Effectiveness of two weight-loss interventions in clinical practice

January 01, 0001

Effectiveness of two weight-loss interventions in clinical practice

These US authors conducted a randomized, controlled trial to examine the effects of two behavioral weight-loss interventions in 415 obese patients with at least one cardiovascular risk factor. Participants were recruited from six primary care practices; 63.6% were women, 41.0% were black, and the mean age was 54.0 years. One intervention provided patients with weight-loss support remotely — through the telephone, a study-specific Web site, and e-mail. The other intervention provided in-person support during group and individual sessions, along with the three remote means of support. There was also a control group in which weight loss was self-directed. Outcomes were compared between each intervention group and the control group and between the two intervention groups. For both interventions, primary care providers reinforced participation at routinely scheduled visits. The trial duration was 24 months.

They found: "At baseline, the mean body-mass index (the weight in kilograms divided by the square of the height in meters) for all participants was 36.6, and the mean weight was 103.8 kg. At 24 months, the mean change in weight from baseline was -0.8 kg in the control group, -4.6 kg in the group receiving remote support only (significant), and -5.1 kg in the group receiving in-person support (significant). The percentage of participants who lost 5% or more of their initial weight was 18.8% in the control group, 38.2% in the group receiving remote support only, and 41.4% in the group receiving in-person support. The change in weight from baseline did not differ significantly between the two intervention groups."

The authors concluded: "In two behavioral interventions, one delivered with in-person support and the other delivered remotely, without face-to-face contact between participants and weight-loss coaches, obese patients achieved and sustained clinically significant weight loss over a period of 24 months."

These interventions are feasible for primary care practice.

For the full abstract, click here.

N Engl J Med Published online 15 November 2011 © 2011 to the Massachusetts Medical Society
Comparative Effectiveness of Weight-Loss Interventions in Clinical Practice. Lawrence J. Appel, Jeanne M. Clark, Hsin-Chieh Yeh, et al. Correspondence to Dr. Appel: lappel@jhmi.edu

Category: T. Endocrine/Metabolic/Nutritional, P. Psychological. Keywords: obesity, weight loss, internet, telephone, in-person support, randomized controlled trial, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 6 December 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.