Small Changes Approach Promotes Initial and Continued Weight Loss with a Phone-Based Follow-Up: Nine-Month Outcomes from ASPIRES II

Abstract

Purpose. To examine the impact of a small-changes weight loss program across a 3-month intervention followed by a 6-month follow-up program. Design. A one-group pre-post intervention study. Setting. Medium-sized Southwestern university. Participants. Twenty-five obese adult women (mean body mass index [BMI] = 31.8 kg/m2, standard deviation [SD] = 4.9). Intervention. Participants were asked to choose and adopt small changes in their diet and physical activity relative to baseline during weekly group-based meetings over 3 months. Participants then received bi-weekly phone calls across a 6-month follow-up period. Measures. Weight change was the primary outcome. Secondary outcomes included waist circumference, daily step count, and caloric intake. Analyses. Intention-to-treat analysis of change from baseline and completers-only analysis (n = 22) for secondary outcomes. Results. Participants achieved clinically significant weight loss (mean [M] = − 3.2 kg standard error [SE] = .47 kg p < .001) across the initial small changes treatment program. Moreover, participants continued to lose weight across the 6-month phone-based follow-up program (M = − 2.1 kg SE = .83 kg, p < .017), totaling > 5% weight loss across the 9-month program (M = 5.3 kg SE= 1.1 kg, p < .001). Conclusion. Using a small changes approach, participants achieved weight loss in an initial group-based program, which continued with minimal phone-based follow-up. Larger randomized studies comparing a small changes approach to traditional obesity treatment are warranted.