Cancer Control Research5R01CA112594-04
PROMOTING HEALTHY WEIGHT WITH "STABILITY FIRST"
DESCRIPTION (provided by applicant): Despite the benefits of weight loss, attempts at weight-loss maintenance are short-lived. Once active maintenance interventions end, individuals often give up lifestyle and self-regulatory changes and regain the weight they lost. We propose that individuals need to learn a novel set of stability skills that optimize current satisfaction with lifestyle and self-regulatory habits: (a) learn to eat a healthy diet and be more active without feeling deprived (relative deprivation theory) and (b) learn to regulate or 'fine-tune' the balance between eating, activity, and weight with the minimum effort and attention necessary (limited resources theory). We also propose that individuals will be more successful if they learn these stability skills before initiating weight loss (i.e., stability first), thus, capitalizing on initial motivation, providing mastery, and increasing self-efficacy for maintaining a stable weight in the future (social cognitive theory). The current revision will test whether learning stability skills before losing weight improves long-term weight management (i.e., during a subsequent follow-up). In this randomized trial, 232 overweight and obese adults will be randomly assigned to 1 of 2 conditions. In the Stability Skills condition, individuals will initially learn stability skills in a 3-month preparatory module before participating in a standard 6-month behavioral weight-loss program. In the Control condition, individuals will initially learn nutrition consumer skills (of demonstrated interest to participants but unrelated to weight stability and maintenance) in a 3-month preparatory module before participating a standard weight-loss program identical to that received in Stability Skills. Participants in both conditions will be assessed during a 12-month follow-up after the weight-loss programs; offered the same number of classes during the 9-month intervention period; and will start and finish the 6-month weight loss programs at the same time. Outcomes will be measured at baseline, 3, 9, 15 and 21 months. Primary aims will examine whether Stability Skills individuals (1a) gain less weight during the 12-month follow-up; and (1b) lose more weight over the entire 21-month study than Control individuals. Secondary aims will: (2a) examine condition differences on lifestyle and self-regulatory changes (e.g., diet, activity, weighing), psychological outcomes (e.g., depressive symptoms), and weight stability; (2b) examine baseline moderators (e.g., gender); and (2c) investigate mediators (e.g., deprivation, effort and attention, and self-efficacy).