Preventing Weight Gain in Young Adults A Randomized Controlled Pilot Study

Background: This pilot study evaluated the preliminary efficacy of two self-regulation approaches to weight-gain prevention: Small Changes (changes in energy balance of roughly 200 kcal/day) and Large Changes (initial weight loss of 5-10 lbs to buffer against future weight gains). Intervention: Participants were enrolled in 8-week programs teaching Small or Large Changes (SC; LC). Both approaches were presented in a self-regulation framework, emphasizing daily self-weighing. Design: Randomized controlled pilot study. Setting/participants: Young adults (N=52) aged 18-35 years (25.6 +/- 4.7 years, BMI of 26.7 +/- 2.4 kg/m(2)) were recruited in Providence RI and Chapel Hill NC. Main outcome measures: Adherence to intervention, weight change, and satisfaction/confidence in approach assessed at 0, 8, and 16 weeks. Data were collected in 2008 and analyzed in 2008-2009. Results: Participants attended 84% of sessions, and 86.5% and 84.5% of participants completed post-treatment and follow-up assessments, respectively. Participants adhered to their prescriptions. Daily weighing increased markedly in both groups, whereas the eating and exercise changes observed in the SC and LC reflected the specific approach taught. Weight changes were significantly different between groups at 8 weeks (SC = 0.68 +/- 1.5 kg, LC = 3.2 +/- 2.5 kg, p<0.001) and 16 weeks (SC = 1.5 +/- 1.8 kg, LC = 3.5 +/- 3.1 kg, p=0.006). Participants in both groups reported high levels of satisfaction and confidence in the efficacy of the approach they were taught. Conclusions: Both Small and Large Change approaches hold promise for weight-gain prevention in young adults; a fully powered trial comparing the long-term efficacy of these approaches is warranted. (Am J Prey Med 2010;39(1):63-68) (C) 2010 American Journal of Preventive Medicine