Maintenance of Weight Loss After Initiation of Nutrition Training: A Randomized Trial
Open accessAbstract
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. DESIGN: 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). SETTING: 3 primary care clinics at the Veterans Affairs Medical Center in Durham and Raleigh, North Carolina. PATIENTS: 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. INTERVENTION: 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. MEASUREMENTS: 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. LIMITATIONS: Results may not generalize to other settings or populations. Dietary intake and physical activity were self-reported. Duration was limited to 56 weeks. CONCLUSION: An intervention focused on maintenance-specific strategies and delivered in a resource-conserving way modestly slowed the rate of weight regain in obese adults. PRIMARY FUNDING SOURCE: Veterans Affairs Health Services Research and Development Service.
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Although research is mixed, several studies show improved weight loss outcomes in patients receiving weight maintenance-specific training compared with those receiving only traditional weight loss training.
“Although the research is mixed, several studies show improved weight loss outcomes in patients receiving weight maintenance-specific training, compared with those who only receive traditional weight loss training76–79.”
From Maintenance of Lost Weight and Long-Term Management of Obesity (2018) · cites this paper as [78]
The Abstract Results report significantly less weight regain with maintenance-specific training, and the Discussion compares this finding with other maintenance trials. However, this study compared the intervention with usual care, which involved no contact except study measurements—not with continued traditional weight-loss training. The cited paper therefore supports the benefit of maintenance training, but not the stated comparator. (LLM, conf=0.87)
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- Authors
- Voils, C. I., Olsen, M. K., Gierisch, J. M., McVay, M. A., Grubber, J. M., Gaillard, L., Bolton, J., Maciejewski, M. L., Strawbridge, E., & Yancy, W. S.
- Affiliations
- Duke Medical Center (US)
- ORCID
- Venue
- Annals of Internal Medicine
- Publisher
- American College of Physicians
- Published
- 2017-04-04
- Volume
- 166
- Issue
- 7
- Pages
- 463-471
- ISSN
- 0003-4819 (ISSN-L)
- 1539-3704
- PMC
- PMC5483942
- OpenAlex
- W2593839531
- Semantic Scholar
- af8b16ea4e676a50622c327900053253086880cb
- Cited by
- 50
- References
- 26
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 5 · 2023: 3 · 2022: 10 · 2021: 5 · 2020: 5 · 2019: 10 · 2018: 4 · 2017: 5
- FWCI
- 6.16
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Annals of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Health Services Research and Development (IIR 11-040, RCS 14-443, RCS 10-391)
- National Heart, Lung, and Blood Institute (K23 HL127334)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Keywords
- weight loss maintenance, weight regain, obesity, nutrition training, telephone-delivered intervention, relapse prevention, self-monitoring, social support, veterans, physical activity, energy intake
- MeSH terms
- Health Expenditures, Female, Follow-Up Studies, Humans, Male, Middle Aged, Obesity, Social Support, Weight Loss, Exercise, Treatment Outcome, Health Care Costs, Patient Satisfaction, Directive Counseling, Secondary Prevention, Weight Reduction Programs
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 ›
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