Objective: Most individuals who complete a behavioral weight loss program (BWLI) will regain weight; without additional intervention, recovery from regain is unlikely. A remotely-delivered, telephone-based intervention aimed at reversing small regains may be a promising and resource-efficient approach, as it would be provided at a targeted, salient time (e.g., following weight regain). The current study is a preliminary investigation into the efficacy of a telephone coaching intervention to aid recovery from weight regain during weight loss maintenance.
Methods: Participants (n=77; mean±SD: age = 54.1±9.9 years; BMI =29.2±4.2 kg/m2; 70.1% Female; 83.1% White, 7.8% Black, 6.5% more than 1 race, and 2.6% other) who had recently completed a BWLI and lost ≥5% of their initial body weight were instructed to engage in daily weighing using a “smart” scale. Participants were randomized to receive 4 consecutive weeks of brief (15-30 minute) coaching phone calls or no intervention. Randomization was activated when individuals regained ≥1.5% of their baseline weight. Coaching calls followed the Supportive Accountability Model and focused on building rapport and accountability to enhance motivation, with the overarching goal of helping participants identify and enact previously successful weight-loss strategies. Weight changes were examined from baseline to 12 months as well as during the coaching period (i.e., from activation of randomization to 40 days later). Only individuals who regained ≥1.5% (thus activating their randomization) were included in analyses.
Results: Sixty-six participants (86%) regained ≥1.5% from study baseline; 35 were randomized to receive coaching and 31 to the control group. Participants who received coaching (Mean±SD: 3.9±0.5 of 4 coaching calls completed) showed statistically significant improvements in weight in the short term compared to control participants (Coaching Mean±SE: -1.05±0.30% vs. Control: 0.37±0.31%). However, weights were not significantly different from baseline to the 12-month study end point (Coaching: 5.18±0.72% vs. Control: 5.71±0.76%).
Conclusions: Brief telephone coaching is a promising intervention for reversing weight regain in the short-term. Future research should focus on strategies to improve long-term coaching outcomes. Potential strategies may include increasing the dose, offering repeated coaching periods, and recommending weight management strategies specific to recovery from regain.