ResearchResearch and Practice InnovationTranslational Research: Bridging the Gap between Long-Term Weight Loss Maintenance Research and Practice
Section snippets
Methods
To identify research articles related to weight loss maintenance intervention for translation potential, a literature search was conducted using four databases (Medline, PubMed, PSYCinfo, and Ebscohost), using standardized search terms as follows: weight maintenance, long-term weight loss maintenance, effectiveness weight loss maintenance, and efficacy weight loss maintenance. For inclusion, articles must have been published in English, been a randomized controlled trial of a long-term weight
Statistical Analysis
Standardized effect sizes d=(x1-x2)/pooled standard deviation were calculated (51) across studies with x1-x2 representing mean change in weight (in kilograms) from baseline weight maintenance to post-intervention weight maintenance. All RE-AIM coding was evaluated across raters using Cohen's κ (49) and the findings were summarized and presented in percents. Percents were computed at two levels. First, the proportion of indicators reported within each RE-AIM dimension was computed (ie, number of
Results
Scoring of the articles resulted in a substantial agreement between raters (κ=.83±.20), with the range −.25±.02 to .89±.04 between the RE-AIM dimensions. The mean effect size of the scored articles was d=0.38±0.05, with effect sizes ranging from 0.00 to 1.22. Details of the 19 studies reviewed, according to RE-AIM dimension, and categorized by intervention type (ie, diet-only; diet and behavior change; physical activity and behavior change; or diet, physical activity, and behavior change) are
Discussion
The field of inquiry within weight loss maintenance is a vibrant research area that could significantly influence population health. However, within the context of attempting to develop weight loss maintenance interventions that have the potential for translation into regular practice, it is critical to address, evaluate, and understand the extent to which interventions have the potential to reach a large proportion of the target population, be effective, align with the available delivery
Conclusions
For practitioners like Paula depicted in our vignette, the internal as well as the external validity in studies should be evaluated to determine the most appropriate weight loss maintenance intervention for a particular practice setting. Examining research and selecting interventions that include a broad heterogenous sample and defined population, consideration of program delivery personnel, costs, and a feasible intervention design will increase likelihood of success when attempting to
J. D. Akers is an assistant professor, James Madison University, Harrisonburg, VA; at the time of the study, he was a doctoral student, Virginia Polytechnic Institute and State University, Blacksburg.
References (59)
- et al.
Long-term weight loss maintenance
Am J Clin Nutr
(2005) - et al.
Outpatient weight management in African-Americans: The Healthy Eating and Lifestyle Program (HELP) study
Prev Med
(2005) - et al.
A moderate-protein diet produces sustained weight loss and long-term changes in body composition and blood lipids in obese adults
J Nutr
(2009) - et al.
Effects of exercise-focused versus weight-focused maintenance programs on the management of obesity
Addict Behav
(1999) - et al.
Maintenance of weight loss after obesity treatment: Is continuous support necessary?
Behav Res Ther
(2002) - et al.
Effect of exercise training on long-term weight maintenance in weight-reduced men
Metab Clin Experiment
(1999) - et al.
Long-term maintenance of exercise and healthy eating behaviors in overweight adults
Prev Med
(2005) - et al.
Long-term weight-loss maintenance: A meta-analysis of US studies
Am J Clin Nutr
(2001) - et al.
Efficacy and effectiveness trials (and other phases of research) in the development of health promotion programs
Prev Med
(1986) eHealth evaluation and dissemination research
Am J Prev Med
(2007)
Review of external validity reporting in childhood obesity prevention research
Am J Prev Med
Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001
JAMA
Obesity Among Adults in the United States—No Statistically Significant Change since 2003-2004
Prevalence of overweight and obesity in the United States, 1999-2004
JAMA
Clinical implications of obesity with specific focus on cardiovascular disease: A statement for professionals from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism: Endorsed by the American College of Cardiology Foundation
Circulation
Obesity and cardiovascular disease: Pathophysiology, evaluation, and effect of weight loss: An update of the 1997 American Heart Association Scientific Statement on Obesity and Heart Disease From the Obesity Committee of the Council on Nutrition, Physical Activity, and Metabolism
Circulation
The Surgeon General's Call to Action to Prevent and Decrease Overweight and Obesity
Long-term maintenance of weight loss: Current status
Health Psychol
Losing weight—An ill-fated New Year's resolution
N Engl J Med
Predictors of weight maintenance
Obes Res
Comparison of strategies for sustaining weight loss: The weight loss maintenance randomized controlled trial
JAMA
Eating control and physical activity as determinants of short-term weight maintenance after a very-low-calorie diet among obese women
Int J Obes Relat Metab Disord
Does using the Internet facilitate the maintenance of weight loss?
Int J Obes Relat Metab Disord
Effect of Internet support on the long-term maintenance of weight loss
Obesity
Effect of exercise on 24-month weight loss maintenance in overweight women
Arch Intern Med
Diet vs exercise in weight maintenanceThe effects of minimal intervention strategies on long-term outcomes in men
Arch Intern Med
Intermittent versus on-demand use of a very low calorie diet: A randomized 2-year clinical trial
J Intern Med
Extended-care programs for weight management in rural communities: The treatment of obesity in underserved rural settings (TOURS) randomized trial
Arch Intern Med
Effects of four maintenance programs on the long-term management of obesity
J Consult Clin Psychol
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J. D. Akers is an assistant professor, James Madison University, Harrisonburg, VA; at the time of the study, he was a doctoral student, Virginia Polytechnic Institute and State University, Blacksburg.
P. A. Estabrooks is a professor, Virginia Polytechnic Institute and State University, Blacksburg.
B. M. Davy is an associate professor, Virginia Polytechnic Institute and State University, Blacksburg.