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doi:10.1016/j.amepre.2008.04.013 
Copyright © 2008 American Journal of Preventive Medicine Published by Elsevier Inc.
Research article
Weight Loss During the Intensive Intervention Phase of the Weight-Loss Maintenance Trial
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Jack F. Hollis PhDa, 
, 
, Christina M. Gullion PhDa, Victor J. Stevens PhDa, Phillip J. Brantley PhDb, Lawrence J. Appel MD, MPHe, Jamy D. Ard MDc, Catherine M. Champagne PhD, RDb, Arlene Dalcine, Thomas P. Erlinger MD, MPHd, Kristine Funk MS, RDa, Daniel Laferriere RN, MSNa, Pao-Hwa Lin PhDf, Catherine M. Loria PhDh, Carmen Samuel-Hodge PhD, RDg, William M. Vollmer PhDa, Laura P. Svetkey MDf and Weight Loss Maintenance Trial Research Group
Available online 8 July 2008.
Background
To improve methods for long-term weight management, the Weight Loss Maintenance (WLM) trial, a four-center randomized trial, was conducted to compare alternative strategies for maintaining weight loss over a 30-month period. This paper describes methods and results for the initial 6-month weight-loss program (Phase I).
Methods
Eligible adults were aged ≥25, overweight or obese (BMI=25–45 kg/m2), and on medications for hypertension and/or dyslipidemia. Anthropomorphic, demographic, and psychosocial measures were collected at baseline and 6 months. Participants (n=1685) attended 20 weekly group sessions to encourage calorie restriction, moderate-intensity physical activity, and the DASH (dietary approaches to stop hypertension) dietary pattern. Weight-loss predictors with missing data were replaced by multiple imputation.
Results
Participants were 44% African American and 67% women; 79% were obese (BMI≥30), 87% were taking anti-hypertensive medications, and 38% were taking antidyslipidemia medications. Participants attended an average of 72% of 20 group sessions. They self-reported 117 minutes of moderate-intensity physical activity per week, kept 3.7 daily food records per week, and consumed 2.9 servings of fruits and vegetables per day. The Phase-I follow-up rate was 92%. Mean (SD) weight change was −5.8 kg (4.4), and 69% lost at least 4 kg. All race–gender subgroups lost substantial weight: African-American men (−5.4 kg ± 7.7); African-American women (−4.1 kg ± 2.9); non–African-American men (−8.5 kg ± 12.9); and non–African-American women (−5.8 kg ± 6.1). Behavioral measures (e.g., diet records and physical activity) accounted for most of the weight-loss variation, although the association between behavioral measures and weight loss differed by race and gender groups.
Conclusions
The WLM behavioral intervention successfully achieved clinically significant short-term weight loss in a diverse population of high-risk patients.
Article Outline
- Introduction
- Research Methods and Procedures
- Overview of the WLM Design
- Phase-I Eligibility
- Recruitment and Screening
- Phase-I Initial Weight-Loss Intervention
- Clinical Assessments
- Statistical Analysis
- Results
- Baseline Characteristics
- Attendance, Adherence, and Follow-Up
- Weight Change
- Predictors of Phase-I Weight Loss
- Discussion
- Acknowledgements
- References
