October 10, 2010 |
In another article being released early online, Cheryl L. Rock, Ph.D., R.D., from Moores UCSD Cancer Center, La Jolla, Calif., and colleagues, conducted a randomized controlled trial of weight loss and weight maintenance in 442 overweight or obese women (BMI, 25 — 40), ages 18 to 69, over a two year period with follow-up between November 2007 and April 2010.
The women were randomized into three intervention groups: in-person, center-based (167 women) or telephone based (164 women) weekly one-to-one weight loss counseling, including free-of-charge prepackaged prepared foods (from Jenny Craig, Inc.) and increased physical activity for 30 minutes a day, five days a week. The participants were eventually transitioned to a meal plan that was not based mainly on the commercial program. The third group was the usual care group (111 women) who received two individualized weight loss counseling sessions with a dietetics professional and monthly contacts. All participants were provided a small monetary compensation ($25) for each completed clinic visit.
At 24 months, weight data were available for 407 of the 442 women (92.1 percent of the study sample). The average weight loss for the women participating in the center-based group was about 16 pounds or 7.9 percent of their initial weight, about 14 pounds or 6.8 percent for the telephone-based group, and about 4.5 pounds for the usual care control group. “By study end, more than half in either intervention group (62 percent of center-based [n=103] and 56 percent [n=91] of telephone-based participants) had a weight loss of at least 5 percent compared with 29 percent (n=32) of usual care participants,” the authors report.
“Findings from this study suggest that this incentivized structured weight loss program with free prepared meals can effectively promote weight loss compared with usual care group,” the authors comment. “Importantly, weight loss was largely maintained at two-year follow-up.” They note that even small percentage weight changes can result in a reduction of risk for cardiovascular disease and diabetes.
In conclusion the authors write: “For clinical practitioners, the evidence suggests that the structured program as applied in this study provides another route for their overweight and obese patients to achieve and maintain weight loss through behavioral changes for at least a two-year period.”
(JAMA. 2010;304:doi:10.1001/JAMA.2010.1503. Available pre-embargo to the media at www.jamamedia.org)
Editor’s Note: Dr. Rock reported serving on the advisory board for Jenny Craig from 2003 — 2004. The study was supported by Jenny Craig, Inc. (Carlsbad, Calif.), which provided program activities, materials, and prepackaged food to individuals assigned to the commercial weight loss program. Funding was provided through a clinical trial contract to the coordinating center (School of Medicine, University of California, San Diego), which subsequently disbursed funds to the collaborating clinical sites and the laboratories. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Editorial: Treatment Options for Obesity
In an accompanying editorial, Rena R. Wing, Ph.D., from the Warren Alpert Medical School, Brown University and Miriam Hospital, Providence, R.I., writes, “ the results of the trial reported by Rock et al probably represent a best-case scenario.”
“The findings of this trial by Rock et al raise the possibility that if structured commercial weight loss programs could be provided free of charge to participants, both retention and average weight loss outcomes might be far better than when participants must pay for these programs.”
“Currently, insurance companies will often cover the cost of bariatric surgery for obesity (estimated at $19,000 – $29,000 per patient from insurance reimbursement data) but do not cover the cost of commercial weight loss programs (such as that evaluated in this study, with estimated costs of approximately $1,600 for 12 weeks of the program and for food.) Providing commercial weight loss programs free to charge to participants might be a worthwhile health care investment.”
(JAMA.2010; 304:doi10.1001/JAMA.2010.1529. Available pre-embargo to the media at www.jamamedia.org.
Editor’s Note: Preparation of this editorial was supported in part by a grant from the National Institute of Diabetes and Digestive and Kidney Diseases. The sponsor had no role in the preparation, review, or approval of the manuscript.