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Weight Maintenance with Five Clinic-Based and Phone-Based Treatment Options.
Grant L, Gotthelf L.
Obes 2006;14 suppl:A101.
Objective: Weight maintenance is more challenging than weight loss for most individuals but participation in a structured program with accountability enhances success.
Method: This study assessed maintenance of weight loss for patients in five weight-loss treatment options (four clinic-based and one phone-based) who were enrolled in three Health Management Resources (HMR®) centers between 1/1/02 and 3/31/05. Patients who completed > 12 weeks of weight loss ("core" classes) and had at least one follow-up weight were included in this sample. HMR offers a range of weight-loss treatment options, including medically supervised low and very low-calorie diets, moderately restricted diets (Healthy Solutions®), and phone-based programs (HMR at Home®). All options for weight loss and maintenance focus on the same lifestyle chnages: increased physical activity (> 2000 kcals/wk); the use of meal replacements (> 35 servings/wk in weight loss and 14/wk in maintenance); and increased vegetable and fruit intake (> 35 servings/wk) for some weight-loss options and all maintenance. Attendance, phone calls, and record-keeping commitments add accountability in all treatments.
Results: Follow-up weights were available for approximately 83% of patients completing the core classes. In the four clinic options, patients were keeping off between 66.0% and 71.1% of their weight loss at an average follow-up time of 64 weeks. Medically supervised patients were keeping off an average of 44.6 lbs. (16.6% of initial body weight) and Healthy Solutions patients were keeping off an average of 27.5 lbs. (12.4% of initial weight). In HMR at Home, patients reported keeping off 26.8 lbs. (12.2% of initial body weight) over a total of 46.7 weeks.
| Measure |
MS |
Int |
Mod |
MS |
AH |
| # Patients |
603 |
97 |
74 |
259 |
52 |
Start Weight
(lbs.) |
268.9 |
201.9 |
191.5 |
221.6 |
218.8 |
Weight Loss
(lbs.) |
-62.8 |
-40.5 |
-36.0 |
-41.6 |
-33.7 |
| Wgt Loss at Follow-up (lbs.) |
-44.6 |
-28.8 |
-25.3 |
-27.5 |
-26.8 |
| % Wgt Loss Maintained |
71.1 |
71.0 |
70.2 |
66.0 |
79.4 |
| % Initial Wgt Maintained |
16.6 |
14.2 |
13.2 |
12.4 |
12.2 |
| Weeks in Maintenance |
33.7 |
37.7 |
37.5 |
37.9 |
20.7 |
| Total Treatment Weeks |
63.9 |
67.8 |
63.1 |
65.4 |
46.7 |
Medically Supervised (MS); Intermediate (Int); Moderate (Mod); Healthy Solutions (HS); HMR at Home (AH)
Conclusion: Weight losses of 40—60 lbs. are possible and necessary in order for patients to maintain significant amounts of weight (> 10%). In summary, patients in a structured, research-based behavioral program experienced successful weight maintenance outcomes both in clinic-based options and the phone-based option.
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