A randomized controlled trial 1 comparing different weight loss maintenance interventions involved 1032 overweight or obese adults with hypertension, dyslipidemia, or both. The participants had lost at least 4 kg during a 6-month weight loss program (phase 1) and were then randomized to one of three groups for 30 months (phase 2): monthly personal contact (supportive telephone contacts and a 1-h meeting with an interventionist quarterly), unlimited access to an interactive website providing a technology-based intervention, or self-directed control (printed lifestyle guidelines and a brief visit with an interventionist at 12 months). Mean entry weight was 96.7 kg. During phase 1, mean weight loss was 8.5 kg. At 30 months, participants in the personal-contact group had regained less weight than those in the self-directed group (4.0 kg vs. 5.5 kg; mean difference -1.5 kg; 95% confidence interval [CI], -2.4 to -0.6 kg; P = 0.001). Weight regain was lower in the interactive technology-based than in the self-directed group at 18 and 24 months, but at 30 months there was no difference left (5.2 vs. 5.5 kg; mean difference -0.3 kg; 95% CI, -1.2 to 0.6 kg; P = 0.51). At 30 months, the difference between the personal-contact and interactive technology-based group was -1.2 kg (95% CI -2.1 to -0.3; P = 0.008). Effects did not differ significantly by sex, race, age, and body mass index subgroups. Overall, 71% of study participants remained below entry weight.
Comment: The quality of evidence is downgraded by limitations in study quality (possible patient selection bias, possible contamination between the groups).
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