The purpose of this project is to test, for the first time, a reverse diet in adults with current or prior overweight/obesity (Ow/Ob). Weight-reduced adults with current or prior Ow/Ob will be randomized to a reverse diet or "standard care" control (CON) intervention for 12 weeks. Eligible participants will have lost \>10% body mass. The reverse diet group will receive personalized caloric intake goals, increasing 2-3%/week. The CON group will receive standard weight maintenance recommendations with matched contact. At baseline and week 12, resting energy expenditure (REE), body mass and composition, subjective appetite, and food intake behaviors will be evaluated. In addition to the pre- and post-intervention measures, body mass and adherence to reverse diet will be monitored weekly.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
SINGLE
Enrollment
24
Participants in both groups will receive a 12-week comprehensive, individually delivered behavioral weight loss maintenance intervention, adapted from the Diabetes Prevention Program (DPP) Post-CORE program. This program focuses on utilization of tools and strategies to maintain a healthy lifestyle and prevent weight regain, and is therefore most appropriate for the weight-reduced population we will enroll. While the DPP Post-CORE program includes 15 sessions delivered over 15-months, we will deliver sessions #1-12 and 15 over a 12-week period. Content for sessions 13 and 14 from the DPP Post-CORE curriculum focus specifically on Type 2 Diabetes Mellitus and Heart Disease. The informational handouts will be provided to participants, but not specifically covered in weekly meetings. Groups will differ only in specific caloric prescriptions (described in the Arms section).
University of Denver, Anschutz Medical Campus
Aurora, Colorado, United States
Adherence to the prescribed diet
Self-reported caloric intake compared to prescribed caloric intake
Time frame: 12 weeks
Adherence to the prescribed diet
Evaluated via mathematical model based on change in body mass and composition.
Time frame: 12 weeks
Enrollment Success
The investigators will assess whether they are able to enroll 24 participants meeting study inclusion/exclusion criteria over a 9-month recruitment window. If enrollment is \<24, the investigators will determine barriers to enrollment and re-evaluate the study design and/or recruitment strategies. The investigators will also assess participation rate (number approached versus enrolled), reasons potential participants decline enrollment, and ability to meet demographic goals for the larger trial (approximately equal men and women, ≥33% racial and ethnic minorities).
Time frame: 9 months
Attrition Rate
The investigators will assess the participant drop-out rate and reasons for attrition over the 12-week study, determine reasons for drop-outs and examine whether drop-out rates differ between intervention arms.
Time frame: 12 Months
Changes in Body Mass
Measured via calibrated digital scale.
Time frame: Measured weekly throughout the 12-week trial.
Changes in Body Composition
Measured via Dual-energy X-ray absorptiometry (DXA) scan
Time frame: At baseline and post intervention (Week 12).
Changes in Resting Energy Expenditure
Measured via standard indirect calorimetry with ventilated hood technique
Time frame: At baseline and post intervention (Week 12).
Dietary Adherence
Evaluated via self-report using a measure created by researchers: * "How adherent were you to the prescribed diet over the past week?", * measured by self-report from 1 (not at all) to 10 (very much so), * higher scores indicate higher dietary adherence
Time frame: Measured weekly throughout the 12-week trial.
Effort
Measure created by researchers: * "How hard was it to adhere to the prescribed diet over the last week?" * measured by self-report from 1(very easy) to 10 (very difficult) * higher scores indicate more expended effort
Time frame: Weekly, throughout the 12-Week Trial
Self-Efficacy
Measure created by researchers: * "How likely do you feel you can adhere to the prescribed diet for the next week?" * measured by self-report from 1(not at all likely) to 10 (very likely) * higher scores indicate higher self-efficacy
Time frame: Weekly, throughout the 12-Week Trial
Changes in Food-Related Behaviors
Evaluated via Three-Factor Eating Questionnaire, which is divided into three subscales: * Factor One: Dietary Restraint (higher scores indicate higher levels of restrained eating) * Factor Two: Dis-inhibition of Control (higher scores indicate higher levels of disinhibited eating) * Factor Three: Susceptibility to Hunger (higher scores indicate higher levels of predisposition to hunger)
Time frame: At baseline and post intervention (Week 12).
Changes in Food-Related Behaviors
Evaluated via the Weight Efficacy Lifestyle Questionnaire, which is divided into five subscales: * Negative Emotions * Availability * Social Pressure * Physical Discomfort * Positive Activities
Time frame: At baseline and post intervention (Week 12).
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.