Changes in eating, physical activity and related behaviors in a primary care-based weight loss intervention

S. Volger; T. A. Wadden; D. B. Sarwer; R. H. Moore; J. Chittams; L. K. Diewald; E. Panigrahi; R. I. Berkowitz; K. Schmitz; M. L. Vetter; Thomas A. Wadden; David B. Sarwer; Robert I. Berkowitz; Jesse Chittams; Lisa Diewald; Shiriki Kumanyika; Renee Moore; Kathryn Schmitz; Adam G. Tsai; Marion Vetter; Sheri Volger; Caroline H. Moran; Jeffrey Derbas; Megan Dougherty; Zahra Khan; Jeffrey Lavenberg; Eva Panigrahi; Joanna Evans; Ilana Schriftman; Dana Tioxon; Victoria Webb; Catherine Williams-Smith; Ronald Barg; Nelima Kute; David Lush; Celeste Mruk; Charles Orellana; Gail Rudnitsky; Angela Monroe; Lisa Anderson; David E. Eberly; Albert H. Fink; Kathleen Malone; Peter B. Nonack; Daniel Soffer; John N. Thurman; Marc J. Wertheimer; Barbara Jean Shovlin; Lanisha Johnson; Jill Esrey; Jeffrey Heit; Barbara C. Joebstl; Oana Vlad; Rose Schneider; Tammi Brandley; Linda Jelinski; Joel Griska; Karen J. Nichols; Edward G. Reis; James W. Shepard; Doris Davis-Whitely; Charin Sturgis; Katherine Fleming; Dana B. Greenblatt; Lisa Schaffer; Tamara Welch; Melissa Rosato; Eugonda Butts; Marta Ortiz; Marysa Nieves; Alethea White; Cassandra Bullard; Jennifer DiMedio; Melanie Ice; Brandt Loev; John S. Potts; Christine Tressel; Iris Perez; Penny Rancy; Dianne Rittenhouse; Joanne Colligan

doi:10.1038/ijo.2013.91

Changes in eating, physical activity and related behaviors in a primary care-based weight loss intervention

S. Volger, T. A. Wadden, D. B. Sarwer, R. H. Moore, J. Chittams, L. K. Diewald, E. Panigrahi, R. I. Berkowitz, K. Schmitz, M. L. Vetter, Thomas A. Wadden, David B. Sarwer, Robert I. Berkowitz, Jesse Chittams, Lisa Diewald, Shiriki Kumanyika, Renee Moore, Kathryn Schmitz, Adam G. Tsai, Marion VetterSheri Volger, Caroline H. Moran, Jeffrey Derbas, Megan Dougherty, Zahra Khan, Jeffrey Lavenberg, Eva Panigrahi, Joanna Evans, Ilana Schriftman, Dana Tioxon, Victoria Webb, Catherine Williams-Smith, Ronald Barg, Nelima Kute, David Lush, Celeste Mruk, Charles Orellana, Gail Rudnitsky, Angela Monroe, Lisa Anderson, David E. Eberly, Albert H. Fink, Kathleen Malone, Peter B. Nonack, Daniel Soffer, John N. Thurman, Marc J. Wertheimer, Barbara Jean Shovlin, Lanisha Johnson, Jill Esrey, Jeffrey Heit, Barbara C. Joebstl, Oana Vlad, Rose Schneider, Tammi Brandley, Linda Jelinski, Joel Griska, Karen J. Nichols, Edward G. Reis, James W. Shepard, Doris Davis-Whitely, Charin Sturgis, Katherine Fleming, Dana B. Greenblatt, Lisa Schaffer, Tamara Welch, Melissa Rosato, Eugonda Butts, Marta Ortiz, Marysa Nieves, Alethea White, Cassandra Bullard, Jennifer DiMedio, Melanie Ice, Brandt Loev, John S. Potts, Christine Tressel, Iris Perez, Penny Rancy, Dianne Rittenhouse, Joanne Colligan

Research output: Contribution to journal › Article › peer-review

21 Scopus citations

Abstract

OBJECTIVE: To examine changes in eating behaviors and physical activity, as well as predictors of weight loss success, in obese adults who participated in a 2-year behavioral weight loss intervention conducted in a primary care setting. DESIGN: A longitudinal, randomized controlled, multisite trial. SUBJECTS: Three hundred ninety obese (body mass index, 30-50 kg m^-2) adults, ≥21 years, in the Philadelphia region. METHODS: Participants were assigned to one of three interventions: (1) Usual Care (quarterly primary care provider (PCP) visits that included education on diet and exercise); (2) Brief Lifestyle Counseling (quarterly PCP visits plus monthly lifestyle counseling (LC) sessions about behavioral weight control); or (3) Enhanced Brief LC (the previous intervention with a choice of meal replacements or weight loss medication). RESULTS: At month 24, participants in both Brief LC and Enhanced Brief LC reported significantly greater improvements in mean (±s.e.) dietary restraint than those in Usual Care (4.4±0.5, 4.8±0.5 and 2.8±0.5, respectively; both P-values≤0.016). The percentage of calories from fat, along with fruit and vegetable consumption, did not differ significantly among the three groups. At month 24, both the Brief LC and Enhanced Brief LC groups reported significantly greater increases than usual care in energy expenditure (kcal per week) from moderately vigorous activity (+593.4±175.9, +415.4±179.6 and -70.4±185.5 kcal per week, respectively; both P-values≤0.037). The strongest predictor of weight loss at month 6 (partial R² =33.4%, P<0.0001) and at month 24 (partial R² =19.3%, P<0.001) was food records completed during the first 6 months. Participants who achieved a 5% weight loss at month 6 had 4.7 times greater odds of maintaining a ≥5% weight loss at month 24. CONCLUSIONS: A behavioral weight loss intervention delivered in a primary care setting can result in significant weight loss, with corresponding improvements in eating restraint and energy expenditure. Moreover, completion of food records, along with weight loss at month 6, is a strong predictor of long-term weight loss.

Original language	English (US)
Pages (from-to)	S12-S18
Journal	International Journal of Obesity
Volume	37
Issue number	SUPPL.1
DOIs	https://doi.org/10.1038/ijo.2013.91
State	Published - Aug 2013

All Science Journal Classification (ASJC) codes

Medicine (miscellaneous)
Endocrinology, Diabetes and Metabolism
Nutrition and Dietetics

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1038/ijo.2013.91

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Volger, S., Wadden, T. A., Sarwer, D. B., Moore, R. H., Chittams, J., Diewald, L. K., Panigrahi, E., Berkowitz, R. I., Schmitz, K., Vetter, M. L., Wadden, T. A., Sarwer, D. B., Berkowitz, R. I., Chittams, J., Diewald, L., Kumanyika, S., Moore, R., Schmitz, K., Tsai, A. G., ... Colligan, J. (2013). Changes in eating, physical activity and related behaviors in a primary care-based weight loss intervention. International Journal of Obesity, 37(SUPPL.1), S12-S18. https://doi.org/10.1038/ijo.2013.91

@article{52d6ab6a48874311a9bf7e7bfb852262,

title = "Changes in eating, physical activity and related behaviors in a primary care-based weight loss intervention",

abstract = "OBJECTIVE: To examine changes in eating behaviors and physical activity, as well as predictors of weight loss success, in obese adults who participated in a 2-year behavioral weight loss intervention conducted in a primary care setting. DESIGN: A longitudinal, randomized controlled, multisite trial. SUBJECTS: Three hundred ninety obese (body mass index, 30-50 kg m-2) adults, ≥21 years, in the Philadelphia region. METHODS: Participants were assigned to one of three interventions: (1) Usual Care (quarterly primary care provider (PCP) visits that included education on diet and exercise); (2) Brief Lifestyle Counseling (quarterly PCP visits plus monthly lifestyle counseling (LC) sessions about behavioral weight control); or (3) Enhanced Brief LC (the previous intervention with a choice of meal replacements or weight loss medication). RESULTS: At month 24, participants in both Brief LC and Enhanced Brief LC reported significantly greater improvements in mean (±s.e.) dietary restraint than those in Usual Care (4.4±0.5, 4.8±0.5 and 2.8±0.5, respectively; both P-values≤0.016). The percentage of calories from fat, along with fruit and vegetable consumption, did not differ significantly among the three groups. At month 24, both the Brief LC and Enhanced Brief LC groups reported significantly greater increases than usual care in energy expenditure (kcal per week) from moderately vigorous activity (+593.4±175.9, +415.4±179.6 and -70.4±185.5 kcal per week, respectively; both P-values≤0.037). The strongest predictor of weight loss at month 6 (partial R2 =33.4%, P<0.0001) and at month 24 (partial R2 =19.3%, P<0.001) was food records completed during the first 6 months. Participants who achieved a 5% weight loss at month 6 had 4.7 times greater odds of maintaining a ≥5% weight loss at month 24. CONCLUSIONS: A behavioral weight loss intervention delivered in a primary care setting can result in significant weight loss, with corresponding improvements in eating restraint and energy expenditure. Moreover, completion of food records, along with weight loss at month 6, is a strong predictor of long-term weight loss.",

author = "S. Volger and Wadden, {T. A.} and Sarwer, {D. B.} and Moore, {R. H.} and J. Chittams and Diewald, {L. K.} and E. Panigrahi and Berkowitz, {R. I.} and K. Schmitz and Vetter, {M. L.} and Wadden, {Thomas A.} and Sarwer, {David B.} and Berkowitz, {Robert I.} and Jesse Chittams and Lisa Diewald and Shiriki Kumanyika and Renee Moore and Kathryn Schmitz and Tsai, {Adam G.} and Marion Vetter and Sheri Volger and Moran, {Caroline H.} and Jeffrey Derbas and Megan Dougherty and Zahra Khan and Jeffrey Lavenberg and Eva Panigrahi and Joanna Evans and Ilana Schriftman and Dana Tioxon and Victoria Webb and Catherine Williams-Smith and Ronald Barg and Nelima Kute and David Lush and Celeste Mruk and Charles Orellana and Gail Rudnitsky and Angela Monroe and Lisa Anderson and Eberly, {David E.} and Fink, {Albert H.} and Kathleen Malone and Nonack, {Peter B.} and Daniel Soffer and Thurman, {John N.} and Wertheimer, {Marc J.} and Shovlin, {Barbara Jean} and Lanisha Johnson and Jill Esrey and Jeffrey Heit and Joebstl, {Barbara C.} and Oana Vlad and Rose Schneider and Tammi Brandley and Linda Jelinski and Joel Griska and Nichols, {Karen J.} and Reis, {Edward G.} and Shepard, {James W.} and Doris Davis-Whitely and Charin Sturgis and Katherine Fleming and Greenblatt, {Dana B.} and Lisa Schaffer and Tamara Welch and Melissa Rosato and Eugonda Butts and Marta Ortiz and Marysa Nieves and Alethea White and Cassandra Bullard and Jennifer DiMedio and Melanie Ice and Brandt Loev and Potts, {John S.} and Christine Tressel and Iris Perez and Penny Rancy and Dianne Rittenhouse and Joanne Colligan",

note = "Funding Information: TAW serves on the advisory boards of Novo Nordisk and Orexigen Therapeutics, which are developing weight loss medications, as well as the advisory boards of Alere and the Cardiometabolic Support Network, which provide behavioral weight loss programs. TAW has also served as a consultant for Boehringer Ingelheim, and has received grant support from the National Institutes of Health (NIH/NIDDK and NIH/NHLBI). DBS discloses relationships with the following companies: Allergan, BariMD, BaroNova, Enteromedics and Galderma. DBS has also received grant support from the National Institutes of Health (NIH). The remaining authors declare no conflict of interest. Funding Information: We thank Christopher Petro, PhD, for his assistance with data management, and Jeffrey Derbas, BS, Megan Dougherty, BS, Zahra Khan, BA, Joanna Perez, BA, Ilana Schriftman, BA and Dana Tioxon for their assistance with the execution of the research study. This research was supported by grants from the National Heart, Lung, and Blood Institute (U01-HL087072) and National Institute of Diabetes and Digestive and Kidney Diseases (K24-DK065018).",

year = "2013",

month = aug,

doi = "10.1038/ijo.2013.91",

language = "English (US)",

volume = "37",

pages = "S12--S18",

journal = "International Journal of Obesity",

issn = "0307-0565",

publisher = "Springer Nature",

number = "SUPPL.1",

}

Volger, S, Wadden, TA, Sarwer, DB, Moore, RH, Chittams, J, Diewald, LK, Panigrahi, E, Berkowitz, RI, Schmitz, K, Vetter, ML, Wadden, TA, Sarwer, DB, Berkowitz, RI, Chittams, J, Diewald, L, Kumanyika, S, Moore, R, Schmitz, K, Tsai, AG, Vetter, M, Volger, S, Moran, CH, Derbas, J, Dougherty, M, Khan, Z, Lavenberg, J, Panigrahi, E, Evans, J, Schriftman, I, Tioxon, D, Webb, V, Williams-Smith, C, Barg, R, Kute, N, Lush, D, Mruk, C, Orellana, C, Rudnitsky, G, Monroe, A, Anderson, L, Eberly, DE, Fink, AH, Malone, K, Nonack, PB, Soffer, D, Thurman, JN, Wertheimer, MJ, Shovlin, BJ, Johnson, L, Esrey, J, Heit, J, Joebstl, BC, Vlad, O, Schneider, R, Brandley, T, Jelinski, L, Griska, J, Nichols, KJ, Reis, EG, Shepard, JW, Davis-Whitely, D, Sturgis, C, Fleming, K, Greenblatt, DB, Schaffer, L, Welch, T, Rosato, M, Butts, E, Ortiz, M, Nieves, M, White, A, Bullard, C, DiMedio, J, Ice, M, Loev, B, Potts, JS, Tressel, C, Perez, I, Rancy, P, Rittenhouse, D & Colligan, J 2013, 'Changes in eating, physical activity and related behaviors in a primary care-based weight loss intervention', International Journal of Obesity, vol. 37, no. SUPPL.1, pp. S12-S18. https://doi.org/10.1038/ijo.2013.91

TY - JOUR

T1 - Changes in eating, physical activity and related behaviors in a primary care-based weight loss intervention

AU - Volger, S.

AU - Wadden, T. A.

AU - Sarwer, D. B.

AU - Moore, R. H.

AU - Chittams, J.

AU - Diewald, L. K.

AU - Panigrahi, E.

AU - Berkowitz, R. I.

AU - Schmitz, K.

AU - Vetter, M. L.

AU - Wadden, Thomas A.

AU - Sarwer, David B.

AU - Berkowitz, Robert I.

AU - Chittams, Jesse

AU - Diewald, Lisa

AU - Kumanyika, Shiriki

AU - Moore, Renee

AU - Schmitz, Kathryn

AU - Tsai, Adam G.

AU - Vetter, Marion

AU - Volger, Sheri

AU - Moran, Caroline H.

AU - Derbas, Jeffrey

AU - Dougherty, Megan

AU - Khan, Zahra

AU - Lavenberg, Jeffrey

AU - Panigrahi, Eva

AU - Evans, Joanna

AU - Schriftman, Ilana

AU - Tioxon, Dana

AU - Webb, Victoria

AU - Williams-Smith, Catherine

AU - Barg, Ronald

AU - Kute, Nelima

AU - Lush, David

AU - Mruk, Celeste

AU - Orellana, Charles

AU - Rudnitsky, Gail

AU - Monroe, Angela

AU - Anderson, Lisa

AU - Eberly, David E.

AU - Fink, Albert H.

AU - Malone, Kathleen

AU - Nonack, Peter B.

AU - Soffer, Daniel

AU - Thurman, John N.

AU - Wertheimer, Marc J.

AU - Shovlin, Barbara Jean

AU - Johnson, Lanisha

AU - Esrey, Jill

AU - Heit, Jeffrey

AU - Joebstl, Barbara C.

AU - Vlad, Oana

AU - Schneider, Rose

AU - Brandley, Tammi

AU - Jelinski, Linda

AU - Griska, Joel

AU - Nichols, Karen J.

AU - Reis, Edward G.

AU - Shepard, James W.

AU - Davis-Whitely, Doris

AU - Sturgis, Charin

AU - Fleming, Katherine

AU - Greenblatt, Dana B.

AU - Schaffer, Lisa

AU - Welch, Tamara

AU - Rosato, Melissa

AU - Butts, Eugonda

AU - Ortiz, Marta

AU - Nieves, Marysa

AU - White, Alethea

AU - Bullard, Cassandra

AU - DiMedio, Jennifer

AU - Ice, Melanie

AU - Loev, Brandt

AU - Potts, John S.

AU - Tressel, Christine

AU - Perez, Iris

AU - Rancy, Penny

AU - Rittenhouse, Dianne

AU - Colligan, Joanne

N1 - Funding Information: TAW serves on the advisory boards of Novo Nordisk and Orexigen Therapeutics, which are developing weight loss medications, as well as the advisory boards of Alere and the Cardiometabolic Support Network, which provide behavioral weight loss programs. TAW has also served as a consultant for Boehringer Ingelheim, and has received grant support from the National Institutes of Health (NIH/NIDDK and NIH/NHLBI). DBS discloses relationships with the following companies: Allergan, BariMD, BaroNova, Enteromedics and Galderma. DBS has also received grant support from the National Institutes of Health (NIH). The remaining authors declare no conflict of interest. Funding Information: We thank Christopher Petro, PhD, for his assistance with data management, and Jeffrey Derbas, BS, Megan Dougherty, BS, Zahra Khan, BA, Joanna Perez, BA, Ilana Schriftman, BA and Dana Tioxon for their assistance with the execution of the research study. This research was supported by grants from the National Heart, Lung, and Blood Institute (U01-HL087072) and National Institute of Diabetes and Digestive and Kidney Diseases (K24-DK065018).

PY - 2013/8

Y1 - 2013/8

N2 - OBJECTIVE: To examine changes in eating behaviors and physical activity, as well as predictors of weight loss success, in obese adults who participated in a 2-year behavioral weight loss intervention conducted in a primary care setting. DESIGN: A longitudinal, randomized controlled, multisite trial. SUBJECTS: Three hundred ninety obese (body mass index, 30-50 kg m-2) adults, ≥21 years, in the Philadelphia region. METHODS: Participants were assigned to one of three interventions: (1) Usual Care (quarterly primary care provider (PCP) visits that included education on diet and exercise); (2) Brief Lifestyle Counseling (quarterly PCP visits plus monthly lifestyle counseling (LC) sessions about behavioral weight control); or (3) Enhanced Brief LC (the previous intervention with a choice of meal replacements or weight loss medication). RESULTS: At month 24, participants in both Brief LC and Enhanced Brief LC reported significantly greater improvements in mean (±s.e.) dietary restraint than those in Usual Care (4.4±0.5, 4.8±0.5 and 2.8±0.5, respectively; both P-values≤0.016). The percentage of calories from fat, along with fruit and vegetable consumption, did not differ significantly among the three groups. At month 24, both the Brief LC and Enhanced Brief LC groups reported significantly greater increases than usual care in energy expenditure (kcal per week) from moderately vigorous activity (+593.4±175.9, +415.4±179.6 and -70.4±185.5 kcal per week, respectively; both P-values≤0.037). The strongest predictor of weight loss at month 6 (partial R2 =33.4%, P<0.0001) and at month 24 (partial R2 =19.3%, P<0.001) was food records completed during the first 6 months. Participants who achieved a 5% weight loss at month 6 had 4.7 times greater odds of maintaining a ≥5% weight loss at month 24. CONCLUSIONS: A behavioral weight loss intervention delivered in a primary care setting can result in significant weight loss, with corresponding improvements in eating restraint and energy expenditure. Moreover, completion of food records, along with weight loss at month 6, is a strong predictor of long-term weight loss.

AB - OBJECTIVE: To examine changes in eating behaviors and physical activity, as well as predictors of weight loss success, in obese adults who participated in a 2-year behavioral weight loss intervention conducted in a primary care setting. DESIGN: A longitudinal, randomized controlled, multisite trial. SUBJECTS: Three hundred ninety obese (body mass index, 30-50 kg m-2) adults, ≥21 years, in the Philadelphia region. METHODS: Participants were assigned to one of three interventions: (1) Usual Care (quarterly primary care provider (PCP) visits that included education on diet and exercise); (2) Brief Lifestyle Counseling (quarterly PCP visits plus monthly lifestyle counseling (LC) sessions about behavioral weight control); or (3) Enhanced Brief LC (the previous intervention with a choice of meal replacements or weight loss medication). RESULTS: At month 24, participants in both Brief LC and Enhanced Brief LC reported significantly greater improvements in mean (±s.e.) dietary restraint than those in Usual Care (4.4±0.5, 4.8±0.5 and 2.8±0.5, respectively; both P-values≤0.016). The percentage of calories from fat, along with fruit and vegetable consumption, did not differ significantly among the three groups. At month 24, both the Brief LC and Enhanced Brief LC groups reported significantly greater increases than usual care in energy expenditure (kcal per week) from moderately vigorous activity (+593.4±175.9, +415.4±179.6 and -70.4±185.5 kcal per week, respectively; both P-values≤0.037). The strongest predictor of weight loss at month 6 (partial R2 =33.4%, P<0.0001) and at month 24 (partial R2 =19.3%, P<0.001) was food records completed during the first 6 months. Participants who achieved a 5% weight loss at month 6 had 4.7 times greater odds of maintaining a ≥5% weight loss at month 24. CONCLUSIONS: A behavioral weight loss intervention delivered in a primary care setting can result in significant weight loss, with corresponding improvements in eating restraint and energy expenditure. Moreover, completion of food records, along with weight loss at month 6, is a strong predictor of long-term weight loss.

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UR - http://www.scopus.com/inward/citedby.url?scp=84882417027&partnerID=8YFLogxK

U2 - 10.1038/ijo.2013.91

DO - 10.1038/ijo.2013.91

M3 - Article

C2 - 23921776

AN - SCOPUS:84882417027

SN - 0307-0565

VL - 37

SP - S12-S18

JO - International Journal of Obesity

JF - International Journal of Obesity

IS - SUPPL.1

ER -

Changes in eating, physical activity and related behaviors in a primary care-based weight loss intervention

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