Location: Children's Nutrition Research CenterTitle: Incremental benefit of adherence in a community-based weight loss program Author
Submitted to: Journal of Clinical Lipidology
Publication Type: Abstract Only
Publication Acceptance Date: 2/27/2013
Publication Date: 5/30/2013
Citation: Johnston, C.A., Rost, S., Miller-Kovach, K., Moreno, J.P., Foreyt, J.P. 2013. Incremental benefit of adherence in a community-based weight loss program [abstract]. Journal of Clinical Lipidology. 7(3):244. Interpretive Summary:
Technical Abstract: While weight loss has been associated with program adherence, less attention has been given to the impact of varying levels of adherence. Because a high degree of adherence is not always feasible, understanding the impact of decreased adherence on outcomes can assist in making realistic goals. This study examined the impact of varying levels of adherence on weight loss in a community-based, intensive behavioral counseling program, Weight Watchers PointsPlus (WW) that included three modes of access (i.e., meeting attendance, WW website, and WW mobile application). We hypothesized that a dose-response relationship would be observed between adherence and the amount of weight change. A total of 292 participants were randomized to a WW (n = 147) or a self-help (n = 145) condition. Measured heights (cm) and weights (kg) were obtained at baseline and 6 months, and weekly participation was monitored. In order to assess the impact of participation, only WW participants were included in the following analyses. Meeting attendance was used as our measure of adherence. Participants were placed in five equal groups based on their level of adherence. A one-way analysis of variance was conducted to determine difference in weight loss between patients with differing levels of adherence. As predicted, a dose response relationship was observed (F = 17.7, P < .001). The highest quintile of adherence demonstrated the greatest weight loss (10.1 kg) (P < .001). The next two quintiles lost significantly more weight (5.1 kg and 3.9 kg, respectively) than the lowest two quintiles (1.5 kgs for both groups) (P < .05). Behavioral theory indicates that successive approximations promote change and that behavioral change should not be viewed as "all-or-nothing." These results suggest that participation in a weight loss program may be beneficial even with lower levels of adherence.