January 25, 2023
3 min read
Das reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
A lifestyle intervention delivered at work sites with or without meal replacement was associated with a mean weight loss of more than 8% at 6 months, according to a study published in Obesity.
Sai Krupa Das
“Work sites are, in fact, a great venue for providing options for weight management,” Sai Krupa Das, PhD, senior scientist at the Jean Mayer USDA Human Nutrition Research Center on Aging and associate professor in the Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy at Tufts University, told Healio. “A program that addresses challenges to weight-loss maintenance, such as hunger control, will help with long-term adherence and result in clinically meaningful weight loss.”
Das and colleagues conducted a parallel-group randomized controlled trial at 12 work sites in the Boston area with recruitment beginning in September 2015 and the trial finishing in February 2018. The 12 work sites were randomly assigned, 2:1, to be a Healthy Weight for Living lifestyle intervention site or a control site with no lifestyle intervention. The lifestyle intervention consisted of 1-hour meetings held weekly for 24 weeks and monthly thereafter in-person or by videoconference at the work site. Meetings were led by an interventionist and included an education unit and time for questions and support. Participants at the intervention sites were randomly assigned, 1:1, to lifestyle intervention alone or lifestyle intervention plus meal replacement. Adults in the meal replacement groups were instructed to eat two calorie-controlled meal replacement products per day for 6 months and then one per day for the remainder of the trial. Adults aged 21 years and older with overweight or obesity who were full-time employees at the participating work sites were eligible to enroll. Weight, body composition, blood pressure, cholesterol, triglycerides and glucose were measured at baseline and 6 months for all participants, as well as 12 and 18 months for intervention participants.
Weight loss at 6 months
The study cohort included 259 intervention participants and 76 control participants. Among the intervention participants, 130 were randomly assigned to lifestyle intervention alone and 129 to lifestyle intervention plus meal replacement. At 6 months, 95% of the control group remained enrolled in the study compared with 85% of the lifestyle intervention group and 75% of those assigned to lifestyle intervention plus meal replacement (P = .002). Excluding participants who were no longer employed with their workplace or pregnant women who were ineligible to complete the trial, net retention at 18 months was higher for those randomly assigned to lifestyle intervention alone vs. lifestyle intervention plus meal replacement (80% vs. 68%; P = .03).
At 6 months, the lifestyle intervention group lost a mean 8.8% of their baseline body weight, and those receiving lifestyle intervention plus meal replacement lost a mean 8% of baseline weight compared with a mean 0.03% weight gain in the control group (P < .001 for both). There were no significant differences in weight loss between the intervention groups at any time point. At 12 months, 52% of intervention participants lost at least 5% of their body weight, and 35% achieved at least a 10% weight loss. A small amount of weight gain was observed at 12 and 18 months. From baseline to 18 months, mean weight loss was 5.6% in the lifestyle intervention group and 6% in the lifestyle intervention plus meal replacement group.
“We were surprised to achieve significant weight loss in a work site setting, given that most other programs were faced with challenges and especially with just a 1-hour mostly video conference-disseminated group program,” Das said. “More importantly, we were pleased with the maintenance of a good amount of weight loss over the longer term.”
Metabolic benefits with lifestyle intervention
At 6 months, both intervention groups had improvements in triglyceride and glucose levels compared with controls. Those receiving the intervention and meal replacement had a greater reduction in total cholesterol compared with the control group (–0.2 mmol/L vs. +0.04 mmol/L; P = .02). The lifestyle intervention-alone group had significant reductions in BP and HDL cholesterol at 6 months. At 18 months, adults receiving lifestyle intervention alone had greater reductions in systolic BP (–5 mm Hg vs. –1 mm Hg; P = .05) and glucose (–6.3 mg/dL vs. –4.6 mg/dL) than those in the intervention plus meal replacement group.
Das said future research should focus on changes to the lifestyle intervention program that could allow personalization to try and maximize weight loss and metabolic benefits for each individual.
For more information:
Sai Krupa Das, PhD, can be reached at [email protected]