Of the lifestyle strategies used following intervention, self-monitoring and group/commercial support may be particularly important in longer-term PA levels.
Background:
Behavioral weight loss interventions are successful in producing weight loss; however, weight regain following cessation of intervention is common. Little is known about use of lifestyle strategies following interventions, differences in use by sex, and how use of strategies relates to longer-term weight trajectories.
Methods:
This analysis includes participants in the Slow the Adverse Vascular Effects of excess weight (SAVE) study with 24 month follow-up data. SAVE included 349 men and women aged 20-45 years with body mass index 25-39.9kg/m
2
. The SAVE weight loss intervention lasted for 18 months, with sessions decreasing in frequency over time. At 24 months, participants completed a survey about lifestyle strategies used in the past six months, including self-monitoring, group support, behavioral skills, and professional support. Chi-square and Fischer exact tests were used to compare frequency of strategies by sex. T tests were used to compare percent change in weight between baseline and 24-month by use of strategies vs. no use.
Results:
214 participants completed 24 month visit (61% of baseline cohort). 74% were female and 86% were white, which did not differ from the baseline cohort. Overall, 65% used self-monitoring, 67% used group support, 94% used behavioral skills, and 27% used professional support within past 6 months. Recording physical activity (52%) and calories (43%) were the most common self-monitoring strategies. Self-weighing (83%), cue management (71%), and portion management (74%) were commonly used behavioral skills. Women were more likely than men to use group support (72% vs. 54%; p = .01). Women were also more likely to use the behavioral skills of rewarding success (32% vs. 9%; p = .001), portion management (78% vs. 64%; p = .046), and cue management (77% vs. 52%; p = .000). Women more frequently reported receiving professional support of diet counseling (48% vs. 15%; p = 0.04) or physical activity counseling (59% vs. 23%; p =0.02) from their PCP than men. Participants who used behavioral strategies had a significantly greater percent change in body weight at 24 months than those who did not (-3.9% vs. -0.7%; p =0.02). No significant differences were found in percent change in body weight at 24 months between participants who used self-monitoring, group support and professional support and those who did not.
Conclusions:
Participants who completed a weight loss intervention report using a variety of lifestyle strategies after cessation of intervention. Women reported more frequent use of lifestyle strategies than men. Behavioral strategies may be particularly important in longer-term weight loss. Attention should be paid to developing strategies to ensure longer-term weight loss after interventions.
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