Minimal Intervention Programs for Weight Loss in Heart Transplant Candidates: A Preliminary Examination

Abstract

Context Overweight can be a contraindication for cardiac transplantation, and empirical findings suggest that obesity may pose serious posttransplant health risks that can increase morbidity and mortality. Objective This study assessed the relative effectiveness of 2 minimal intervention programs to assist weight loss in heart transplant candidates. Design A randomized trial was employed to assess changes in body weight. Setting A large, tertiary care hospital in a Southern locale. Patients Forty-three heart transplant candidates (74% men, 79% married, 86% white), with a mean pretreatment body mass index of 32.4 (SD=4.4). Interventions Patients were randomly assigned to a bibliotherapy weight-loss program or a bibliotherapy plus telephone contact weight-loss program. Main Outcome Measures Change in body weight over 3 months and return rate of measures of program adherence (3-day food diaries and self-monitoring postcards). Results An intent-to-treat analysis showed a significant weight loss at posttreatment for the sample as a whole. Within-group analyses indicated that a significant weight change ( P<.05) in the telephone contact group (mean[SD]=-2.76[4.96] kg) but not the bibliotherapy-only group (mean[SD]=-1.02[2.97] kg). Participants in the telephone contact group returned more 3-day food diaries and self-monitoring postcards, with pounds lost significantly correlated with the number of completed self-monitoring postcards. These findings suggest that a minimal intervention program involving information plus limited professional contact may represent a viable approach to assisting overweight transplant candidates in weight management.