Preventing Weight Gain : One-Year Results of a Randomized Lifestyle Intervention

BackgroundLifestyle interventions targeting prevention of weight gain may have better long-term success than when aimed at weight loss. Limited evidence exists about such an approach in the primary care setting.DesignAn RCT was conducted.Setting/participantsParticipants were 457 overweight or obese patients (BMI=25–40 kg/m2, mean age 56 years, 52% women) with either hypertension or dyslipidemia, or both, from 11 general practice locations in the Netherlands.InterventionIn the intervention group, four individual visits to a nurse practitioner (NP) and one feedback session by telephone were scheduled for lifestyle counseling with guidance of the NP using a standardized computerized software program. The control group received usual care from their general practitioner (GP).Main outcome measuresChanges in body weight, waist circumference, blood pressure, and blood lipids after 1 year (dropout <10%). Data were collected in 2006 and 2007. Statistical analyses were conducted in 2007 and 2008.ResultsThere were more weight losers and stabilizers in the NP group than in the general practitioner usual care (GP-UC) group (77% vs 65%; p<0.05). In men, mean weight losses were 2.3% for the NP group and 0.1% for the GP-UC group (p<0.05). Significant reductions occurred also in waist circumference but not in blood pressure, blood lipids, and fasting glucose. In women, mean weight losses were in both groups 1.6%. In the NP group, obese people lost more weight (−3.0%) than the non-obese (−1.3%; p<0.05).ConclusionsStandardized computer-guided counseling by NPs may be an effective strategy to support weight-gain prevention and weight loss in primary care, in the current trial, particularly among men.Trial registrationThe study was registered with the Netherlands Trial Register (NTR), www.trialregister.nl, study no. TC 1365.