Randomized Controlled Trial Examining the Ripple Effect of a Nationally Available Weight Management Program on Untreated Spouses

Amy A Gorin, Erin M Lenz, Talea Cornelius, Tania Huedo-Medina, Alexis C Wojtanowski, Gary D Foster, Amy A Gorin, Erin M Lenz, Talea Cornelius, Tania Huedo-Medina, Alexis C Wojtanowski, Gary D Foster

Abstract

Objective: For married couples, when one spouse participates in weight loss treatment, the untreated spouse can also experience weight loss. This study examined this ripple effect in a nationally available weight management program.

Methods: One hundred thirty dyads were randomized to Weight Watchers (WW; n = 65) or to a self-guided control group (SG; n = 65) and assessed at 0, 3, and 6 months. Inclusion criteria were age ≥ 25 years, BMI 27 to 40 kg/m2 (≥ 25 kg/m2 for untreated spouses), and no weight loss contraindications. WW participants received 6 months of free access to in-person meetings and online tools. SG participants received a weight loss handout. Spouses did not receive treatment.

Results: Untreated spouses lost weight at 3 months (WW = -1.5 ± 2.9 kg; SG = -1.1 ± 3.3 kg) and 6 months (WW = -2.2 ± 4.2 kg; SG = -1.9 ± 3.6 kg), but weight losses did not differ by condition. Overall, 32.0% of untreated spouses lost ≥ 3% of initial body weight by 6 months. Baseline weight was significantly correlated within couples (r = 0.26; P < 0.01) as were weight loss trajectories (r = 0.52; P < 0.001).

Conclusions: Evidence of a ripple effect was found in untreated spouses in both formal and self-guided weight management approaches. These data suggest that weight loss can spread within couples, and that widely available lifestyle programs have weight loss effects beyond the treated individual.

Trial registration: ClinicalTrials.gov NCT03042208.

© 2018 The Authors. Obesity published by Wiley Periodicals, Inc. on behalf of The Obesity Society (TOS).

Figures

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Figure 1
Study Flow [Color figure can be viewed at wileyonlinelibrary.com]

References

    1. Christakis NA, Fowler JH. The spread of obesity in a large social network over 32 years. N Engl J Med 2007;3570:370‐379.
    1. Jeffery RW, Rick AM. Cross‐sectional and longitudinal associations between body mass index and marriage‐related factors. Obes Res 2002;10:809‐815.
    1. Allison DB, Neale MC, Kezis MI, Alfonso VC, Heshka S, Heymsfield SB. Assortative mating for relative weight: genetic implications. Behav Genet 1996;26:103‐111.
    1. Speakman JR, Djafarian K, Stewart J, Jackson DM. Assortative mating for obesity. Am J Clin Nutr 2007;86:316‐323.
    1. Di Castelnuovo A, Quacquaruccio G, Donati MB, de Gaetano, Iacoviello L. Spousal concordance for major coronary risk factors: a systematic review and meta‐analysis. Am J Epidemiol 2009;169:1‐8.
    1. The NS, Gordon‐Larsen P. Entry into romantic partnership is associated with obesity. Obesity (Silver Spring) 2009;17:1441‐1447.
    1. Gorin AA, Wing RR, Fava JL, et al. Weight loss treatment influences untreated spouses and the home environment: evidence of a ripple effect. Int J Obes (Lond) 2008;32:1678‐1684.
    1. Jackson SE, Steptoe A, Wardle J. The influence of partner's behavior on health behavior change: the English Longitudinal Study of Ageing. JAMA Intern Med 2015;175:385‐392.
    1. White E, Hurlich M, Thompson RS, et al. Dietary changes among husbands of participants in a low‐fat dietary intervention. Am J Prev Med 1991;7:319‐325.
    1. Shattuck AL, White E, Kristal AR. How women's adopted low‐fat diets affect their husbands. Am J Public Health 1992;82:1244‐1250.
    1. Gorin AA, Raynor HA, Fava J, et al. Randomized controlled trial of a comprehensive home environment‐focused weight‐loss program for adults. Health Psychol 2013;32:128‐137.
    1. Hagobian TA, Phelan S, Gorin AA, Phipps MG, Abrams B, Wing RR. Effects of maternal lifestyle intervention during pregnancy on untreated partner weight: results from fit for delivery study. Obesity (Silver Spring) 2016;24:23‐25.
    1. Aarts F, Radhakishun NN, van Vliet M, et al. Gastric bypass may promote weight loss in overweight partners. J Am Board Fam Med 2015;28:90‐96.
    1. Woodard GA, Encarnacion B, Peraza J, Hernandez‐Boussard T, Morton J. Halo effect for bariatric surgery: collateral weight loss in patients' family members. Arch Surg 2011;146:1185‐1190.
    1. Madan AK, Turman KA, Tichansky DS. Weight changes in spouses of gastric bypass patients. Obes Surg 2005;15:191‐194.
    1. Willmer M, Berglind D, Thorell A, et al. Changes in BMI and psychosocial functioning in partners of women who undergo gastric bypass surgery for obesity. Obes Surg 2015;25:319‐324.
    1. Johnston CA, Rost S, Miller‐Kovach K, Moreno JP, Foreyt JP. A randomized controlled trial of a community‐based behavioral counseling program. Am J Med 2013;126:1143.e19‐e24.
    1. Pinto AM, Fava JL, Hoffman DA, Wing RR. Combining behavioral weight loss treatment and a commercial program: a randomized clinical trial. Obesity (Silver Spring) 2013;21:673‐680.
    1. Gudzune KA, Doshi RS, Mehta AK, et al. Efficacy of commercial weight‐loss programs: an updated systematic review. Ann Intern Med 2015;162:501‐512.
    1. Ahern AL, Wheeler GM, Aveyard P, et al. Extended and standard duration weight‐loss programme referrals for adults in primary care (WRAP): a randomised controlled trial. Lancet 2017;389:2214‐2225.
    1. Foster GD, Makris A, Wojtanowski AC. The role of scalable, community‐based weight management programs In: Bronwell K, Walsh B, eds. Eating Disorders and Obesity: A Comprehensive Handbook. 3rd ed. New York, NY: Guilford Press; 2017.
    1. Taves DR. Minimization: a new method of assigning patients to treatment and control groups. Clin Pharmacol Ther 1974;15:443‐453.
    1. Gorin AA, Wing RR, Fava JL, et al. Weight loss treatment influences untreated spouses and the home environment: evidence of a ripple effect. Int J Obes (Lond) 2008;32:1678‐1684.
    1. Jensen MD, Ryan DH, Donato KA, et al. Guidelines (2013) for managing overweight and obesity in adults. Obesity (Silver Spring) 2014;22(S2):S1–S410.
    1. Kenny D, Kashy D, Cook W. The Analysis of Dyadic Data. New York, NY: Guilford Press; 2006.
    1. Cornelius T, Gettens K, Gorin AA. Dyadic dynamics in a randomized weight loss intervention. Ann Behav Med 2016;50:506‐515.

Source: PubMed

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