Small Changes in Nutrition and Physical Activity Promote Weight Loss and Maintenance: 3-Month Evidence from the ASPIRE Randomized Trial
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Current obesity interventions use intensive behavior changes to achieve large initial weight loss. However, weight regain after treatment is common, and drop out rates are relatively high. Smaller behavioral changes could produce initial weight loss and be easier to sustain after active treatment.
We examined the efficacy of an intervention that targeted small but cumulative participant-chosen changes in diet and physical activity (ASPIRE) and compared this treatment to standard didactic and wait-list control groups. The primary outcome measures were body weight, waist circumference, and intra-abdominal fat.
Fifty-nine overweight or obese sedentary adults were randomized to one of three groups: (1) the ASPIRE group (n = 20), (2) a standard educationally-based treatment group (n = 20), or (3) a wait list control group (n = 19) for 4 months. Active treatment groups received identical resistance and aerobic training programs.
Intention-to-treat analyses showed that participants in the ASPIRE group lost significantly more weight than the standard and control groups (−4.4 vs. −1.1 and +0.1 kg, respectively), and the greater initial weight loss in the ASPIRE group was sustained 3 months after active treatment (4.1 kg). An alternative analytic strategy (0.3 kg/month weight gain for those lost to follow-up) showed continued weight loss (−0.2 kg after active treatment; −4.6 kg from baseline) at follow-up in the ASPIRE group. Similar patterns were observed for the other adiposity measures.
More modest behavioral changes are capable of promoting weight loss, decreasing adiposity markers and sustaining these changes over 3 months. Longer-term studies comparing this approach with traditional behavioral weight loss treatments are warranted.
KeywordsASPIRE Weight loss Nutrition
- 2.Wing RR. Behavioral weight control. In: Wadden TA, Stunkard AJ, eds. Handbook of Obesity Treatment. New York: Guilford; 2002: 301–316.Google Scholar
- 6.Perri MG, Corisca JA. Improving the maintenance of weight lost in behavioral treatment of obesity. In: Wadden TA, Stunkard AJ, eds. Handbook of Obesity Treatment. New York: Guilford; 2002: 357–375.Google Scholar
- 7.Perri MG, Durning PE, Janicke DM, et al. (2007, April) Treatment of obesity in underserved rural settings (TOURS): 18-month findings. 28th annual meeting for Society of Behavioral Medicine. Washington, DC: 2007.Google Scholar
- 10.Foster GD, McGuckin BG. Nondieting approches: principles, practices, and evidence. In: Wadden TA, Stunkard AJ, eds. Handbook of Obesity Treatment. New York: Guilford; 2002: 494–512.Google Scholar
- 17.Altman RA, Schulz KF, Moher D, et al. The revised CONSORT statement for reporting randomized trials: Explanation and Elaboration. Ann Inter Med. 2001; 1348: 665–694.Google Scholar
- 18.Winett RA, Wojcik JR, Fox LD, et al. The effects of very brief duration, infrequent cardiovascular training and resistance training protocols on the aerobic capacity and strength of unfit men and women: A demonstration of the threshold model. J Behav Med. 2003; 26: 183–195.PubMedCrossRefGoogle Scholar
- 19.US Department of Health and Human Services. Nutrition and Your Health: Dietary Guidelines for Americans. (http://www.health.gov/dietary guidelines/) 2004.
- 20.Harris J, Benedict F. A biometric study of basal metabolism in man. Washington DC: Carnegie Institute of Washington; 1919.Google Scholar
- 21.Jakicic JM, Donnelly JE, Pronk NP, Jawad AF, Jacobsen DJ. Prescription of exercise intensity for the obese patient: the relationship between heart rate, VO2 and perceived exertion. Int J Obes. 1995; 19: 382–387.Google Scholar