• Jack F Hollis, Christina M Gullion, Victor J Stevens, Phillip J Brantley, Lawrence J Appel, Jamy D Ard, Catherine M Champagne, Arlene Dalcin, Thomas P Erlinger, Kristine Funk, Daniel Laferriere, Pao-Hwa Lin, Catherine M Loria, Carmen Samuel-Hodge, William M Vollmer, Laura P Svetkey, and Weight Loss Maintenance Trial Research Group.
• Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon 97227, USA. jack.hollis@kpchr.org
• Am J Prev Med. 2008 Aug 1; 35 (2): 118126118-26.

BackgroundTo improve methods for long-term weight management, the Weight Loss Maintenance (WLM) trial, a four-center randomized trial, was conducted to compare alternative strategies for maintaining weight loss over a 30-month period. This paper describes methods and results for the initial 6-month weight-loss program (Phase I).MethodsEligible adults were aged > or =25, overweight or obese (BMI=25-45 kg/m2), and on medications for hypertension and/or dyslipidemia. Anthropomorphic, demographic, and psychosocial measures were collected at baseline and 6 months. Participants (n=1685) attended 20 weekly group sessions to encourage calorie restriction, moderate-intensity physical activity, and the DASH (dietary approaches to stop hypertension) dietary pattern. Weight-loss predictors with missing data were replaced by multiple imputation.ResultsParticipants were 44% African American and 67% women; 79% were obese (BMI> or =30), 87% were taking anti-hypertensive medications, and 38% were taking antidyslipidemia medications. Participants attended an average of 72% of 20 group sessions. They self-reported 117 minutes of moderate-intensity physical activity per week, kept 3.7 daily food records per week, and consumed 2.9 servings of fruits and vegetables per day. The Phase-I follow-up rate was 92%. Mean (SD) weight change was -5.8 kg (4.4), and 69% lost at least 4 kg. All race-gender subgroups lost substantial weight: African-American men (-5.4 kg +/- 7.7); African-American women (-4.1 kg +/- 2.9); non-African-American men (-8.5 kg +/- 12.9); and non-African-American women (-5.8 kg +/- 6.1). Behavioral measures (e.g., diet records and physical activity) accounted for most of the weight-loss variation, although the association between behavioral measures and weight loss differed by race and gender groups.ConclusionsThe WLM behavioral intervention successfully achieved clinically significant short-term weight loss in a diverse population of high-risk patients.

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