Replication and Extension of the Weight Loss For Life Community-Based Treatment Protocol

Maintaining weight-loss beyond 6-9 months within behavioral treatments has been problematic. However, a social cognitive theory-driven, community-based curriculum emphasizing the generalization of physical activity-related self-regulation, to eating-related self-regulation (phase 1 treatment; n = 55), demonstrated success at both inducing lost weight over its initial 6 months, and maintaining that loss through month 24. The present replication study contrasted those outcomes with a phase 2 version of the year-long treatment (n = 74) that added a follow-up component during year 2 consisting of 5 brief phone interactions to reinforce self-regulatory skills. Participants were all women with obesity (body mass index 30-40 kg/m²; mean age = 48 years). In phase 2, the mean weight loss of 6.3% during baseline-month 6, and regain of 0.7% through month 24, did not significantly differ from phase 1. However, phase 2 methods were associated with significantly better retention of improvements in self-regulation, fruit/vegetable intake, and physical activity. For phase 2 results, second-year change in fruit/vegetable consumption completely mediated the significant relationship between self-regulation and weight change, and change in physical activity completely mediated the significant relationship between self-regulation and weight change, over the 2-year study. Findings suggest the importance of moderate physical activity and more intensive follow-up focused on self-regulation processes.