Evaluation of a Health at Every Size vs a Behavioral Weight Loss Approach for Obese Women
Recruitment status was Active, not recruiting
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Purpose
For over four decades the medical literature has observed a relationship between obesity and poorer health outcomes. The causal mechanisms of these poorer outcomes however are unclear. One assumption that has been supported by correlational data is that increased weight is associated with increased cardiovascular disease (CVD) risk factors (i.e., hypertension, dyslipidemia, and type 2 diabetes). Consequently, obese people are routinely prescribed weight loss programs in order to prevent or control these conditions. Unfortunately, long term weight loss has been met with minimal success for the large majority of people. Furthermore, the data suggesting that weight loss leads to long term health benefits and decreased mortality is limited and contradictory. The purpose of the proposed project is to perform a randomized controlled pilot study comparing the effectiveness of two lifestyle interventions for preventing CVD risk factors (hypertension, dyslipidemia, and type 2 diabetes). The interventions are constitutionally similar; however, the treatment condition is a wellness-focused intervention that teaches healthy living without consideration of weight. The control condition is a traditional curriculum where the prescribed outcome is weight loss. The primary goals of both programs are to reduce hypertension and total cholesterol, and to enhance glucose control. Secondary outcomes of interest are psychological and behavioral in nature (e.g., self-esteem; depressed mood; anxiety; stress; quality of life; dietary habits; and physical activity). We will compare the trajectories of the CVD and psychological/behavioral risk factors for a total period of 24 months (including the time from baseline to the end of the 6-month intervention). Our objectives are to collect data to a) determine whether participants in both programs reduce CVD and psychological/behavioral risk factors at the completion of the 6-month program, and b) compare the persistency of health improvements and rate of relapse at the end of the 18-month follow-up period between the traditional weight loss intervention and the wellness-focused intervention.
| Condition | Intervention | Phase |
|---|---|---|
|
Obesity |
Behavioral: Wellness-Centered (HUGS) Behavioral: Weight-Centered (LEARN) |
Phase 2 Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind (Subject) Primary Purpose: Treatment |
| Official Title: | Comparative Health Improvements and Rate of Relapse in Weight-Centered vs. Wellness-Centered Interventions for Obese Women |
- Systolic and Diastolic Blood Pressure [ Time Frame: Baseline, post-intervention, 6-months post intervention, 12-months post intervention, 18-months post intervention ] [ Designated as safety issue: No ]
- Blood Lipids (HDL cholesterol, LDL cholesterol, triglycerides, and total cholesterol) [ Time Frame: baseline, post intervention, 6-months post intervention, 12-months post intervention, 18-months post intervention ] [ Designated as safety issue: No ]
- Fasting Blood Glucose [ Time Frame: baseline, post intervention, 6-months post intervention, 12-months post intervention, 18-months post intervention ] [ Designated as safety issue: No ]
- self-esteem [ Time Frame: baseline, post intervention, 6-months post intervention, 12-months post intervention, 18-months post intervention ] [ Designated as safety issue: No ]
- depressed mood [ Time Frame: baseline, post intervention, 6-months post intervention, 12-months post intervention, 18-months post intervention ] [ Designated as safety issue: No ]
- anxiety [ Time Frame: baseline, post intervention, 6-months post intervention, 12-months post intervention, 18-months post intervention ] [ Designated as safety issue: No ]
- stress [ Time Frame: baseline, post intervention, 6-months post intervention, 12-months post intervention, 18-months post intervention ] [ Designated as safety issue: No ]
- eating, weight, and body shape attitudes [ Time Frame: baseline, post intervention, 6-months post intervention, 12-months post intervention, 18-months post intervention ] [ Designated as safety issue: No ]
- quality of life [ Time Frame: baseline, post intervention, 6-months post intervention, 12-months post intervention, 18-months post intervention ] [ Designated as safety issue: No ]
- physical activity [ Time Frame: baseline, post intervention, 6-months post intervention, 12-months post intervention, 18-months post intervention ] [ Designated as safety issue: No ]
- eating behavior (emotional eating, cognitive restraint, uncontrolled eating, intuitive eating) [ Time Frame: baseline, post intervention, 6-months post intervention, 12-months post intervention, 18-months post intervention ] [ Designated as safety issue: No ]
- power of food (the extent to which food controls one's life) [ Time Frame: baseline, post intervention, 6-months post intervention, 12-months post intervention, 18-months post intervention ] [ Designated as safety issue: No ]
- dietary habits [ Time Frame: baseline, post intervention, 6-months post intervention, 12-months post intervention, 18-months post intervention ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 80 |
| Study Start Date: | October 2008 |
| Estimated Study Completion Date: | May 2011 |
| Estimated Primary Completion Date: | May 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Wellness-Centered
A health at every size intervention, the HUGS program was conceived and developed in 1987 by Linda Omichinski, Registered Dietitian. HUGS stands for Health focused, Understanding lifestyle, Group supported, and Self-esteem building. It is an integrated approach that promotes healthy eating, active living, and self acceptance regardless of weight. HUGS teaches strategies to recognize and respond to physiological signs of hunger and satiety to determine food intake. The manualized curriculum is accompanied by the books Tailoring Your Tastes and Staying Off of the Diet Roller Coaster which participants will receive in addition to a booklet of handouts. Kelly Bliss, a psychotherapist and fitness professional with 17 years experience in health-centered approaches for weight management, will deliver the intervention in 2 groups of 20 people that meet weekly for 6 months.
|
Behavioral: Wellness-Centered (HUGS)
A health at every size intervention, the HUGS program was conceived and developed in 1987 by Linda Omichinski, Registered Dietitian. HUGS stands for Health focused, Understanding lifestyle, Group supported, and Self-esteem building. It is an integrated approach that promotes healthy eating, active living, and self acceptance regardless of weight. HUGS teaches strategies to recognize and respond to physiological signs of hunger and satiety to determine food intake. The manualized curriculum is accompanied by the books Tailoring Your Tastes and Staying Off of the Diet Roller Coaster which participants will receive in addition to a booklet of handouts. Kelly Bliss, a psychotherapist and fitness professional with 17 years experience in health-centered approaches for weight management, will deliver the intervention in 2 groups of 20 people that meet weekly for 6 months.
Other Names:
|
|
Active Comparator: Weight-Centered
The LEARN Program for Weight Management is an evidence-based behavior modification approach to weight loss developed by Dr. Kelly Brownell, Ph.D. Psychologist. LEARN is an acronym that stands for Lifestyle, Exercise, Attitudes, Relationships, and Nutrition. This manualized curriculum shares many principals with the HUGS program in that both emphasize the importance of healthy lifestyle choices and gradual sustainable change. However, the LEARN program makes weight loss an explicit goal and focuses more on food intake levels based on external prescriptions and caloric restriction. Participants in the LEARN program will receive the LEARN Program for Weight Management manual and the LEARN Weight Stabilization and Maintenance Guide along with the LEARN Program CD set. Ann Wellock, a Registered Dietician from The Reading Hospital and Medical Center will deliver the intervention in 2 groups of 20 people that meet weekly for 6 months.
|
Behavioral: Weight-Centered (LEARN)
The LEARN Program for Weight Management is an evidence-based behavior modification approach to weight loss developed by Dr. Kelly Brownell, Ph.D. Psychologist. LEARN is an acronym that stands for Lifestyle, Exercise, Attitudes, Relationships, and Nutrition. This manualized curriculum shares many principals with the HUGS program in that both emphasize the importance of healthy lifestyle choices and gradual sustainable change. However, the LEARN program makes weight loss an explicit goal and focuses more on food intake levels based on external prescriptions and caloric restriction. Participants in the LEARN program will receive the LEARN Program for Weight Management manual and the LEARN Weight Stabilization and Maintenance Guide along with the LEARN Program CD set. Ann Wellock, a Registered Dietician from The Reading Hospital and Medical Center will deliver the intervention in 2 groups of 20 people that meet weekly for 6 months.
Other Name: behavior based weight loss program
|
Eligibility| Ages Eligible for Study: | 30 Years to 45 Years |
| Genders Eligible for Study: | Female |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- Women ages 30 to 45 years old (at intervention onset);
- BMI between 30 and 45
- Physically inactive
- Practicing birth control if heterosexually active and pre-menopausal.
- English speaking
Exclusion Criteria:
- Current smoker
- Use of medications known to affect weight/energy expenditure;
- Pregnant, intending to get pregnant over next two years, or lactating;
- Recent myocardial infarction (within 6 months);
- Congestive heart failure
- Active neoplasms
- Type 1 and insulin-dependent Type 2 diabetes
- Cerebrovascular disease
- Renal disease
- Cirrhosis
- Bulimia nervosa
- Alcohol and/or Substance Abuse
- Major psychiatric disturbance (suicidality, psychosis, anti-social personality disorder, current manic episode)
- Prior bariatric surgery
- Plans to have bariatric surgery over next 2.5 years
Contacts and Locations| United States, Pennsylvania | |
| The Reading Hospital and Medical Center | |
| West Reading, Pennsylvania, United States, 19611 | |
| Principal Investigator: | Janell L Mensinger, Ph.D. | The Reading Hospital and Medical Center |
| Principal Investigator: | James Ku, MD | The Reading Hospital and Medical Center |
More Information
Additional Information:
No publications provided
| Responsible Party: | Janell Mensinger, Ph.D., Sr. Research Associate, The Reading Hospital and Medical Center |
| ClinicalTrials.gov Identifier: | NCT00769717 History of Changes |
| Other Study ID Numbers: | TRHMC 02708 |
| Study First Received: | October 8, 2008 |
| Last Updated: | August 26, 2009 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by The Reading Hospital and Medical Center:
|
obesity wellness cardiovascular disease prevention health at every size weight loss |
Additional relevant MeSH terms:
|
Obesity Overnutrition Nutrition Disorders |
Overweight Body Weight Signs and Symptoms |
ClinicalTrials.gov processed this record on May 23, 2013