Overweight and obesity are the second leading cause of preventable death, primarily through effects on cardiovascular disease (CVD) risk factors and cancer. Despite inclusion of weight control as a core component of treatment guidelines for hypertension, hyperlipidemia, and type 2 diabetes, the obesity epidemic continues to grow, affecting over 100 million Americans. A major factor contributing to this escalating epidemic is the disappointingly common phenomenon of re-gain of weight after successful initial weight loss. We recently completed a pilot trial assessing the feasibility and impact of two mind-body interventions from the Chinese Medicine tradition for weight loss maintenance in overweight and obese adults. Results of the pilot suggested that the Tapas Acupressure Technique (TAT) warrants further research as a potential tool for weight loss maintenance. The TAT procedure combines self-acupressure administration with specific mental focus. Patients are taught how to first identify counterproductive beliefs and actions, focus on those images while applying pressure to acupoints GB21, BL1, and Yin Tang, and then transition to a focus on positive images. We now propose a randomized clinical trial evaluating the efficacy of TAT compared to a usual care control support group for the primary outcome of weight loss maintenance. We will recruit obese and overweight adults from community and managed care settings. Those meeting eligibility requirements will be assigned to a 20-week intensive group-based behavioral weight loss intervention. Approximately 288 patients who upon completion of the weight loss component meet threshold weight loss criteria will then be randomly assigned to either TAT instruction or the facilitated support group control. Patients in both groups will attend a total of 8 group meetings over 6 months for a total of 13 contact hours, and patients in the TAT group will be advised to practice the technique at home. Participants will be weighed at baseline, randomization, and then again at 3, 6, 9, and 12 months. Questionnaires will also be administered at baseline and one year follow-up toward measuring both secondary outcomes (quality of life and psychosocial function) and potential mediators (diet, physical activity, food cravings, psychosocial stress). Statistically significant improvements in weight loss maintenance in the proposed trial could indicate inclusion of TAT as a standard weight loss maintenance intervention within the conventional care setting. The relevance of this research to public health is: Overweight and obesity are the second leading cause of preventable death, primarily through effects on cardiovascular disease (CVD) risk factors and cancer. Despite inclusion of weight control as a core component of treatment guidelines for hypertension, hyperlipidemia, and type 2 diabetes, the obesity epidemic continues to grow, affecting over 100 million Americans.
