Lifestyle strategies after intentional weight loss: results from the MAINTAIN-pc randomized trial

Tanya M Halliday; Molly McFadden; Maribel Cedillo; Bethany Barone Gibbs; Rachel Hess; Cindy Bryce; Gary S Fischer; Kimberly Huber; Kathleen M McTigue; Molly B Conroy

doi:10.1249/tjx.0000000000000220

Lifestyle strategies after intentional weight loss: results from the MAINTAIN-pc randomized trial

Transl J Am Coll Sports Med. 2023 Spring;8(2):e000220. doi: 10.1249/tjx.0000000000000220. Epub 2023 Feb 10.

Authors

Affiliations

¹ Department of Health and Kinesiology, College of Health, University of Utah, Salt Lake City, UT, USA.
² Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA.
³ Division of General Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA.
⁴ Department of Health and Human Development, University of Pittsburgh, Pittsburgh, PA, USA.
⁵ Division of Health System Innovation and Research, Departments of Population Health Sciences and Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA.
⁶ Department of Health Policy & Management, Graduate School of Public Health, University of Pittsburgh, Pittsburgh PA, USA.
⁷ Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
⁸ Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Abstract

Introduction/purpose: Weight maintenance following intentional weight loss is challenging and often unsuccessful. Physical activity and self-monitoring are strategies associated with successful weight loss maintenance. However, less is known about the type and number of lifestyle strategies used following intentional weight loss. The purpose of this study was to determine the types and amounts of strategies associated with successful long-term weight loss maintenance.

Methods: Data from the 24-month Maintaining Activity and Nutrition Through Technology-Assisted Innovation in Primary Care (MAINTAIN-pc) trial were analyzed. MAINTAIN-pc recruited adults (n=194; 53.4±12.2 years of age, body mass index (BMI): 30.4±5.9 kg/m², 74% female) with recent intentional weight loss of ≥5%, randomized to tracking tools plus coaching (i.e., coaching group) or tracking tools without coaching (i.e., tracking-only group). At baseline, 6, 12, and 24 months, participants reported lifestyle strategies used in the past 6 months, including self-monitoring, group support, behavioral skills, and professional support. General linear models evaluated changes in the number of strategies over time between groups and the consistency of strategies used over the 24-month intervention.

Results: At baseline, 100% used behavioral skills, 73% used group support, 69% used self-monitoring, and 68% used professional support in the past 6 months; at 24 months, these rates were 98%, 60%, 75%, and 61%, respectively. While the number of participants utilizing individual strategies did not change significantly over time, the overall number of strategies participants reported decreased. More strategies were used at baseline and 6 months compared to 12- and 24-month follow-ups. The coaching group used more strategies at months 6 and 12 than the tracking-only group. Consistent use of professional support strategies over the 24-month study period was associated with less weight regain.

Conclusion: Weight loss maintenance interventions that incorporate continued follow-up and support from healthcare professionals are likely to prevent weight regain after intentional weight loss.

Keywords: electronic-health-record-delivered intervention; primary care; professional support; weight loss maintenance.

Abstract

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