June 10, 2013

Novel weight-loss study seeks to end yo-yo dieting

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Yo-yo dieter.

gareth dutton 2013 13It’s not something anyone sets out to be, but many who fight the battle of the bulge find the label fits. They lose 10, 20, 30 or more pounds, only to regain it — often in greater amounts than was lost. It can be a vicious cycle that repeats itself over and again.

Gareth Dutton, Ph.D., UAB associate professor of preventive medicine, seeks to enroll more than 100 people in the third round of his Improving Weight Loss (ImWeL) study during the next two months. Dutton hypothesizes that brief but intensive follow-up care may bolster dieters’ motivation and prevent relapse.

“The trial examines the effects of an alternative schedule of follow-up, or a clustered campaign approach,” Dutton says. “It sets this study apart from other behavioral weight-loss trials in which participants come on a pre-established, fixed schedule. Our trial includes sets of clustered treatment sessions that share common themes or campaigns. Participants will have more frequent contact with staff during these brief periods, which may keep participants engaged in long-term treatment.”

Overweight and obese adults will be enrolled in a 16-week, behavioral weight-loss program. Those who lose 5 percent of initial body weight — with the help of professional health-care interventionists — will be randomized into a 12-month weight-loss-maintenance program. The research will compare the outcomes of two extended-care obesity programs — the clustered campaign approach and a self-directed comparison.

There is no cost for participation, and study participants will receive a $25 gift card at each of three follow-up assessments. All information collected for the trial is confidential. For information on the ImWeL study or to volunteer, call 975-7108 or email IMWEL@dopm.uab.edu.

Dutton wants to enroll 320 participants total in this initial trial, which he hopes is a prelude to a larger, nationwide trial.

“This is the first time this particular design has been examined — a maintenance program with periods of intense contact and chunks of independent work,” Dutton says. “If it shows promise, we hope to conduct a larger trial with more participants, other comparisons and for a longer period of time.”

The study is funded by the National Institute of Diabetes and Digestive and Kidney Diseases, one of the National Institutes of Health.

Success so far

To date, trial participants who have been in the program the longest have lost an average 17 pounds — a clinically meaningful number that equates to 7 to 8 percent weight-loss for participants.

“Research shows us weight-loss is associated with prevention of chronic conditions like diabetes and heart disease,” Dutton says. “It also helps manage those conditions if someone already has been diagnosed.

“So we are very pleased with the weight-loss and excited that participants are maintaining losses during this first year that presents the highest risk for weight gain.”

Anne Hubbell, a lifestyle counselor and nutritionist in UAB’s Division of Preventive Medicine, co-leads the weight-loss groups and follows participants into maintenance.

Hubbell says the patients have lauded the study’s focus on accountability and lifestyle changes instead of dieting.

“We give the participants guidance in making changes that will last and help break the gain-lose-regain cycle of weight-loss,” Hubbell says. “Participants receive scientifically sound recommendations from health-care professionals in nutrition, exercise and behavior change.”

The novel scheduling approach enables participants to work on their own and have periods of more intense support.

During the clustered campaigns, health-care professionals educate participants on varied topics.

“We’re reinforcing things they’ve already learned,” Dutton says. “But we’re also trying to keep it interesting, fresh and exciting with new topics during the maintenance sessions.”

“We know from other studies that people lose motivation because they get bored,” Dutton says. “We aim to keep it from becoming boring.”