| Article ID | Journal | Published Year | Pages | File Type |
|---|---|---|---|---|
| 906432 | Eating Behaviors | 2014 | 4 Pages |
•Maintenance of lost weight remains a significant problem in obesity treatment.•Innovative weight loss maintenance programs in real-world settings are needed.•Small Changes Maintenance (SCM) offered alternative to traditional maintenance.•SCM was feasible to implement and acceptable to participants.•SCM resulted in significantly less weight regain compared to historical controls.
Clinic-based liquid meal replacement (800 kcals/day) programs produce substantial weight loss. Nevertheless, long-term maintenance remains a challenge. A limitation of maintenance programs is that they continue to promote large behavior changes that are initially required to induce weight loss which may be unsustainable long-term. The study aims were to conduct a preliminary assessment of the feasibility, acceptability, and effectiveness of a small changes maintenance intervention (SCM) for 30 patients who completed liquid meal replacement program (LMR). The 20-session SCM delivered over 52 weeks offered no preset goals for maintenance behaviors and all changes in behavior were self-selected. Participants had a median BMI of 40.9 kg/m2 and weight of 111 kg at the start of LMR. At LMR completion, they lost 18% (21 kg) of body weight. The SCM was completed by 22 patients (73%); 19 completers (86%) attended ≥ 17 of 20 sessions with a median satisfaction rating of 9 (on a scale of 1 to 9). Completers were asked to record self-selected maintenance behaviors daily (median 351 days recorded). The most commonly reported daily behaviors were self-weighing, use of meal replacements and step counting. Median percent regain at week 52 was 14% (2.8 kg) of lost weight (range, − 42 to 74%), significantly less than a median of 56% (11 kg) percent regain of lost weight (range, − 78 to 110%) in a demographically similar historical control group with no maintenance intervention after LMR completion (P < 0.001). Thus, SCM holds promise for improving weight maintenance. Future research should compare SCM to standard maintenance programs that promote large program-directed changes.
