Personal contact is best strategy for maintaining successful weight loss

Regular personal contact with a health care professional, even by phone, is more effective than other approaches to long-term maintenance of a stable body weight after successful weight loss. A randomised controlled trial in the United States enrolled 1,032 men and women with hypertension and/or dyslipidaemia who had successfully lost at least 4 kg during a six-month group-based program of dietary change and physical activity. They were randomised to one of three interventions during a 30-month follow-up study. The least intensive was ‘self-directed control’, in which participants received a package of printed materials supporting their behavioural changes and saw a study staff member at a single 12-month visit. Another group used an interactive website to support their weight loss. It features included a facility for setting personal goals and action plans (and then monitoring them), graphing personal data over time, and reminder emails and phone calls if they failed to log on as often as they had planned. The third group had a five to 15 minute phone call from a staff member every month, except for every fourth month when they had a 45-60 minute individual, face-to-face consultation. Participants had lost an average of 8.5 kg in the first phase of the study. Overall, roughly half the weight was regained in the subsequent 30 months, but those having continued personal contact regained significantly less (4.0 kg) than those randomised to the minimalist self-directed strategy (5.5 kg). The Internet-based strategy had some early benefits, with less weight regain at 18 and 24 months than the minimalist strategy, but no significant difference by 30 months (5.2 kg). “Relatively short-term behavioural interventions for adults result in clinically significant weight loss, but regain is an intractable problem,” the researchers said. Despite the benefits from sustaining weight loss once it had been achieved, there had been surprisingly little research on the issue. This trial added to the data, but also emphasised the need for continuing efforts to develop and test effective — and cost-effective — long-term strategies. Reference...