Strategi menjaga berat badan

Penelitian berikut membandingkan strategi mempertahankan penurunan berat badan. Para ahli melakukan randomized two-phase trial terhadap >1000 penderita obesitas disertai hipertensi dan dyslipidemia, yang telah mengalami penurunan berat badan minimal 4 kg dalam 6 bulan (fase 1).

Subyek di-randomized untuk fase 2, intervensi untuk mempertahankan penurunan berat badan selama 30 bulan berikut kelompok 1) monthly personal contact, kelompok 2)unlimited access to an interactive technology-based intervention, atau kelompok 3)self-directed control.

 

Hasilnya BB rata2 96,7 kg. Penurunan BB fase 1 rata2 8,5 kg. Setelah randomization kelompok 1 BB naik 4,0 kg ; kelompok 3 BB naik 5,5 kg. Kelompok 2 mengalami kenaikan BB lebih kecil dibanding kelompok 3 tapi perbedaannya tidak bermakna. Setelah 30 bulan juga ada perbedaan bermakna antara kelompok 1 dan kelompok 2. Pada akhir penelitian 71% subyek BB-nya tetap di bawah BB awal.

 

Kesimpulan sebagian besar penderita obesitas yang berhasil menurunkan BB berhasil mempertahankan BB-nya. Kontrol setiap bulan (monthly brief personal contact) merupakan cara terbaik untuk mempertahankan BB.

 

Berikut ini abstract dari penelitian tersebut

 

JAMA 2008;299(10): 1139-1148. Vol. 299 No. 10, March 12, 2008 © 2008 American Medical Association.
Comparison of Strategies for Sustaining Weight Loss. The Weight Loss Maintenance Laura P. Svetkey, MD; Victor J. Stevens, PhD; Phillip J. Brantley, PhD;  Lawrence J. Appel, MD; Jack F. Hollis, PhD; Catherine M. Loria, PhD; William M. Vollmer, PhD; Christina M. Gullion, PhD; Kristine Funk; Patti Smith; Carmen Samuel-Hodge, PhD; Valerie Myers, PhD; Lillian F. Lien, MD; Daniel Laferriere; Betty Kennedy, PhD; Gerald J. Jerome, PhD; Fran Heinith; David W. Harsha, PhD; Pamela Evans; Thomas P. Erlinger, MD; Arline T. Dalcin; Janelle Coughlin, PhD; Jeanne Charleston; Catherine M. Champagne, PhD; Alan Bauck; Jamy D. Ard, MD; Kathleen Aicher; for the Weight Loss Maintenance Collaborative Research Group

 

Context  Behavioral weight loss interventions achieve short-term success, but re-gain is common.

Objective  To compare 2 weight loss maintenance interventions with a self-directed control group.

Design, Setting, and Participants  Two-phase trial in which 1032 overweight or obese adults (38% African American, 63% women) with hypertension, dyslipidemia, or both who had lost at least 4 kg during a 6-month weight loss program (phase 1) were randomized to a weight-loss maintenance intervention (phase 2). Enrollment at 4 academic centers occurred August 2003-July 2004 and randomization, February-December 2004. Data collection was completed in June 2007.

Interventions  After the phase 1 weight-loss program, participants were randomized to one of the following groups for 30 months: monthly personal contact, unlimited access to an interactive technology–based intervention, or self-directed control.

Main Outcome  Changes in weight from randomization.

Results  Mean entry weight was 96.7 kg. During the initial 6-month program, mean weight loss was 8.5 kg. After randomization, weight regain occurred. Participants in the personal-contact group regained less weight (4.0 kg) than those in the self-directed group (5.5 kg; mean difference at 30 months, –1.5 kg; 95% confidence interval [CI], –2.4 to –0.6 kg; P = .001). At 30 months, weight regain did not differ between the interactive technology–based (5.2 kg) and self-directed groups (5.5 kg; mean difference –0.3 kg; 95% CI, –1.2 to 0.6 kg; P = .51); however, weight regain was lower in the interactive technology–based than in the self-directed group at 18 months (mean difference, –1.1 kg; 95% CI, –1.9 to –0.4 kg; P = .003) and at 24 months (mean difference, –0.9 kg; 95% CI, –1.7 to –0.02 kg; P = .04). At 30 months, the difference between the personal-contact and interactive technology–based group was –1.2 kg (95% CI –2.1 to –0.3; P = .008). Effects did not differ significantly by sex, race, age, and body mass index subgroups. Overall, 71% of study participants remained below entry weight.

Conclusions  The majority of individuals who successfully completed an initial behavioral weight loss program maintained a weight below their initial level. Monthly brief personal contact provided modest benefit in sustaining weight loss, whereas an interactive techonology–based intervention provided early but transient benefit.