Changes in eating, physical activity and related behaviors in a primary care-based weight loss intervention

S. Volger, T. A. Wadden, D. B. Sarwer, R. H. Moore, J. Chittams, L. K. Diewald, E. Panigrahi, R. I. Berkowitz, K. Schmitz, M. L. Vetter, Thomas A. Wadden, David B. Sarwer, Robert I. Berkowitz, Jesse Chittams, Lisa Diewald, Shiriki Kumanyika, Renee Moore, Kathryn Schmitz, Adam G. Tsai, Marion VetterSheri Volger, Caroline H. Moran, Jeffrey Derbas, Megan Dougherty, Zahra Khan, Jeffrey Lavenberg, Eva Panigrahi, Joanna Evans, Ilana Schriftman, Dana Tioxon, Victoria Webb, Catherine Williams-Smith, Ronald Barg, Nelima Kute, David Lush, Celeste Mruk, Charles Orellana, Gail Rudnitsky, Angela Monroe, Lisa Anderson, David E. Eberly, Albert H. Fink, Kathleen Malone, Peter B. Nonack, Daniel Soffer, John N. Thurman, Marc J. Wertheimer, Barbara Jean Shovlin, Lanisha Johnson, Jill Esrey, Jeffrey Heit, Barbara C. Joebstl, Oana Vlad, Rose Schneider, Tammi Brandley, Linda Jelinski, Joel Griska, Karen J. Nichols, Edward G. Reis, James W. Shepard, Doris Davis-Whitely, Charin Sturgis, Katherine Fleming, Dana B. Greenblatt, Lisa Schaffer, Tamara Welch, Melissa Rosato, Eugonda Butts, Marta Ortiz, Marysa Nieves, Alethea White, Cassandra Bullard, Jennifer DiMedio, Melanie Ice, Brandt Loev, John S. Potts, Christine Tressel, Iris Perez, Penny Rancy, Dianne Rittenhouse, Joanne Colligan

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

OBJECTIVE: To examine changes in eating behaviors and physical activity, as well as predictors of weight loss success, in obese adults who participated in a 2-year behavioral weight loss intervention conducted in a primary care setting. DESIGN: A longitudinal, randomized controlled, multisite trial. SUBJECTS: Three hundred ninety obese (body mass index, 30-50 kg m-2) adults, ≥21 years, in the Philadelphia region. METHODS: Participants were assigned to one of three interventions: (1) Usual Care (quarterly primary care provider (PCP) visits that included education on diet and exercise); (2) Brief Lifestyle Counseling (quarterly PCP visits plus monthly lifestyle counseling (LC) sessions about behavioral weight control); or (3) Enhanced Brief LC (the previous intervention with a choice of meal replacements or weight loss medication). RESULTS: At month 24, participants in both Brief LC and Enhanced Brief LC reported significantly greater improvements in mean (±s.e.) dietary restraint than those in Usual Care (4.4±0.5, 4.8±0.5 and 2.8±0.5, respectively; both P-values≤0.016). The percentage of calories from fat, along with fruit and vegetable consumption, did not differ significantly among the three groups. At month 24, both the Brief LC and Enhanced Brief LC groups reported significantly greater increases than usual care in energy expenditure (kcal per week) from moderately vigorous activity (+593.4±175.9, +415.4±179.6 and -70.4±185.5 kcal per week, respectively; both P-values≤0.037). The strongest predictor of weight loss at month 6 (partial R2 =33.4%, P<0.0001) and at month 24 (partial R2 =19.3%, P<0.001) was food records completed during the first 6 months. Participants who achieved a 5% weight loss at month 6 had 4.7 times greater odds of maintaining a ≥5% weight loss at month 24. CONCLUSIONS: A behavioral weight loss intervention delivered in a primary care setting can result in significant weight loss, with corresponding improvements in eating restraint and energy expenditure. Moreover, completion of food records, along with weight loss at month 6, is a strong predictor of long-term weight loss.

Original languageEnglish (US)
Pages (from-to)S12-S18
JournalInternational Journal of Obesity
Volume37
Issue numberSUPPL.1
DOIs
StatePublished - Aug 1 2013

Fingerprint

Weight Loss
Primary Health Care
Eating
Exercise
Life Style
Counseling
Energy Metabolism
Food
Feeding Behavior
Vegetables
Meals
Fruit
Body Mass Index
Randomized Controlled Trials
Fats
Diet
Education
Weights and Measures

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics

Cite this

Volger, S., Wadden, T. A., Sarwer, D. B., Moore, R. H., Chittams, J., Diewald, L. K., ... Colligan, J. (2013). Changes in eating, physical activity and related behaviors in a primary care-based weight loss intervention. International Journal of Obesity, 37(SUPPL.1), S12-S18. https://doi.org/10.1038/ijo.2013.91
Volger, S. ; Wadden, T. A. ; Sarwer, D. B. ; Moore, R. H. ; Chittams, J. ; Diewald, L. K. ; Panigrahi, E. ; Berkowitz, R. I. ; Schmitz, K. ; Vetter, M. L. ; Wadden, Thomas A. ; Sarwer, David B. ; Berkowitz, Robert I. ; Chittams, Jesse ; Diewald, Lisa ; Kumanyika, Shiriki ; Moore, Renee ; Schmitz, Kathryn ; Tsai, Adam G. ; Vetter, Marion ; Volger, Sheri ; Moran, Caroline H. ; Derbas, Jeffrey ; Dougherty, Megan ; Khan, Zahra ; Lavenberg, Jeffrey ; Panigrahi, Eva ; Evans, Joanna ; Schriftman, Ilana ; Tioxon, Dana ; Webb, Victoria ; Williams-Smith, Catherine ; Barg, Ronald ; Kute, Nelima ; Lush, David ; Mruk, Celeste ; Orellana, Charles ; Rudnitsky, Gail ; Monroe, Angela ; Anderson, Lisa ; Eberly, David E. ; Fink, Albert H. ; Malone, Kathleen ; Nonack, Peter B. ; Soffer, Daniel ; Thurman, John N. ; Wertheimer, Marc J. ; Shovlin, Barbara Jean ; Johnson, Lanisha ; Esrey, Jill ; Heit, Jeffrey ; Joebstl, Barbara C. ; Vlad, Oana ; Schneider, Rose ; Brandley, Tammi ; Jelinski, Linda ; Griska, Joel ; Nichols, Karen J. ; Reis, Edward G. ; Shepard, James W. ; Davis-Whitely, Doris ; Sturgis, Charin ; Fleming, Katherine ; Greenblatt, Dana B. ; Schaffer, Lisa ; Welch, Tamara ; Rosato, Melissa ; Butts, Eugonda ; Ortiz, Marta ; Nieves, Marysa ; White, Alethea ; Bullard, Cassandra ; DiMedio, Jennifer ; Ice, Melanie ; Loev, Brandt ; Potts, John S. ; Tressel, Christine ; Perez, Iris ; Rancy, Penny ; Rittenhouse, Dianne ; Colligan, Joanne. / Changes in eating, physical activity and related behaviors in a primary care-based weight loss intervention. In: International Journal of Obesity. 2013 ; Vol. 37, No. SUPPL.1. pp. S12-S18.
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abstract = "OBJECTIVE: To examine changes in eating behaviors and physical activity, as well as predictors of weight loss success, in obese adults who participated in a 2-year behavioral weight loss intervention conducted in a primary care setting. DESIGN: A longitudinal, randomized controlled, multisite trial. SUBJECTS: Three hundred ninety obese (body mass index, 30-50 kg m-2) adults, ≥21 years, in the Philadelphia region. METHODS: Participants were assigned to one of three interventions: (1) Usual Care (quarterly primary care provider (PCP) visits that included education on diet and exercise); (2) Brief Lifestyle Counseling (quarterly PCP visits plus monthly lifestyle counseling (LC) sessions about behavioral weight control); or (3) Enhanced Brief LC (the previous intervention with a choice of meal replacements or weight loss medication). RESULTS: At month 24, participants in both Brief LC and Enhanced Brief LC reported significantly greater improvements in mean (±s.e.) dietary restraint than those in Usual Care (4.4±0.5, 4.8±0.5 and 2.8±0.5, respectively; both P-values≤0.016). The percentage of calories from fat, along with fruit and vegetable consumption, did not differ significantly among the three groups. At month 24, both the Brief LC and Enhanced Brief LC groups reported significantly greater increases than usual care in energy expenditure (kcal per week) from moderately vigorous activity (+593.4±175.9, +415.4±179.6 and -70.4±185.5 kcal per week, respectively; both P-values≤0.037). The strongest predictor of weight loss at month 6 (partial R2 =33.4{\%}, P<0.0001) and at month 24 (partial R2 =19.3{\%}, P<0.001) was food records completed during the first 6 months. Participants who achieved a 5{\%} weight loss at month 6 had 4.7 times greater odds of maintaining a ≥5{\%} weight loss at month 24. CONCLUSIONS: A behavioral weight loss intervention delivered in a primary care setting can result in significant weight loss, with corresponding improvements in eating restraint and energy expenditure. Moreover, completion of food records, along with weight loss at month 6, is a strong predictor of long-term weight loss.",
author = "S. Volger and Wadden, {T. A.} and Sarwer, {D. B.} and Moore, {R. H.} and J. Chittams and Diewald, {L. K.} and E. Panigrahi and Berkowitz, {R. I.} and K. Schmitz and Vetter, {M. L.} and Wadden, {Thomas A.} and Sarwer, {David B.} and Berkowitz, {Robert I.} and Jesse Chittams and Lisa Diewald and Shiriki Kumanyika and Renee Moore and Kathryn Schmitz and Tsai, {Adam G.} and Marion Vetter and Sheri Volger and Moran, {Caroline H.} and Jeffrey Derbas and Megan Dougherty and Zahra Khan and Jeffrey Lavenberg and Eva Panigrahi and Joanna Evans and Ilana Schriftman and Dana Tioxon and Victoria Webb and Catherine Williams-Smith and Ronald Barg and Nelima Kute and David Lush and Celeste Mruk and Charles Orellana and Gail Rudnitsky and Angela Monroe and Lisa Anderson and Eberly, {David E.} and Fink, {Albert H.} and Kathleen Malone and Nonack, {Peter B.} and Daniel Soffer and Thurman, {John N.} and Wertheimer, {Marc J.} and Shovlin, {Barbara Jean} and Lanisha Johnson and Jill Esrey and Jeffrey Heit and Joebstl, {Barbara C.} and Oana Vlad and Rose Schneider and Tammi Brandley and Linda Jelinski and Joel Griska and Nichols, {Karen J.} and Reis, {Edward G.} and Shepard, {James W.} and Doris Davis-Whitely and Charin Sturgis and Katherine Fleming and Greenblatt, {Dana B.} and Lisa Schaffer and Tamara Welch and Melissa Rosato and Eugonda Butts and Marta Ortiz and Marysa Nieves and Alethea White and Cassandra Bullard and Jennifer DiMedio and Melanie Ice and Brandt Loev and Potts, {John S.} and Christine Tressel and Iris Perez and Penny Rancy and Dianne Rittenhouse and Joanne Colligan",
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Volger, S, Wadden, TA, Sarwer, DB, Moore, RH, Chittams, J, Diewald, LK, Panigrahi, E, Berkowitz, RI, Schmitz, K, Vetter, ML, Wadden, TA, Sarwer, DB, Berkowitz, RI, Chittams, J, Diewald, L, Kumanyika, S, Moore, R, Schmitz, K, Tsai, AG, Vetter, M, Volger, S, Moran, CH, Derbas, J, Dougherty, M, Khan, Z, Lavenberg, J, Panigrahi, E, Evans, J, Schriftman, I, Tioxon, D, Webb, V, Williams-Smith, C, Barg, R, Kute, N, Lush, D, Mruk, C, Orellana, C, Rudnitsky, G, Monroe, A, Anderson, L, Eberly, DE, Fink, AH, Malone, K, Nonack, PB, Soffer, D, Thurman, JN, Wertheimer, MJ, Shovlin, BJ, Johnson, L, Esrey, J, Heit, J, Joebstl, BC, Vlad, O, Schneider, R, Brandley, T, Jelinski, L, Griska, J, Nichols, KJ, Reis, EG, Shepard, JW, Davis-Whitely, D, Sturgis, C, Fleming, K, Greenblatt, DB, Schaffer, L, Welch, T, Rosato, M, Butts, E, Ortiz, M, Nieves, M, White, A, Bullard, C, DiMedio, J, Ice, M, Loev, B, Potts, JS, Tressel, C, Perez, I, Rancy, P, Rittenhouse, D & Colligan, J 2013, 'Changes in eating, physical activity and related behaviors in a primary care-based weight loss intervention', International Journal of Obesity, vol. 37, no. SUPPL.1, pp. S12-S18. https://doi.org/10.1038/ijo.2013.91

Changes in eating, physical activity and related behaviors in a primary care-based weight loss intervention. / Volger, S.; Wadden, T. A.; Sarwer, D. B.; Moore, R. H.; Chittams, J.; Diewald, L. K.; Panigrahi, E.; Berkowitz, R. I.; Schmitz, K.; Vetter, M. L.; Wadden, Thomas A.; Sarwer, David B.; Berkowitz, Robert I.; Chittams, Jesse; Diewald, Lisa; Kumanyika, Shiriki; Moore, Renee; Schmitz, Kathryn; Tsai, Adam G.; Vetter, Marion; Volger, Sheri; Moran, Caroline H.; Derbas, Jeffrey; Dougherty, Megan; Khan, Zahra; Lavenberg, Jeffrey; Panigrahi, Eva; Evans, Joanna; Schriftman, Ilana; Tioxon, Dana; Webb, Victoria; Williams-Smith, Catherine; Barg, Ronald; Kute, Nelima; Lush, David; Mruk, Celeste; Orellana, Charles; Rudnitsky, Gail; Monroe, Angela; Anderson, Lisa; Eberly, David E.; Fink, Albert H.; Malone, Kathleen; Nonack, Peter B.; Soffer, Daniel; Thurman, John N.; Wertheimer, Marc J.; Shovlin, Barbara Jean; Johnson, Lanisha; Esrey, Jill; Heit, Jeffrey; Joebstl, Barbara C.; Vlad, Oana; Schneider, Rose; Brandley, Tammi; Jelinski, Linda; Griska, Joel; Nichols, Karen J.; Reis, Edward G.; Shepard, James W.; Davis-Whitely, Doris; Sturgis, Charin; Fleming, Katherine; Greenblatt, Dana B.; Schaffer, Lisa; Welch, Tamara; Rosato, Melissa; Butts, Eugonda; Ortiz, Marta; Nieves, Marysa; White, Alethea; Bullard, Cassandra; DiMedio, Jennifer; Ice, Melanie; Loev, Brandt; Potts, John S.; Tressel, Christine; Perez, Iris; Rancy, Penny; Rittenhouse, Dianne; Colligan, Joanne.

In: International Journal of Obesity, Vol. 37, No. SUPPL.1, 01.08.2013, p. S12-S18.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Changes in eating, physical activity and related behaviors in a primary care-based weight loss intervention

AU - Volger, S.

AU - Wadden, T. A.

AU - Sarwer, D. B.

AU - Moore, R. H.

AU - Chittams, J.

AU - Diewald, L. K.

AU - Panigrahi, E.

AU - Berkowitz, R. I.

AU - Schmitz, K.

AU - Vetter, M. L.

AU - Wadden, Thomas A.

AU - Sarwer, David B.

AU - Berkowitz, Robert I.

AU - Chittams, Jesse

AU - Diewald, Lisa

AU - Kumanyika, Shiriki

AU - Moore, Renee

AU - Schmitz, Kathryn

AU - Tsai, Adam G.

AU - Vetter, Marion

AU - Volger, Sheri

AU - Moran, Caroline H.

AU - Derbas, Jeffrey

AU - Dougherty, Megan

AU - Khan, Zahra

AU - Lavenberg, Jeffrey

AU - Panigrahi, Eva

AU - Evans, Joanna

AU - Schriftman, Ilana

AU - Tioxon, Dana

AU - Webb, Victoria

AU - Williams-Smith, Catherine

AU - Barg, Ronald

AU - Kute, Nelima

AU - Lush, David

AU - Mruk, Celeste

AU - Orellana, Charles

AU - Rudnitsky, Gail

AU - Monroe, Angela

AU - Anderson, Lisa

AU - Eberly, David E.

AU - Fink, Albert H.

AU - Malone, Kathleen

AU - Nonack, Peter B.

AU - Soffer, Daniel

AU - Thurman, John N.

AU - Wertheimer, Marc J.

AU - Shovlin, Barbara Jean

AU - Johnson, Lanisha

AU - Esrey, Jill

AU - Heit, Jeffrey

AU - Joebstl, Barbara C.

AU - Vlad, Oana

AU - Schneider, Rose

AU - Brandley, Tammi

AU - Jelinski, Linda

AU - Griska, Joel

AU - Nichols, Karen J.

AU - Reis, Edward G.

AU - Shepard, James W.

AU - Davis-Whitely, Doris

AU - Sturgis, Charin

AU - Fleming, Katherine

AU - Greenblatt, Dana B.

AU - Schaffer, Lisa

AU - Welch, Tamara

AU - Rosato, Melissa

AU - Butts, Eugonda

AU - Ortiz, Marta

AU - Nieves, Marysa

AU - White, Alethea

AU - Bullard, Cassandra

AU - DiMedio, Jennifer

AU - Ice, Melanie

AU - Loev, Brandt

AU - Potts, John S.

AU - Tressel, Christine

AU - Perez, Iris

AU - Rancy, Penny

AU - Rittenhouse, Dianne

AU - Colligan, Joanne

PY - 2013/8/1

Y1 - 2013/8/1

N2 - OBJECTIVE: To examine changes in eating behaviors and physical activity, as well as predictors of weight loss success, in obese adults who participated in a 2-year behavioral weight loss intervention conducted in a primary care setting. DESIGN: A longitudinal, randomized controlled, multisite trial. SUBJECTS: Three hundred ninety obese (body mass index, 30-50 kg m-2) adults, ≥21 years, in the Philadelphia region. METHODS: Participants were assigned to one of three interventions: (1) Usual Care (quarterly primary care provider (PCP) visits that included education on diet and exercise); (2) Brief Lifestyle Counseling (quarterly PCP visits plus monthly lifestyle counseling (LC) sessions about behavioral weight control); or (3) Enhanced Brief LC (the previous intervention with a choice of meal replacements or weight loss medication). RESULTS: At month 24, participants in both Brief LC and Enhanced Brief LC reported significantly greater improvements in mean (±s.e.) dietary restraint than those in Usual Care (4.4±0.5, 4.8±0.5 and 2.8±0.5, respectively; both P-values≤0.016). The percentage of calories from fat, along with fruit and vegetable consumption, did not differ significantly among the three groups. At month 24, both the Brief LC and Enhanced Brief LC groups reported significantly greater increases than usual care in energy expenditure (kcal per week) from moderately vigorous activity (+593.4±175.9, +415.4±179.6 and -70.4±185.5 kcal per week, respectively; both P-values≤0.037). The strongest predictor of weight loss at month 6 (partial R2 =33.4%, P<0.0001) and at month 24 (partial R2 =19.3%, P<0.001) was food records completed during the first 6 months. Participants who achieved a 5% weight loss at month 6 had 4.7 times greater odds of maintaining a ≥5% weight loss at month 24. CONCLUSIONS: A behavioral weight loss intervention delivered in a primary care setting can result in significant weight loss, with corresponding improvements in eating restraint and energy expenditure. Moreover, completion of food records, along with weight loss at month 6, is a strong predictor of long-term weight loss.

AB - OBJECTIVE: To examine changes in eating behaviors and physical activity, as well as predictors of weight loss success, in obese adults who participated in a 2-year behavioral weight loss intervention conducted in a primary care setting. DESIGN: A longitudinal, randomized controlled, multisite trial. SUBJECTS: Three hundred ninety obese (body mass index, 30-50 kg m-2) adults, ≥21 years, in the Philadelphia region. METHODS: Participants were assigned to one of three interventions: (1) Usual Care (quarterly primary care provider (PCP) visits that included education on diet and exercise); (2) Brief Lifestyle Counseling (quarterly PCP visits plus monthly lifestyle counseling (LC) sessions about behavioral weight control); or (3) Enhanced Brief LC (the previous intervention with a choice of meal replacements or weight loss medication). RESULTS: At month 24, participants in both Brief LC and Enhanced Brief LC reported significantly greater improvements in mean (±s.e.) dietary restraint than those in Usual Care (4.4±0.5, 4.8±0.5 and 2.8±0.5, respectively; both P-values≤0.016). The percentage of calories from fat, along with fruit and vegetable consumption, did not differ significantly among the three groups. At month 24, both the Brief LC and Enhanced Brief LC groups reported significantly greater increases than usual care in energy expenditure (kcal per week) from moderately vigorous activity (+593.4±175.9, +415.4±179.6 and -70.4±185.5 kcal per week, respectively; both P-values≤0.037). The strongest predictor of weight loss at month 6 (partial R2 =33.4%, P<0.0001) and at month 24 (partial R2 =19.3%, P<0.001) was food records completed during the first 6 months. Participants who achieved a 5% weight loss at month 6 had 4.7 times greater odds of maintaining a ≥5% weight loss at month 24. CONCLUSIONS: A behavioral weight loss intervention delivered in a primary care setting can result in significant weight loss, with corresponding improvements in eating restraint and energy expenditure. Moreover, completion of food records, along with weight loss at month 6, is a strong predictor of long-term weight loss.

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U2 - 10.1038/ijo.2013.91

DO - 10.1038/ijo.2013.91

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C2 - 23921776

AN - SCOPUS:84882417027

VL - 37

SP - S12-S18

JO - International Journal of Obesity

JF - International Journal of Obesity

SN - 0307-0565

IS - SUPPL.1

ER -