Preventing weight gain in adults: the pound of prevention study.

Abstract

Obesity has attracted increasing concern in recent years as a public health issue because it is causally related to a variety of negative health outcomes, including diabetes, ' hypertension,2 cardiovascular disease,3 and some cancers,4 and its prevalence in the United States has risen dramatically in the last decade.5 The magnitude of the problem of obesity is further underscored by the fact that extensive research has not yet produced practical and effective long-term treatments for the disorder once it has developed.6Bleak prospects for successful medical management of obesity suggest that an approach to the problem that focuses on primary prevention rather than treatment may be more effective. From a population perspective, obesity is primarily an adult-onset disorder. Between the ages of 20 and 50 years, average weight gain per year among adults in the United States is approximately 0.5 to 1 kg.7 Slowing this rate of weight gain would be an important step in reducing the population impact of obesity. However, methods for accomplishing this objective have, to date, received little research attention.Only one published study has specifically evaluated a program for weight gain prevention. Forster and colleagues conducted a 1-year weight gain prevention trial with normalweight adults.8 In this study, an intervention involving low-intensity education with fmancial incentives for maintaining body weight produced an average weight loss of 1 kg, which differed significantly from the 0-kg weight change observed in an untreated control group.The present article reports the results of a 3-year weight gain prevention trial that was an extension of this earlier work. A large and diverse sample of adults participated in the study, half receiving low-intensity educational interventions and the other half receiving no treatment. This report describes participation in the intervention and the effects of the intervention on weight-related behaviors and body weight. Methods SettingThe Pound of Prevention study was conducted in collaboration with 4 local health departments serving individuals in the cities of Minneapolis and St. Paul, Minn, and 2 adjacent suburbs. Study participants were assessed at 1 of3 health department sites or a university site annually for 3 years. Intervention activities were conducted by mail and through face-toface education at health department sites and other community settings. ParticipantsStudy participants were recruited from a variety of sources. Two hundred twenty-eight men and 594 women were recruited by direct phone solicitation, newspaper advertisements, and mailings to employees of a large educational institution (the University of Minnesota). Because obesity and weight gain with age are particularly problematic for women of low socioeconomic status (SES),9 404 low-income women (household incomes of $25 000 or less per year) were recruited via telephone solicitations in neighborhoods with a high concentration of low-SES households, information booths at shopping centers in low-income nei...

A systematic review of interventions aimed at the prevention of weight gain in adults

“…In other studies, the activity advice was not clearly reported (12,13,16) . Three studies reported no significant difference in physical activity between groups (13)(14)(15) . One reported no change in fitness but a change in self-reported physical activity (12) .…”

The definition of weight maintenance

“…The majority of the studies in Table 2 were observational, but the Pound of Prevention Study tested an intervention to promote weight maintenance. The primary paper from that study 53 examined weight change as a continuous variable, and therefore was not included in our table. However, two follow-up articles from this same study categorized weight change using different criteria: a 5.0 pound absolute weight change 40 and a 5.0% weight change.…”

Can anyone successfully control their weight? Findings of a three year community-based study of men and women

“…These have been described elsewhere in detail, 6 and since this report is not concerned with the effects of the intervention, they are described only brie¯y here. Half of the subjects were assigned to a no-contact control group, one-quarter received education through monthly newsletters, and one-quarter received education plus participation incentives.…”

“…The effects of that intervention on weight-related behaviours and mean change in body weight have been reported previously. 6 The present study describes the prevalence, distribution and correlates of successful weight loss and successful weight maintenance over 3 y. This study is unique in providing data from a non-clinical sample in which success at weight control has been objectively assessed.…”