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Small-changes obesity treatment among veterans: 12-month outcomes

Laura J Damschroder1, Lesley D Lutes2, Susan Kirsh3

  • 1Veterans Affairs Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan.

American Journal of Preventive Medicine
|September 14, 2014
PubMed
Abstract

Insights

Group-based weight loss (ASPIRE-Group) significantly outperformed phone-based (ASPIRE-Phone) and standard (MOVE!) programs in a trial with Veterans. This small-changes intervention shows promise for real-world weight management.

Area of Science:

  • Obesity research
  • Behavioral medicine
  • Public health

Background:

  • Weight-loss trials often use selective samples, limiting generalizability.
  • Challenging, real-world populations require effective weight management strategies.

Purpose of the Study:

  • To compare a small-changes intervention (ASPIRE) delivered via phone or group sessions against standard care (MOVE!) in Veterans.
  • To assess effectiveness in a predominantly male, high-risk population.

Main Methods:

  • A 12-month, three-arm randomized pragmatic effectiveness trial.
  • 481 overweight/obese Veterans randomized to ASPIRE-Phone, ASPIRE-Group, or standard MOVE! program.
  • Interventions involved 28 coaching sessions (ASPIRE) vs. 15-30 sessions (MOVE!).

Main Results:

  • All groups achieved significant weight loss (p<0.01) at 12 months.
  • ASPIRE-Group yielded greater weight loss (-2.8 kg) than ASPIRE-Phone (-1.4 kg) and MOVE! (-1.4 kg) (p<0.05).
  • ASPIRE-Group also showed superior improvements in other anthropometric measures compared to MOVE! and ASPIRE-Phone.

Conclusions:

  • Group-based ASPIRE is more effective for sustained weight loss in this Veteran population.
  • The findings suggest potential for significant population-level benefits if group-based ASPIRE is widely implemented.

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