Comparative effectiveness of three doses of weight-loss counseling: two-year findings from the rural LITE trial

Michael G Perri, Marian C Limacher, Kristina von Castel-Roberts, Michael J Daniels, Patricia E Durning, David M Janicke, Linda B Bobroff, Tiffany A Radcliff, Vanessa A Milsom, Chanmin Kim, A Daniel Martin, Michael G Perri, Marian C Limacher, Kristina von Castel-Roberts, Michael J Daniels, Patricia E Durning, David M Janicke, Linda B Bobroff, Tiffany A Radcliff, Vanessa A Milsom, Chanmin Kim, A Daniel Martin

Abstract

Objective: To evaluate the effects and costs of three doses of behavioral weight-loss treatment delivered via Cooperative Extension Offices in rural communities.

Methods: Obese adults (N = 612) were randomly assigned to low, moderate, or high doses of behavioral treatment (i.e., 16, 32, or 48 sessions over two years) or to a control condition that received nutrition education without instruction in behavior modification strategies.

Results: Two-year mean reductions in initial body weight were 2.9% (95% Credible Interval = 1.7-4.3), 3.5% (2.0-4.8), 6.7% (5.3-7.9), and 6.8% (5.5-8.1) for the control, low-, moderate-, and high-dose conditions, respectively. The moderate-dose treatment produced weight losses similar to the high-dose condition and significantly larger than the low-dose and control conditions (posterior probability > 0.996). The percentages of participants who achieved weight reductions ≥ 5% at two years were significantly higher in the moderate-dose (58%) and high-dose (58%) conditions compared with low-dose (43%) and control (40%) conditions (posterior probability > 0.996). Cost-effectiveness analyses favored the moderate-dose treatment over all other conditions.

Conclusions: A moderate dose of behavioral treatment produced two-year weight reductions comparable to high-dose treatment but at a lower cost. These findings have important policy implications for the dissemination of weight-loss interventions into communities with limited resources.

Conflict of interest statement

The authors declared no conflict of interest.

© 2014 The Obesity Society.

Figures

Figure 1
Figure 1
Participant flow through screening, randomization, and follow up
Figure 2
Figure 2
Weight trajectories showing mean reductions (kg) in initial body weight at months 6 and 24. At 6 months, all conditions differed significantly from each other (posterior probability > .996) except for MOD vs. HIGH. At 24 months, the MOD and HIGH conditions had significantly larger reductions than the LOW and CONTROL conditions (posterior probability > .996), and the differences between CONTROL and LOW and between MOD and HIGH were not significantly different.
Figure 3
Figure 3
Percentage of participants in each treatment condition achieving body weight reductions ≥ 5% at months 6 and 24. At each time point, conditions that do not share a superscript are significantly different from each other.

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Source: PubMed

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