A randomized trial comparing weight loss treatment delivered in large versus small groups

Dutton, Gareth R.; Nackers, Lisa M.; Dubyak, Pamela Jean; Rushing, Nicole C.; Huynh, Tuong Vi T.; Tan, Fei; Anton, Stephen D.; Perri, Michael G.

doi:10.1186/s12966-014-0123-y

Cited by 19 publications

(18 citation statements)

References 40 publications

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“…Questionnaires utilized in this study were previously validated within diverse samples and demonstrated good reliability within the present sample. To our knowledge, only one other study has reported on group dynamics within lifestyle interventions for obesity , and therefore this study adds useful information on the associations between group dynamics and weight loss, attendance, and adherence.…”

Section: Discussionmentioning

confidence: 94%

“…Although the association of group dynamics and treatment outcomes has been researched extensively within the psychotherapy literature, it remains a largely unstudied phenomenon within lifestyle interventions for obesity. In a year long obesity intervention using groups of approximately 10 and 30 participants, Dutton et al found that participants within smaller groups endorsed greater cohesion than those in larger groups. Group cohesion, however, did not impact weight loss.…”

Section: Introductionmentioning

confidence: 99%

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Group dynamics are associated with weight loss in the behavioral treatment of obesity

Nackers

Dubyak

et al. 2015

Obesity

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Objective: To assess whether group dynamics are associated with weight loss, session attendance, and self-monitoring adherence after 6 months of lifestyle intervention for obesity. Methods: Women with obesity (N 5 125; mean 6 SD BMI 5 37.84 6 3.94 kg/m 2 ; age 5 51.99 6 10.81 years) participated in a 24-week group-based lifestyle weight loss intervention and achieved a weight loss of 9.13 6 7.15 kg after 6 months. Participants reported their perceptions of group conflict, avoidance, engagement, social support, and attraction at the end of treatment. Multiple regression with forward selection assessed which group dynamic variables were associated with weight loss, attendance, and adherence. Results: Greater perceived group conflict was associated with smaller weight losses (b 5 1.833, P 5 0.044) and lower attendance (b 5 22.313, P 5 0.002) and adherence rates (b 5 22.261, P 5 0.030). Higher group attraction was associated with higher attendance rates (b 5 0.051, P 5 0.039). The association between perceived conflict and weight change was mediated by attendance and adherence (P 5 0.019). Conclusions: Findings demonstrate that group dynamics associate with weight loss outcomes, attendance, and adherence. Addressing conflicts and fostering acceptance among group members may promote success in group-based lifestyle interventions for obesity.

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Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Group dynamics are associated with weight loss in the behavioral treatment of obesity

Nackers

Dubyak

et al. 2015

Obesity

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“…Intensive behavioral lifestyle interventions have been developed and are proven to reduce weight in clinical trials at levels that are beneficial for health [ 5 – 8 ]. The 2014 American Heart Association evidence-based guidelines on the treatment of obesity suggest that lifestyle interventions are most successful when they include face-to-face sessions [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…In an analysis controlling for site differences, group size was not found to be associated with mean weight loss [ 10 ]. In the single randomized trial conducted to date on this topic in obesity, Dutton and colleagues examined the effects of group size on engagement and weight loss [ 5 ]. Sixty-six participants were randomized to one group of 30 or to one of three smaller groups of 12 members.…”

Section: Introductionmentioning

confidence: 99%

Randomized trial comparing group size of periodic in-person sessions in a remotely delivered weight loss intervention

Tate

Valle

Crane

et al. 2017

Int J Behav Nutr Phys Act

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BackgroundFew randomized studies have examined differential effects of group size in behavioral weight control, especially in hybrid programs that include Internet treatment approaches.MethodsRandomized controlled trial (n = 195) comparing a 4 month hybrid internet weight loss program coupled with monthly face to face groups of 100 persons (Large Group, LG; 1 group) or to the same approach with monthly groups of 20 persons (Small Group, SG; 4 groups). Repeated-measures mixed-model analysis with age and race as covariates were used to estimate primary (weight) and secondary outcomes, and to test group differences in change over time.ResultsThe sample was 46.3 years old ±10.4, 90.3% female, and 51.9% non-white, with BMI 37.9 ± 8.4 kg/m2. Participants in the LG were more likely to return for the 4-month assessment visit than those in the SG (p = 0.04). Participants randomized to both the LG and SG conditions experienced significant WL over time (no between group difference: −4.1 kg and −3.7 kg, respectively) and weight loss was positively associated with attendance at monthly meetings and logins to the website. Satisfaction with the program was high and similar in both groups (94.4% reported that they were “satisfied” or “very satisfied”).ConclusionsUsing a hybrid approach of in-person and online weight loss interventions may be an effective way to reach larger and more diverse populations. Delivering the face to face component of the intervention in groups larger than those traditionally delivered (20–25 people) could increase the cost-effectiveness of group-based behavioral weight loss interventions.Clinical trials registration number NCT01615471. Registered June 6, 2012. Registered retrospectively.

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“…Participants perceived the group component of the intervention as important to their weight loss success, because the group provided an environment for both social support (encouragement, advice for addressing challenges, shared weight loss goal) and accountability in meeting dietary and physical activity goals. The superior weight loss benefits of group versus individual therapy have been documented [27, 28] and previous studies have found that level of group engagement [35] and conflict [36] were associated with weight loss during interventions for obese adults from the general population. Our findings contribute to the existing literature in identifying multiple group process mechanisms that were important specifically to breast cancer survivors.…”

Section: Discussionmentioning

confidence: 99%

A qualitative evaluation of a group phone-based weight loss intervention for rural breast cancer survivors: Themes and mechanisms of success

Fazzino

Sporn

Befort

2016

Support Care Cancer

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Purpose Obesity is prevalent in breast cancer survivors and is a significant risk factor for recurrence and mortality. Weight management interventions for survivors have been diverse in design (in-person vs. phone-based, group vs. individual) and yielded varying weight loss results. Given these issues, participants themselves may provide insight into treatment-based factors that contributed to their weight loss outcomes. Here we report qualitative results from interviews with survivors in a group phone-based weight loss intervention, with the objective of identifying mechanisms that facilitated or hindered adherence and weight loss. We explored interest in paying for continued treatment as an indicator of dissemination potential. Methods Individual interviews were conducted with 186 rural, obese breast cancer survivors upon completion of a six-month weight loss intervention that produced clinically meaningful weight loss (> 5%) in 91% of participants. A thematic analysis of the interview data was performed. Results Five themes were identified as impacting adherence and success: 1) accountability, 2) importance of the group, with varying levels of connectedness, 3) dietary convenience, 4) difficulty maintaining intervention components that required more effort, and 5) importance of internal motivation to attributions of physical activity success or failure. Most were interested in paying to continue the program if it were extended beyond the study. Conclusions Key intervention components that participants attributed to their success included supportive group processes and convenience. Results highlight the group phone-based approach as a potential venue for disseminating an effective weight loss program for breast cancer survivors.

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A randomized trial comparing weight loss treatment delivered in large versus small groups

Cited by 19 publications

References 40 publications

Group dynamics are associated with weight loss in the behavioral treatment of obesity

Group dynamics are associated with weight loss in the behavioral treatment of obesity

Randomized trial comparing group size of periodic in-person sessions in a remotely delivered weight loss intervention

A qualitative evaluation of a group phone-based weight loss intervention for rural breast cancer survivors: Themes and mechanisms of success

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