Obesity

Adaptive vs Monthly Support for Weight-Loss Maintenance: A Randomized Clinical Trial

JAMA Netw OpenPublished Randomised controlled trial

Authors' conclusion

In this randomized clinical trial, participants in both conditions were successful at maintaining initial weight loss 20 months after the end of a weight-loss program, but providing extended care on an adaptive schedule did not confer additional benefit vs the once-per-month static schedule. Future research should investigate whether more precise algorithms of high-risk periods for weight regain can be developed and whether these models can improve weight maintenance outcomes. Moreover, given success of participants in both conditions at maintaining initial weight loss, future research should also investigate methods of improving the implementation and dissemination potential of telephone-based extended care interventions.

Study context

Population
Adults with obesity who lost ≥5% of baseline weight in a 16-week weight-loss program, areas within driving distance of Gainesville, Florida; mean age 50.6 years, 82.0% women
Participants
255 adults
Comparison
Telephone-based extended care on an adaptive vs static schedule
  • Adaptiven = 128
  • Staticn = 127reference
Primary endpoint
Weight change from month 4 (end of initial intervention) to month 24
Follow-up
Month 4 to month 24
Methodological detailsConducted October 2019 to November 2024, 20 months of telephone-based extended care delivered individually by a trained interventionist
  • Conducted October 2019 to November 2024
  • 20 months of telephone-based extended care delivered individually by a trained interventionist

Primary result

As reported in the abstract

Weight regain · month 4 to 24

Further findings

Proportion maintaining weight loss ≥5% · month 24

Mean

OutcomeAdaptiveStatic
Weight loss maintained from initial intervention baseline · month 248.1% (SD 7.8%)7.9% (SD 8.5%)

Proportion maintaining weight loss ≥5% · month 24

Not a significant difference

Original publication

Adaptive vs Monthly Support for Weight-Loss Maintenance: A Randomized Clinical Trial. JAMA Netw Open. Published 2 September 2025. doi:10.1001/jamanetworkopen.2025.32681

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