Weight loss maintenance is a critical challenge for obesity treatment. Extended treatment length and enactment of key behaviors (e.g., physical activity, self-monitoring) can improve maintenance. Treatment studies have incorporated these strategies;however, the most intensive treatment typically occurs during weight loss initiation with the maintenance phase occurring after treatment novelty has faded. Increasing duration improves weight loss, but there is a point of diminishing returns as people eventually stop attending sessions. Recruiting people who have recently lost weight to a maintenance-specific intervention may be a viable alternative. A key issue for maintenance-specific interventions is defining the optimal timing of delivery. One approach suggests that maintenance will be enhanced by teaching people about the key behaviors required and assisting them with these behaviors. Following this approach, maintenance programs would be designed like weight loss programs where sessions addressing relevant behaviors occur on a pre- set schedule. Another approach recognizes that maintenance inevitably includes periods of weight regain and will be enhanced if individuals use cognitive and behavioral strategies to reverse small weight gains. Following this approach, intervention contact would occur in a """"""""just-in-time"""""""" manner, in response to weight trends. Data from our Keep It Off pilot study suggest that effectiveness may be maximized by integrating these two complementary approaches and including core content, continued support and tailored feedback. We propose to evaluate the efficacy of this innovative approach to promoting long-term maintenance among adults who have recently lost weight. Four hundred adults who have recently lost at least 5 percent of their weight will be recruited and randomly assigned to: 1) a brief intervention comparison group during which participants will receive two phone sessions addressing key maintenance behaviors or 2) an enhanced scheduled maintenance intervention (SMI+) that includes a core set of phone sessions addressing maintenance behaviors and a second phase with bimonthly continued support calls, monthly tailored feedback reports and """"""""just in time"""""""" support to reverse small weight gains. Outcomes will be assessed at 6, 12, 18, and 24 months, with 24-month weight change and maintenance as the primary outcomes. The proposed research is innovative because it targets individuals who have recently lost weight and evaluates a novel intervention to enhance weight maintenance. Results will provide important information on the effectiveness of a new weight loss maintenance intervention that could potentially be widely disseminated.
| Crain, A L; Sherwood, N E; Martinson, B C et al. (2018) Mediators of Weight Loss Maintenance in the Keep It Off Trial. Ann Behav Med 52:9-18 |
| Crane, Melissa M; Jeffery, Robert W; Sherwood, Nancy E (2017) Exploring Gender Differences in a Randomized Trial of Weight Loss Maintenance. Am J Mens Health 11:369-375 |
| Fuglestad, Paul T; Rothman, Alexander J; Jeffery, Robert W et al. (2015) Regulatory Focus, Proximity to Goal Weight, and Weight Loss Maintenance. Am J Health Behav 39:709-20 |
| Senso, Meghan M; Anderson, Christopher P; Crain, A Lauren et al. (2014) Self-reported activity and accelerometry in 2 behavior-maintenance trials. Am J Health Behav 38:254-64 |
| Sherwood, Nancy E; Crain, A Lauren; Martinson, Brian C et al. (2013) Enhancing long-term weight loss maintenance: 2 year results from the Keep It Off randomized controlled trial. Prev Med 56:171-7 |
| Fuglestad, Paul T; Jeffery, Robert W; Sherwood, Nancy E (2012) Lifestyle patterns associated with diet, physical activity, body mass index and amount of recent weight loss in a sample of successful weight losers. Int J Behav Nutr Phys Act 9:79 |
| Sherwood, Nancy E; Crain, A Lauren; Martinson, Brian C et al. (2011) Keep it off: a phone-based intervention for long-term weight-loss maintenance. Contemp Clin Trials 32:551-60 |
