Enhancing long-term weight loss maintenance: 2year results from the Keep It Off randomized controlled trial

Nancy E. Sherwood, A. Lauren Crain, Brian C. Martinson, Christopher P. Anderson, Marcia G. Hayes, Julie D. Anderson, Meghan M. Senso, Robert W. Jeffery

Research output: Contribution to journalArticlepeer-review

40 Scopus citations


Objective: The Keep It Off trial evaluated the efficacy of a phone-based weight loss maintenance intervention among adults who had recently lost weight in Minnesota (2007-2010). Methods: 419 adults who had recently lost ≥ 10% of their body weight were randomized to the "Guided" or "Self-Directed" intervention. Guided participants received a 10 session workbook, 10 biweekly, eight monthly and six bimonthly phone coaching calls, bimonthly weight graphs and tailored letters based on self-reported weights. Self-Directed participants received the workbook and two calls. Primary outcomes are weight change and maintenance (regain of < 2.5% of baseline body weight). Results: Mixed model repeated-measures analysis examining weight change revealed a significant time by treatment group interaction (p < 0.0085). Guided participants regained significantly less weight than the Self-Directed participants at 12 and 24. months. The odds of 24. month maintenance were 1.37 (95% CI: 0.97-2.03) times greater in the Guided than in the Self-Directed group. When maintenance rates were compared across all follow-ups, there was a consistently higher maintenance rate for Guided participants (HR 1.31, 95% CI: 1.12-1.54). Conclusions: A sustained, supportive phone- and mail-based intervention promotes weight loss maintenance relative to a brief intervention for participants who have recently lost weight.

Original languageEnglish (US)
Pages (from-to)171-177
Number of pages7
JournalPreventive medicine
Issue number3-4
StatePublished - Mar 2013

Bibliographical note

Funding Information:
This study was supported by a grant from the National Cancer Institute ( R01 CA128211 ). The project was initiated and analyzed by the study investigators. This manuscript represents original work. All authors have contributed to and approved the manuscript and this material has not been published nor is it under consideration for publication at any other journal or electronic media.

Copyright 2013 Elsevier B.V., All rights reserved.


  • Behavioral intervention
  • Maintenance
  • Obesity
  • Weight loss


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