Public Release: 

A maintenance program key to keeping off lost weight

American College of Physicians

Abstract: http://annals.org/aim/article/doi/10.7326/M16-2160

URLs go live when the embargo lifts

A weight loss program that incorporates a maintenance intervention could help participants be more successful at keeping off pounds long term. Researchers found that a primarily telephone-based intervention focused on providing strategies for maintaining weight loss modestly slowed the rate of participants' weight regain after weight loss. Results of a randomized trial are published in Annals of Internal Medicine.

Despite the efficacy of behavioral weight loss programs, weight loss maintenance remains the holy grail of weight loss research. After initial weight loss, most people tend to regain weight at a rate of about 2 to 4 pounds a year. Teaching people weight maintenance skills has been shown to slow weight gain, but can be time and resource-intensive. Simple and effective weight maintenance interventions are needed.

Researchers tested a weight maintenance intervention on obese outpatients who had lost an average of 16 pounds during a 16-week, group-based weight loss program to determine if a low-intensity intervention could help participants keep off the weight they lost. Participants were randomly assigned to the intervention or usual care. The intervention focused on providing participants with skills to help them make the transition from initiating weight loss to maintaining their weight. Over the first 42 weeks, the intervention shifted from group visits to individual telephone calls, with decreased frequency of contact. There was no intervention contact during the final 14 weeks. The usual care group had no contact except for weight assessments. After 56 weeks, mean weight regain in the intervention group was about 1.5 pounds compared to 5 pounds in the usual care group. The evidence suggests that incorporating a weight maintenance intervention into clinical or commercial weight loss programs could make them more effective over the long term.

Note: For an embargoed PDF, please contact Cara Graeff. To speak with the lead author, Corrine Voils at the Clinical Science Center, Madison, WI, please contact Isatu Hughes at Isatu.Hughes@va.gov or 1-888-478-8321 ext. 11011.


2. The Internet may be an effective tool for treating chronic knee pain
Abstract: http://annals.org/aim/article/doi/10.7326/M16-1714
Editorial: http://annals.org/aim/article/doi/10.7326/M17-0330
Free patient summary: http://annals.org/aim/article/doi/10.7326/P17-9031
URLs go live when the embargo lifts

An online intervention combining home exercise and pain-coping skills training provided substantial clinical benefits for patients suffering from chronic knee pain. This model of care delivery could greatly improve patient access to effective treatments. Results of a randomized, controlled trial are published in Annals of Internal Medicine.

Knee osteoarthritis, the leading cause of chronic knee pain, causes loss of function, reduced quality of life, and psychological disability. There is no cure for osteoarthritis and given the aging population and increasing obesity, disease burden is rapidly increasing. Home-based exercise and pain-coping skills training (an approach based on cognitive behavioral principles to target psychological factors that are common in persons with chronic pain) have been shown to offer relief, but accessing specialist clinicians to prescribe and supervise these treatments may be a challenge for some patients.

Researchers tested an Internet-delivered treatment program to determine if it could improve pain and function in patients with chronic knee pain. Participants were randomly assigned to an intervention or control group. The intervention group had seven Skype sessions with a physical therapist to learn home exercises and pain-coping skills over 3 months. The control group received educational materials online. The researchers measured pain and physical functioning in both groups at baseline, 3 months, and 9 months. Participants in the intervention group reported significantly more improvement in pain and physical function than those in the control group.

The author of an accompanying editorial suggests that these findings are encouraging and show that "telemedicine" can break down barriers to care, making treatment inexpensive and easily scalable.

Note: For an embargoed PDF, please contact Cara Graeff. To speak with the lead author, Dr. Kim L. Bennell at the University of Melbourne, please contact Liz Lopez at lopez.e@unimelb.edu.au or +61 3 834 42704. To reach the editorialist, Lisa Mandl, MD, MPH, at the hospital for Special Surgery, New York, NY, please contact Tracy Hickenbottom at hickenbottomt@hss.edu or 212-606-1197.

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Free video: http://annals.org/aim/article/doi/10.7326/W17-0002

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