This research study will compare two weight loss programs that provide different recommendations for how to reduce your energy (or calorie) intake to achieve weight loss in an effort to determine if fixed calorie reduction or varied calorie reduction is more effective for weight loss.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
223
University of Alabama at Birmingham, Medical Towers Building
Birmingham, Alabama, United States
Measure change in body weight (kg) from baseline to follow-up assessments
Participants will be weighed by body scale in kilograms
Time frame: Baseline, 6 months, 18 months
Resting energy expenditure
An indirect calorimeter with the ventilated hood technique will be used for the 30-minute measurement (the first 10 minutes will be excluded from analysis). The respiratory quotient will be calculated as the ratio of carbon dioxide production to oxygen consumption. Resting metabolic rate will be calculated from VO2 and VCO2 measurements using the Weir equation.
Time frame: 6, 12, and 18 months
Body composition
Assessed by full body DXA scan to evaluate percentage of body fat.
Time frame: 6, 12, and 18 months
Laboratory analyses
Glucose, lipids, and insulin will be analyzed using blood samples.
Time frame: 6, 12, and 18 months
Blood pressure
After a 5 minute seated rest, three measurements using an automated blood pressure device will be taken to obtain the average systolic and diastolic blood pressures.
Time frame: 6, 12, and 18 months
Hormones - ghrelin
Total ghrelin will be assessed using blood samples.
Time frame: 6, 12, and 18 months
Hormones - leptin
Total leptin will be assessed using blood samples.
Time frame: 6, 12, and 18 months
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Satiety/hunger
Visual analogue scales (VAS) will be used to measure subjective ratings of appetite. Participants will be asked to provide a rating in response to several questions (e.g., "How hungry did you feel this week? How much did you think about food this week?") using a 100-mm line ranging from "not at all" to "extremely".
Time frame: 6, 12, and 18 months
Physical activity - objective
Will be assessed via accelerometers worn by participants for seven days. Participants will be instructed to position the accelerometer at the right hip and to wear the device throughout the day except when sleeping, bathing, or participating in swimming or other water activities. These data will be used to estimate total minutes of moderate- to vigorous-intensity PA.
Time frame: 6, 12, and 18 months
Physical activity - self-report
Self-reported PA will also be assessed with the Paffenbarger Physical Activity Questionnaire (PPAQ). Both methods of PA measurement are included, as accelerometers provide objective information about total levels of activity, while the PPAQ provides additional details about the type and schedule of activities.
Time frame: 6, 12, and 18 months
Treatment adherence
Treatment adherence will be assessed by the number of treatment sessions attended as well as the number of self-monitoring forms completed, which have both been used as indicators of adherence in our previous work
Time frame: 6, 12, and 18 months
Treatment novelty
This construct will be evaluated with a 6-item measure of treatment reinforcement that assesses the extent to which participants enjoy and become less habituated to the behavioral strategies required for weight loss.
Time frame: 6, 12, and 18 months
Treatment burden
Behavioral burden of treatment will be assessed with a modified version of the Treatment Burden Questionnaire (TBQ), which includes 15 items measuring the burden of treatment, including behaviors of self-monitoring, dietary changes, maintaining physical activity, and the impact of treatment on social relationships.
Time frame: 6, 12, and 18 months
Treatment satisfaction
Participants will complete a modified version of the Treatment Satisfaction Questionnaire for Medication (TSQM) to assess attitudes and satisfaction regarding the weight loss intervention, energy prescriptions provided, and weight loss achieved. A composite score of treatment satisfaction will be calculated based on participants' responses.
Time frame: 6, 12, and 18 months