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Weight loss with self-help compared with a structured commercial program: a randomized trial.

Publication ,  Journal Article
Heshka, S; Anderson, JW; Atkinson, RL; Greenway, FL; Hill, JO; Phinney, SD; Kolotkin, RL; Miller-Kovach, K; Pi-Sunyer, FX
Published in: JAMA
April 9, 2003

CONTEXT: Although commercial weight loss programs provide treatment to millions of clients, their efficacy has not been evaluated in rigorous long-term trials. OBJECTIVE: To compare weight loss and health benefits achieved and maintained through self-help weight loss vs with a structured commercial program. DESIGN AND SETTING: A 2-year, multicenter randomized clinical trial with clinic visits at 12, 26, 52, 78, and 104 weeks conducted at 6 academic research centers in the United States between January 1998 and January 2001. PARTICIPANTS: Overweight and obese men (n = 65) and women (n = 358) (body mass index, 27-40) aged 18 to 65 years. INTERVENTION: Random assignment to either a self-help program (n = 212) consisting of two 20-minute counseling sessions with a nutritionist and provision of self-help resources or to a commercial weight loss program (n = 211) consisting of a food plan, an activity plan, and a cognitive restructuring behavior modification plan, delivered at weekly meetings. MAIN OUTCOME MEASURES: Weight change was the primary outcome measure. Secondary outcomes included waist circumference, body mass index, blood pressure, serum lipids, glucose, and insulin levels. RESULTS: At 2 years, 150 participants (71%) in the commercial group and 159 (75%) in the self-help group completed the study. In the intent-to-treat analysis, mean (SD) weight loss of participants in the commercial group was greater than in the self-help group at 1 year (-4.3 [6.1] kg vs -1.3 [6.1] kg, respectively; P<.001) and at 2 years (-2.9 [6.5] kg vs -0.2 [6.5] kg, respectively; P<.001). Waist circumference (P =.003) and body mass index (P<.001) decreased more in the commercial group. Changes in blood pressure, lipids, glucose, and insulin levels were related to changes in weight in both groups, but between-group differences in biological parameters were mainly nonsignificant by year 2. CONCLUSION: The structured commercial weight loss program provided modest weight loss but more than self-help over a 2-year period.

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Published In

JAMA

DOI

ISSN

0098-7484

Publication Date

April 9, 2003

Volume

289

Issue

14

Start / End Page

1792 / 1798

Location

United States

Related Subject Headings

  • Weight Loss
  • Self Care
  • Risk Reduction Behavior
  • Quality of Life
  • Patient Participation
  • Patient Education as Topic
  • Outcome Assessment, Health Care
  • Obesity
  • Nutritional Sciences
  • Middle Aged
 

Citation

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Heshka, S., Anderson, J. W., Atkinson, R. L., Greenway, F. L., Hill, J. O., Phinney, S. D., … Pi-Sunyer, F. X. (2003). Weight loss with self-help compared with a structured commercial program: a randomized trial. JAMA, 289(14), 1792–1798. https://doi.org/10.1001/jama.289.14.1792
Heshka, Stanley, James W. Anderson, Richard L. Atkinson, Frank L. Greenway, James O. Hill, Stephen D. Phinney, Ronette L. Kolotkin, Karen Miller-Kovach, and F Xavier Pi-Sunyer. “Weight loss with self-help compared with a structured commercial program: a randomized trial.JAMA 289, no. 14 (April 9, 2003): 1792–98. https://doi.org/10.1001/jama.289.14.1792.
Heshka S, Anderson JW, Atkinson RL, Greenway FL, Hill JO, Phinney SD, et al. Weight loss with self-help compared with a structured commercial program: a randomized trial. JAMA. 2003 Apr 9;289(14):1792–8.
Heshka, Stanley, et al. “Weight loss with self-help compared with a structured commercial program: a randomized trial.JAMA, vol. 289, no. 14, Apr. 2003, pp. 1792–98. Pubmed, doi:10.1001/jama.289.14.1792.
Heshka S, Anderson JW, Atkinson RL, Greenway FL, Hill JO, Phinney SD, Kolotkin RL, Miller-Kovach K, Pi-Sunyer FX. Weight loss with self-help compared with a structured commercial program: a randomized trial. JAMA. 2003 Apr 9;289(14):1792–1798.
Journal cover image

Published In

JAMA

DOI

ISSN

0098-7484

Publication Date

April 9, 2003

Volume

289

Issue

14

Start / End Page

1792 / 1798

Location

United States

Related Subject Headings

  • Weight Loss
  • Self Care
  • Risk Reduction Behavior
  • Quality of Life
  • Patient Participation
  • Patient Education as Topic
  • Outcome Assessment, Health Care
  • Obesity
  • Nutritional Sciences
  • Middle Aged