The Implementation Guide is a resource for implementing this evidence-based program. It provides important information about the staffing and functions necessary for administering this program in the user's setting. Additionally, the steps needed to carry out the program, relevant program materials, and information for evaluating the program are included. The Implementation Guide can be viewed and downloaded in the Program Materials page.
Designed to improve dietary habits and increase physical activity to reduce obesity, this intervention is led by wellness counselors who facilitate (1) one-on-one sessions following THE COACH APPROACH exercise support protocol that teach self-regulatory skills of goal planning and progress monitoring and (2) group sessions that focus on strengthening self-regulation skills in weight loss and weight- loss maintenance, increasing fruit and vegetable intake, and controlling eating behaviors. The study showed a decrease in weight and increases in physical activity and fruit and vegetable intake.
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Currently in the United States, 72 million adults are obese. Many health-related conditions are linked to obesity, including heart disease, stroke, type 2 diabetes, and certain types of cancer. Multi-component interventions that are widely applicable are needed to combat obesity by targeting both nutrition and physical activity.
Weight Loss For Life is a nutrition and exercise intervention that targets weight loss and maintenance of weight loss among adults. Weight Loss For Life combines the exercise-support protocol of THE COACH APPROACH, an intervention that has been reviewed separately by RTIPs, with a component focused on nutrition. Built upon social cognitive and self-efficacy theories, the 14-month program includes one-on-one and group sessions designed to increase self-regulation, ability to address barriers to weight management, and mastery and competence.
For the first 6.5 months of the intervention, participants attend six one-on-one 45-minute sessions consisting of THE COACH APPROACH exercise support protocol. These sessions focus on developing an exercise plan and initiating exercise, developing self-regulatory skills such as goal planning and progress monitoring, and assessing exercise-induced changes in mood. At 2 months, after participants have had the opportunity to adopt a regular exercise routine, sessions targeting eating behavior change are added sequentially and continue until 14 months. These sessions include two one-on-one 30-minute sessions in which participants are provided methods for tracking calories (e.g., website, calorie counter workbook) and a customized calorie-intake goal based on weight; ten 60-minute group nutrition sessions focused on weight reduction in which participants learn to apply the self-regulatory skills learned in THE COACH APPROACH to eating behaviors; and 14 group sessions focused on strengthening self-regulation skills in the areas of weight loss and weight-loss maintenance, increasing fruit and vegetable intake, and controlling eating behaviors.
All sessions are led by wellness counselors with a minimum of one national certification (e.g., American College of Sports Medicine) and training on the intervention. Although the intervention targets men and women who are overweight and obese, the study included in this summary involved only female participants with obesity.
-- 11 hours for training wellness counselors
-- Six 45-minute one-on-one meetings for exercise planning and support
-- Two 30-minute one-on-one meetings for calorie-intake planning
-- Ten 60-minute group nutrition meetings
-- 14 group sessions for additional skill building on self-regulation for weight loss and weight-loss maintenance
Weight Loss For Life targets overweight and obese adults aged 18 years and older who are not currently in any regular exercise program and want to achieve and sustain weight loss.
This intervention can be implemented in any facility where wellness counselors can meet regularly with participants.
Required resources to implement the program include the following:
-- Coach Approach Manual
-- Coach Approach Training for Wellness Counselors
-- Weight Loss For Life Module 1
-- Weight Loss For Life Module 2
-- Weight Loss For Life Module 3
-- Weight Loss For Life Timeline
For costs associated with this program, please contact the developer, James J. Annesi. (See products page on the RTIPs website for developer contact information.)
About the Study
A randomized controlled trial compared Weight Loss For Life with an alternative intervention involving review of a print manual and telephone follow-ups. The study recruited women who were at least 21 years of age (n=110) at small, community-based wellness/fitness centers. Women who had a BMI greater or equal to 30 and less than 40 were eligible to participate. The study excluded women who planned to become pregnant in the near future or who were currently pregnant, as well as those using psychotropic or weight-loss medications, currently participating in a weight-loss program, or participating in a physical activity/exercise program in the past year that averaged a minimum of 20 minutes per week. The demographics of the participants were mostly middle-class women with the following racial identities: 83% White, 11% African American, and 6% other racial/ethnic groups. Participants had a mean age of 48.2 years and a mean BMI of 35.3 kg/m2.
Participants were randomized at the site level to either the experimental condition (n=55) or a 24-week comparison condition (n=55). Women in the comparison condition received a 265-page, 12-lesson print manual, The LEARN (lifestyle, exercise, attitudes, relationships, nutrition) Program for Weight Management (10th edition), which they reviewed independently. Every 2 weeks, participants read one lesson and received a follow-up telephone call with a wellness counselor to discuss lesson contents and the participant's plans for behavior change.
The main outcomes weight, physical activity, and fruit and vegetable intake were assessed at baseline and 3, 6, 12, and 24 months after baseline. Weight change was measured by study staff using a recently calibrated scale (Healthometer Professional 800KL, Buffalo Grove, IL). Participants stepped on the scale twice without shoes or heavy material, and the mean weight was recorded by a staff member. Physical activity was measured using the Godin-Shephard Leisure-Time Physical Activity Questionnaire. Using this instrument, participants recorded their weekly sessions of physical exertion of more than 15 minutes, with strenuous activity such as running equaling about 9 METs, moderate activity such as fast walking equaling about 5 METs, and light activity such as easy walking equaling about 3 METs. Fruit and vegetable intake was measured through a self-report survey. The serving amounts reported were based on serving sizes determined by the U.S. Department of Agriculture's MyPlate and former Food Guide Pyramid.
- Over the 24-month study period, women in the experimental group had significantly greater weight loss than women in the comparison group (p<.001).
- Over the 24-month study period, women in the experimental group had a significantly greater increase in physical activity than women in the comparison group (p<.001).
- Over the 24-month study period, women in the experimental group had a significantly greater increase in fruit and vegetable intake than women in the comparison group (p<.01).
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