The beneficial effect of weight loss on cardiovascular risk factors such as hypertension, dyslipidemia, and type 2 diabetes is well established. However, this effect only lasts as long as weight loss is maintained, and since regain is a common and complex problem, there is a critical need for practical and affordable strategies to effectively maintain weight loss. The goal of this study was to compare two practical strategies for maintaining weight loss for 30 months following initial weight loss with a self-directed control group. The study was conducted in a large, diverse adult population (n=1,032, body mass index from 25 to 45 kg/m2) at high risk for cardiovascular diseases (CVD). The first strategy involved monthly personal contact and the second strategy involved unlimited access to an interactive technology-based intervention (website). The study revealed that after an average 30 months of randomization, subjects in the personal contact group regained 1.5 kg less weight than subjects in the self-directed control group (95% CI, 2.4 to -0.6 kg; p=0.001). In addition, subjects in the interactive technology-based group regained only 0.3 kg less than those in the self-directed control group (95% CI, -1.2 to 0.6 kg; p=0.51). Although weight regain with the personal contact intervention was statistically less than weight regain in the self-directed control group, the mean effect was a modest 1.5 kg. However, even modest weight loss can improve cardiovascular risk factors. In conclusion, subjects randomly assigned to the personal contact intervention regained significantly less weight than those assigned to the self-directed and interactive technology-based interventions. The authors concluded that further research should focus on longer interventions and follow-up, on the study of predictors of successful maintenance, and how to further improve both personal contact and interactive technology-based interventions.
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