Original Article

Annals of Behavioral Medicine

, Volume 46, Issue 3, pp 369-381

First online:

Behavioral Mediators of Treatment Effects in the Weight Loss Maintenance Trial

  • J. W. CoughlinAffiliated withJohns Hopkins University School of Medicine Email author 
  • , C. M. GullionAffiliated withKaiser Permanente Center for Health Research
  • , P. J. BrantleyAffiliated withPennington Biomedical Research Center, Louisiana State University System
  • , V. J. StevensAffiliated withKaiser Permanente Center for Health Research
  • , A. BauckAffiliated withKaiser Permanente Center for Health Research
  • , C. M. ChampagneAffiliated withPennington Biomedical Research Center, Louisiana State University System
  • , A. T. DalcinAffiliated withJohns Hopkins University School of Medicine
  • , K. L. FunkAffiliated withKaiser Permanente Center for Health Research
  • , J. F. HollisAffiliated withKaiser Permanente Center for Health Research
    • , G. J. JeromeAffiliated withTowson University
    • , L. F. LienAffiliated withDuke University Medical Center
    • , C. M. LoriaAffiliated withNational Heart, Lung, and Blood Institute
    • , V. H. MyersAffiliated withKlein Buendel, Inc.
    • , L. J. AppelAffiliated withJohns Hopkins University School of Medicine

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Abstract

Background

The Weight Loss Maintenance Trial tested strategies for maintenance of weight loss. Personal contact was superior to interactive technology and self-directed conditions.

Purpose

We aimed to identify behavioral mediators of the superior effect of personal contact vs. interactive technology and of personal contact vs. self-directed arms.

Methods

Overweight/obese adults at risk for cardiovascular disease (n = 1,032) who lost at least 4 kg were randomized to personal contact, interactive technology, or self-directed. After 30 months, 880 participants had data on weight and behavioral strategies.

Results

Reported increase of intake of fruits and vegetables and physical activity and more frequent self-weighing met criteria as mediators of the better outcome of personal contact vs. interactive technology. Increased intake of fruits and vegetables, more frequent self-weighing, and decreased dessert consumption were mediators of the difference between personal contact vs. self-directed.

Conclusion

Inducing changes in the identified behaviors might yield better outcomes in future weight loss maintenance trials.

(ClinicalTrials.gov number NCT00054925)

Keywords

Obesity Weight maintenance Weight regain Behavioral strategies Mediators