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Routine-based intervention fails to improve outcomes in behavioral weight-loss program
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Adults with overweight or obesity who participated in a 4-week intervention that emphasized eating only at five prespecified meal times while keeping a consistent sleep/wake schedule lost significantly less weight in a behavioral weight-loss program that followed vs. adults who attended a control program, according to research in Obesity Science & Practice.
Kathryn E. Demos, PhD, assistant professor of psychiatry and human behavior at Brown University and the Weight Control and Diabetes Research Center in Providence, Rhode Island, and colleagues analyzed data from 25 adults younger than 65 years with a BMI between 25 kg/m² and 45 kg/m² who were weight stable (within 5% of their current body weight during the preceding 6 months). Researchers performed baseline assessments of body weight and randomly assigned participants to either weekly routine intervention sessions for 4 weeks (n = 12; 75% women; mean age, 55 years; all white; mean baseline BMI, 32.8 kg/m²) or to weekly education-only control group sessions for 4 weeks (n = 13; 69% women; mean age, 50 years; 77% white; mean baseline BMI, 34 kg/m²). Participants in the routine intervention group were instructed to eat only at five prespecified times each day (three meals and two snacks) and to keep a consistent sleep/wake schedule that allowed for 8 hours of sleep nightly; participants scheduled eating times in food diaries.
Control group participants attended weekly educational sessions on the prevalence and health consequences of obesity and the importance of fruit and vegetable intake; no behavior modification strategies were taught or promoted. Participants in both groups were asked not to attempt weight loss during the 4-week period.
Body weight assessments were repeated and all participants began an 18-week behavioral weight-loss intervention with six weekly meetings, followed by 12 weeks of biweekly meetings incorporating diet (a 1,200-1,500 kcal/day diet, based on weight), exercise (increasing physical activity to at least 200 minutes per week) and behavioral therapy (self-monitoring, goal setting, stimulus control and problem solving). Participants received $25 compensation for completing both the 4-week and 18-week programs.
Participants in the routine group lost significantly less weight in the first 6 weeks of behavioral intervention vs. the control group (mean, –2.3 kg vs. –4.6 kg; P = .04) and lost less weight than controls over the full 18-week program (mean, –3.2 kg vs. –5.8 kg; P = .23). The routine group reported an increase in “on-schedule” eating and a decrease in “off-schedule” eating during the 4-week routine intervention, but there was no change in on-schedule sleep patterns.
“The hypothesis that working on establishing healthy eating and sleep routines prior to the start of a [behavioral weight-loss] program would improve weight loss was not supported,” the researchers wrote. “Although the difference between groups at the conclusion of treatment was not statistically significant with the relatively small sample, this finding represents a medium size effect ... with the routine intervention group losing less weight than [the control group] overall.” – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.
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