481 1486 21593294 PMC3120182 source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: The trial participants are representative of obese adults in primary care practice.
- It may state two separate claims as one. 18
- Probably not a substantial claim. 13
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“the mean (±SE) weight loss with usual care, brief lifestyle counseling, and enhanced brief lifestyle counseling was 1.7±0.7, 2.9±0.7, and 4.6±0.7 kg, respectively.”
- Also stated in: § WEIGHT LOSS · plain
“At month 24, the mean (±SE) weight loss among participants assigned to usual care, those assigned to brief lifestyle counseling, and those assigned to enhanced lifestyle counseling was 1.7±0.7, 2.9±0.7, and 4.6±0.7 kg, respectively.”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > Abstract > RESULTS
plainn = 390- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Also stated in: § WEIGHT LOSS · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“An analysis of weight loss in the 66 participants in the enhanced-lifestyle-counseling group who used meal replacements (without exposure to sibutramine) for most of the trial revealed a loss of 4.1±0.9 kg at month 24, which was significantly greater than that in the usual-care group (P = 0.04) but did not differ significantly from the weight loss in the brief-lifestyle- counseling group (P = 0.30”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > RESULTS > WEIGHT LOSS
plainn = 66- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Sibutramine was discontinued in five participants because of increases in blood pressure (≥10 mm Hg), in a sixth participant because of tachycardia, and in a seventh because of anxiety. Orlistat was discontinued in five participants because of gastrointestinal symptoms.”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > RESULTS > ADVERSE EVENTS
plaindirectn = 5- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“At baseline, participants who received enhanced lifestyle counseling chose one of three additional treatment enhancements: meal replacements (67 participants), sibutramine (38), or orlistat (24).”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > RESULTS > WEIGHT LOSS
plainn = 67- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Participants who received enhanced lifestyle counseling had significantly greater improvements in waist circumference and in HDL cholesterol and triglyceride levels at one or more assessments, as compared with the other two groups (in the intention-to-treat population) (Table 2A in the Supplementary Appendix).”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > RESULTS > CHANGES IN CARDIOVASCULAR RISK FACTORS
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Participants in the lifestyle-counseling group and those in the enhanced-lifestyle-counseling group attended 56.1±28.8% and 64.7±25.8% of the 25 scheduled coaching visits, respectively.”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > RESULTS > ATTENDANCE AT SCHEDULED VISITS
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The remaining 85 participants lost a mean of 4.3±0.8 kg at month 24, which was significantly greater than the loss for those who received usual care (1.7±0.7 kg) but did not differ significantly from the weight loss for those who received brief lifestyle counseling (2.9±0.7 kg).”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > RESULTS > WEIGHT LOSS
plainn = 85- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This included 21 events in 16 participants in the usual-care group, 26 events in 20 participants in the brief-lifestyle-counseling group, and 26 events in 22 participants in the enhanced-lifestyle-counseling group, with no significant differences between groups (P = 0.556).”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > RESULTS > ADVERSE EVENTS
plainn = 22- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“An intention-to-treat analysis, based on participants’initial choice of enhancement, revealed a mean weight loss of 3.9±1.0, 5.5±1.3, and 4.6±1.7 kg in these three subgroups, respectively, at month 24, with no significant differences among them.”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > RESULTS > WEIGHT LOSS
plainn = 67- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Eleven participants (16%) who initially chose meal replacements switched to a different enhancement, as did 15 participants (39%) who chose sibutramine (including 9 in whom the drug was withdrawn in response to the FDA’s actions) and 8 participants (33%) who chose orlistat.”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > RESULTS > WEIGHT LOSS
plainn = 11- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Long-term weight loss in the group that received enhanced lifestyle counseling (as well as in the group that received brief lifestyle counseling without enhancement) was greater than weight loss observed in other primary care trials,5–7,30,31 with the exception of a study involving extremely obese patients who were treated with intensive group lifestyle modification and weight-loss medications.32”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > DISCUSSION
What the sources say
- Not checked yetcites [5] Martin PD Dutton GR Rhode PC Horswell RL Ryan DH Brantley PJ Weight loss maintenance following a primary care intervention for low-income minority women Obesity (Silver Spring) 2008 16 2462 2467 18787526 PMC2753427 source
- Not checked yetcites [6] Christian JG Bessesen DH Byers TE Christian KK Goldstein MG Bock BC Clinic-based support to help overweight patients with type 2 diabetes increase physical activity and lose weight Arch Intern Med 2008 168 141 146 18227359 source
- Not checked yetcites [7] Ockene IS Hebert JR Ockene JK Effect of physician-delivered nutrition counseling training and an office-support program on saturated fat intake, weight, and serum lipid measurements in a hyperlipidemic population: Worcester Area Trial for Counseling in Hyperlipidemia (WATCH) Arch Intern Med 1999 159 725 731 10218753 source
- Not checked yetcites [30] Cohen MD D’Amico FJ Merenstein JH Weight reduction in obese hypertensive patients Fam Med 1991 23 25 28 2001777
- Not checked yetcites [31] Kumanyika S Fassbender J Sarwer D One-year results of the Think Health! study of weight management in primary care practice Obesity (Silver Spring) (in press) 22051940 source
- Not checked yetcites [32] Ryan DH Johnson WD Myers VH Nonsurgical weight loss for extreme obesity in primary care settings: results of the Louisiana Obese Subjects Study Arch Intern Med 2010 170 146 154 20101009 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The study had 80% power to detect a 2.75-kg difference in weight change at month 24 between the usual-care and brief-lifestyle-counseling groups and between the usual-care and enhanced-lifestyle-counseling groups.”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > METHODS > STATISTICAL ANALYSIS
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Overweight patients who received eight brief counseling sessions (and met quarterly with their PCP to manage coexisting illnesses) lost 4.4 kg in 6 months, as compared with 0.9 kg for the patients in the control group, who were limited to quarterly PCP visits.”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > Abstract > CONCLUSIONS
What the sources say
- Not checked yetcites [9] Tsai AG Wadden TA Rogers MA Day SC Moore RH Islam BJ A primary care intervention for weight loss: results of a randomized controlled pilot study Obesity (Silver Spring) 2010 18 1614 1618 20019680 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Participants were randomly assigned to interventions (in equal numbers) with the use of a computer-generated algorithm that was operated by the Investigational Drug Service at the University of Pennsylvania.”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > METHODS > SCREENING AND RANDOMIZATION
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
In the paper
“All providers were certified in intervention delivery at baseline and were recertified at 6-month intervals, according to previously described methods.27”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > METHODS > PCPs AND LIFESTYLE COACHES
What the sources say
- Not checked yetcites [27] Wadden TA West DS Delahanty L The Look AHEAD study: a description of the lifestyle intervention and the evidence supporting it Obesity (Silver Spring) 2006 14 737 752 16855180 PMC2613279
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Approximately 86% of the participants in each group had their weight measured at 24 months (Fig. 1).”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > RESULTS > BASELINE CHARACTERISTICS OF THE STUDY PARTICIPANTS
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Weight was measured by a certified staff member at baseline and at 6, 12, 18, and 24 months with the use of a digital scale (Tanita BWB-800).”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > METHODS > OUTCOMES AND ASSESSMENTS
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“Both orlistat (GlaxoSmithKline) and sibutramine (Abbott) increase weight loss by approximately 3 to 5 kg, as compared with placebo,12–14”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > Abstract > CONCLUSIONS
What the sources say
- Not checked yetcites [12] Davidson MH Hauptman J DiGirolamo M Weight control and risk factor reduction in obese subjects treated for 2 years with orlistat: a randomized controlled trial JAMA 1999 281 235 242 [Erratum, JAMA 1999;281:1174.] 9918478 source
- Not checked yetcites [13] James WP Astrup A Finer N Effect of sibutramine on weight maintenance after weight loss: a randomised trial Lancet 2000 356 2119 2125 11191537 source
- Not checked yetcites [14] Li Z Maglione M Tu W Meta-analysis: pharmacologic treatment of obesity Ann Intern Med 2005 142 532 546 15809465 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Changes in weight in the intention-to-treat population were compared with the use of repeated-measures linear mixed-effects models (for continuous outcomes) and generalized-estimating-equation models (for categorical outcomes), which controlled for initial weight, age, sex, race or ethnic group, and study site.”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > METHODS > STATISTICAL ANALYSIS
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Assignments were stratified by clinic, with randomly varied block sizes (3, 6, or 9).”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > METHODS > SCREENING AND RANDOMIZATION
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“a difference addressed in the analyses by the a priori decision to control for initial weight.”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > RESULTS > BASELINE CHARACTERISTICS OF THE STUDY PARTICIPANTS
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“which is a common criterion for clinically meaningful weight loss.11,29”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > DISCUSSION
What the sources say
- Not checked yetcites [11] National Heart Lung and Blood Institute (NHLBI) Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: the evidence report: National Institutes of Health Obes Res 1998 6 Suppl 2 51S 209S [Erratum, Obes Res 1998;6:464.] 9813653
- Not checked yetcites [29] Wing RR Lang W Wadden TA Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes Diabetes Care 2011 34 1481 1486 21593294 PMC3120182 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“Holm’s procedure28 was used to adjust for multiple comparisons and to identify significant differences in at least one of the two between-group comparisons (P = 0.025).”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > METHODS > STATISTICAL ANALYSIS
What the sources say
- Not matchedcites [28] Holm S A simple sequentially rejective multiple test procedure Scand J Stat 1979 6 65 70
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
- Not matched
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The strengths of this study include the randomized design”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“the provision of free treatment enhancements (which may limit the generalizability of the results)”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > DISCUSSION
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Our data support the screening by PCPs of all adults for obesity, as well as efforts to help patients understand the health consequences of excess weight and the benefits of modest weight loss; these practices are consistent with prior recommendations.1,11”
§ A Two-Year Randomized Trial of Obesity Treatment in Primary Care Practice > DISCUSSION
What the sources say
- Not checked yetcites [1] Preventive Services Task Force Screening for obesity in adults: recommendations and rationale Ann Intern Med 2003 139 930 932 14644896 source
- Not checked yetcites [11] National Heart Lung and Blood Institute (NHLBI) Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: the evidence report: National Institutes of Health Obes Res 1998 6 Suppl 2 51S 209S [Erratum, Obes Res 1998;6:464.] 9813653
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
- Rests on an assumption: The trial participants are representative of obese adults in primary care practice.
The paper relies on this without support.
The trial participants are representative of obese adults in primary care practice.
“Enhanced weight-loss counseling helps about one third of obese patients achieve long-term, clinically meaningful weight loss.”
“By providing enhanced lifestyle counseling, as described here, PCPs could help a considerable minority of obese persons achieve clinically meaningful weight loss,11,29 which they might not achieve if they were simply told to reduce their weight on their own.”
The paper relies on this without support.
The primary care practices and staff in the trial are typical of primary care practices generally.
“Enhanced lifestyle counseling offers a model for treating obesity in primary care practices with the help of regular staff members (PCPs and medical assistants).”
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?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“A large body of clinical evidence has shown that voluntary attempts to eat less and exercise more render only modest effects on body weight in most individuals with severe obesity96,97.”
From Joint international consensus statement for ending stigma of obesity (2020) · cites this paper as [97]
Experimental — accuracy not yet measuredIn the citing paper
“large randomised clinical trials with long-term dietary interventions aiming weight loss showed that individuals under intensive lifestyle interventions lose about 4·8 kg (2,38) .”
From Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trials (2013) · cites this paper as [38]
In the citing paper
“Researchers continue the search for effective weight loss interventions that can be applied in outpatient settings but these are often time consuming and resource intensive, requiring repeated counseling (3).”
From Effectiveness of a Smartphone Application for Weight Loss Compared With Usual Care in Overweight Primary Care Patients: A Randomized, Controlled Trial (2014) · cites this paper as [3]
In the citing paper
“Combining a weight loss app with a proven weight-loss counseling program could also be a powerful combination of tools (3).”
From Effectiveness of a Smartphone Application for Weight Loss Compared With Usual Care in Overweight Primary Care Patients: A Randomized, Controlled Trial (2014) · cites this paper as [3]
Citations
Cites
Grundy, S. M., Bilheimer, D. W., Chait, A., Clark, L. T., Denke, M. A., Havel, R. J., Hazzard, W. R., Hulley, S. B., Hunninghake, D. B., Kreisberg, R. A., et al. (1993) · JAMA · doi:10.1001/jama.269.23.3015 · Cited by 27,944
Expert Panel on Detection, E. (2001) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.285.19.2486 · Cited by 26,011
A Simple Sequentially Rejective Multiple Test Procedure
(1979) · Scandinavian Journal of Statistics · doi:10.2307/4615733 · Cited by 21,526
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
(1998) · PubMed · Cited by 2,737
Comparison of Weight-Loss Diets with Different Compositions of Fat, Protein, and Carbohydrates
Sacks, F. M., Bray, G. A., Carey, V. J., Smith, S. R., Ryan, D. H., Anton, S. D., McManus, K., Champagne, C. M., Bishop, L. M., Laranjo, N., et al. (2009) · New England Journal of Medicine · doi:10.1056/nejmoa0804748 · Cited by 1,966
Wing, R. R., Lang, W., Wadden, T. A., Safford, M., Knowler, W. C., Bertoni, A. G., Hill, J. O., Brancati, F. L., Peters, A., Wagenknecht, L., et al. (2011) · Diabetes Care · doi:10.2337/dc10-2415 · Cited by 1,828
Self-citationDavidson, M. H., Hauptman, J., DiGirolamo, M., Foreyt, J. P., Halsted, C. H., Heber, D., Heimburger, D. C., Lucas, C. P., Robbins, D. C., Chung, J., et al. (1999) · JAMA · doi:10.1001/jama.281.3.235 · Cited by 947
Effect of Sibutramine on Cardiovascular Outcomes in Overweight and Obese Subjects
James, W. P. T., Caterson, I. D., Coutinho, W., Finer, N., Van Gaal, L. F., Maggioni, A. P., Torp-Pedersen, C., Sharma, A. M., Shepherd, G. M., Rode, R. A., et al. (2010) · New England Journal of Medicine · doi:10.1056/nejmoa1003114 · Cited by 943
Research works printed but not linked: 2
- Holm S, 1979, Scand J Stat, 6, 65
- Cohen MD, 1991, Fam Med, 23, 25
Cited by
Sorted by citations
2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults
Jensen, M. D., Ryan, D. H., Apovian, C. M., Ard, J. D., Comuzzie, A. G., Donato, K. A., Hu, F. B., Hubbard, V. S., Jakicic, J. M., Kushner, R. F., et al. (2014) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2013.11.004 · Cited by 4,058
Self-citationJensen, M. D., Ryan, D. H., Apovian, C. M., Ard, J. D., Comuzzie, A. G., Donato, K. A., Hu, F. B., Hubbard, V. S., Jakicic, J. M., Kushner, R. F., et al. (2014) · Circulation · doi:10.1161/01.cir.0000437739.71477.ee · Cited by 2,735
“The remaining 51 trials (72 articles) were rated good or fair quality (22,23,69-138), and included in the evidence base that was used to formulate the ESs and recommendations.”
BackgroundSelf-citationFrom ideas to efficacy: The ORBIT model for developing behavioral treatments for chronic diseases
Czajkowski, S. M., Powell, L. H., Adler, N., Naar-King, S., Reynolds, K. D., Hunter, C. M., Laraia, B., Olster, D. H., Perna, F. M., Peterson, J. C., et al. (2015) · Health Psychology · doi:10.1037/hea0000161 · Cited by 1,161
Joint international consensus statement for ending stigma of obesity
Rubino, F., Puhl, R. M., Cummings, D. E., Eckel, R. H., Ryan, D. H., Mechanick, J. I., Nadglowski, J., Ramos Salas, X., Schauer, P. R., Twenefour, D., et al. (2020) · Nature Medicine · doi:10.1038/s41591-020-0803-x · Cited by 1,152
“A large body of clinical evidence has shown that voluntary attempts to eat less and exercise more render only modest effects on body weight in most individuals with severe obesity 96, 97 .”
BackgroundKhera, R., Murad, M. H., Chandar, A. K., Dulai, P. S., Wang, Z., Prokop, L. J., Loomba, R., Camilleri, M., & Singh, S. (2016) · JAMA · doi:10.1001/jama.2016.7602 · Cited by 865
Metadata
- Authors
- Wadden, T. A., Volger, S., Sarwer, D. B., Vetter, M. L., Tsai, A. G., Berkowitz, R. I., Kumanyika, S., Schmitz, K. H., Diewald, L. K., Barg, R., Chittams, J., & Moore, R. H.
- Affiliations
- University of Pennsylvania (US)
- University of Colorado Anschutz (US)
- Children's Hospital of Philadelphia (US)
- University of Pennsylvania Health System (US)
- ORCID
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2011-11-24
- Volume
- 365
- Issue
- 21
- Pages
- 1969-1979
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- PMC
- PMC3282598
- OpenAlex
- W2137765752
- Cited by
- 487
- References
- 39
- Citations by year
- 2026: 5 · 2025: 8 · 2024: 13 · 2023: 28 · 2022: 24 · 2021: 31 · 2020: 38 · 2019: 30 · 2018: 27 · 2017: 34 · 2016: 41 · 2015: 49 · 2014: 49 · 2013: 61 · 2012: 45
- FWCI
- 37.24
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5u01hl087072-05)
- National Heart, Lung, and Blood Institute (U01-HL087072)
- Topics
- Health Sciences › Medicine › Pharmacology (medical) › Pharmacology and Obesity Treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity and Health Practices
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- obesity, weight loss, lifestyle intervention, primary care, meal replacement, orlistat, sibutramine, weight management, long-term weight maintenance
- MeSH terms
- Adult, Behavior Therapy, Cardiovascular Diseases, Counseling, Diet, Reducing, Female, Humans, Life Style, Male, Middle Aged, Obesity, Primary Health Care, Risk Factors, Weight Loss, Exercise, Risk Reduction Behavior, Intention to Treat Analysis
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.
A language model drew the claims from the paper on 2026-10-10, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-10 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
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 ›
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