In the Journals

Personalized weight-loss interventions effective among obese, sedentary primary care patients

A home-based, personalized intervention that included telephone counseling, individually tailored print materials, and DVDs, in addition to face-to-face meetings, was effective in promoting weight loss and increasing physical activity among primary care patients with obesity, according to data published in the Annals of Family Medicine.

The researchers further reported that the effects of the tailored intervention peaked at 12 months, but later waned at 24 months.

“Despite numerous efforts to identify successful weight-loss strategies, the prevalence of obesity has remained stable,” Charles B. Eaton, MD, MS, FAHA, of the Alpert Medical School of Brown University, in Providence, Rhode Island, and colleagues wrote. “Although interventions can produce weight reduction to improve health and delay onset of diabetes and hypertension, the existing research-based programs have not been translated into clinical practice.”

To test an individually tailored lifestyle weight-loss intervention aimed at aiding primary care patients who are obese, the researchers conducted a 24-month randomized clinical trial among 24 practices in Rhode Island, recruiting 211 participants identified by their physicians as sedentary and obese, yet motivated to increase physical activity. Patients were randomly assigned to one of two groups — a standard intervention group or an enhanced intervention group.

Patients in both groups received three face-to-face weight loss meetings. However, the enhanced intervention group also received telephone counseling, individually tailored print materials, and DVDs focused on diet and physical activity. Active intervention occurred in year 1, with a tapered maintenance phase in year 2.

According to the researchers, significantly more patients in the enhanced group lost 5% of their baseline weight than those who received the standard intervention (group by visit, P < .001). Although the difference was significant at 6 months (37.2% among the enhanced intervention group vs 12.9% in the standard group) and 12 months (47.8% compared with 11.6%), that was no longer the case by 18 months (31.4% vs 26.7%) or 24 months (33.3% vs 24.6%).

In addition, the enhanced intervention group reported significantly more minutes of moderate-to-vigorous physical activity over time than those who receive the standard intervention (group by visit, P = .04). The differences in minutes per week at 6 months was 95.7 for the enhanced group, compared with 68.3 minutes for those in the standard group. At 12 months, the difference was 126.1 vs 73.7, at 18 months it was 103.7 vs 63.7, and at 24 months it was 101.3 vs 75.4.

“Home-based, individually tailored weight loss interventions with minimal face-to-face contact can be effective for helping patients reach clinically significant weight loss and increased physical activity goals, realizing that only 25% to 35% of participants will be able to maintain a 5% clinically relevant weight loss at 24 months, if our findings are generalizable,” Eaton and colleagues wrote. “Better understanding the amount of and channel for continued contact needed to support maintenance of weight loss and physical activity is needed for the long-term success of obesity and sedentary lifestyle management in primary care.” – by Jason Laday

Disclosure: The researchers report no relevant financial disclosures.