The University of Sydney, Sydney School of Public Health, Prevention Research Collaboration, Charles Perkins Centre, New South Wales, Australia.
The Australian Prevention Partnership Centre, Ultimo, New South Wales, Australia.
Clin Obes. 2020 Jun;10(3):e12359. doi: 10.1111/cob.12359. Epub 2020 Mar 26.
Weight-loss maintenance and lifestyle behaviour necessary to manage weight are undisputedly challenging. We evaluated a secondary prevention weight-loss maintenance programme for participants (n = 490) with weight-related chronic disease in the Australian private health insurance setting. This study investigated the impact of the maintenance programme on anthropometric and lifestyle risk behaviour changes after 6 and 12 months, and trends in weight-loss maintenance after 1 year. Using a pre- and post-test design, data were analysed with generalized linear mixed models for repeated measures to determine the effect of the programme on weight loss and lifestyle behaviour outcomes. After initially losing a clinically significant amount of weight (mean 9.1 kg), maintenance-programme participants maintained clinically significant weight loss (mean 7.6 kg) at 12 months. Rates of discontinuation in the programme were high (47% at 6 months and 73% at 12 months). Weight-loss maintenance was achieved by 76% of participants at 3 months and 62% at 6 months, stabilizing at 55% and 56% at 9 and 12 months, respectively. Greater initial weight loss was associated with weight-loss maintenance at 12 months. Participants <55 years demonstrated consistent weight-loss maintenance over this time but the odds for successful weight-loss maintenance for those ≥55 years continued to decrease over time. At maintenance-baseline, 68.3% of participants had sufficient physical activity for health; 61.4% and 19.8% met recommended fruit and vegetable consumption, respectively. All lifestyle risk behaviours were maintained at 12 months. A programme extending support strategies for maintaining weight-related behaviour shows promise to successfully support these changes over 12 months. There is a potentially important opportunity for targeted intervention at 6 to 9 months.
体重减轻的维持和管理体重所需的生活方式行为无疑具有挑战性。我们在澳大利亚私人健康保险环境中评估了针对患有与体重相关的慢性疾病的参与者（n=490）的二级预防体重减轻维持计划。本研究调查了维持计划对 6 个月和 12 个月后人体测量和生活方式风险行为变化的影响，以及 1 年后体重减轻维持的趋势。使用前后测试设计，使用广义线性混合模型进行重复测量分析来确定计划对体重减轻和生活方式行为结果的影响。在最初减轻了临床显著的体重（平均 9.1 公斤）后，维持计划的参与者在 12 个月时保持了临床显著的体重减轻（平均 7.6 公斤）。该计划的退出率很高（6 个月时为 47%，12 个月时为 73%）。76%的参与者在 3 个月时和 62%的参与者在 6 个月时实现了体重减轻维持，在 9 个月和 12 个月时分别稳定在 55%和 56%。初始体重减轻越多，12 个月时体重减轻维持的可能性越大。<55 岁的参与者在此期间持续保持体重减轻维持，但≥55 岁的参与者成功维持体重减轻的可能性随着时间的推移继续下降。在维持基线时，68.3%的参与者有足够的体力活动以保持健康；61.4%和 19.8%分别达到了推荐的水果和蔬菜摄入量。所有生活方式风险行为在 12 个月时都得到了维持。一个延长维持体重相关行为的支持策略的计划显示出在 12 个月内成功支持这些变化的潜力。在 6 至 9 个月期间，有一个潜在的重要干预机会。
