Randomized controlled trial of a novel lifestyle intervention used with or without meal replacements in work sites

Authors: DAS, SAI KRUPA - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; SILVER, RACHEL - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; VAIL, TAYLOR - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; CHIN, MEGHAN - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; BLANCHARD, CAROLINE - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; DICKINSON, STEPHANIE - Indiana University; CEG;OA, LISA - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; SALTZMAN, EDWARD - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; XIWEI, CHEN - Indiana University; ALLISON, DAVID - Indiana University; ROBERTS, SUSAN - Jean Mayer Human Nutrition Research Center On Aging At Tufts University

Submitted to: Obesity
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 11/11/2022
Publication Date: 1/25/2023
Citation: Das, S., Silver, R., Vail, T.A., Chin, M.K., Blanchard, C.M., Dickinson, S.L., Ceglia, L., Saltzman, E., Xiwei, C., Allison, D.B., Roberts, S. 2023. Randomized controlled trial of a novel lifestyle intervention used with or without meal replacements in work sites. Obesity. https://doi.org/10.1002/oby.23636.
DOI: https://doi.org/10.1002/oby.23636

Interpretive Summary: Traditional lifestyle interventions have had limited effectiveness in work sites, but interventions designed to emphasize healthy foods and manage hunger have had promising results. We randomly assigned enrollees to receive a Healthy Weight for Living program, either with or without a meal replacement, or to a wait-listed Control. The Healthy Weight for Living groups achieved clinically meaningful weight loss compared to Controls, with corresponding improvements in disease risk factors and diet. Rising health care costs necessitate employer support of employee health, and these results show a promising approach to weight management to reduce high rates of obesity in the workforce.

Technical Abstract: Objective: Lifestyle interventions have had limited effectiveness in work sites when evaluated in randomized trials. This study assessed the effectiveness of a novel lifestyle intervention for weight loss (Healthy Weight for Living [HWL]) implemented with or without meal replacements (MR) in work sites. HWL used a new behavioral approach emphasizing reducing hunger and building healthy food preferences, and, unlike traditional lifestyle interventions, it did not require calorie counting. Methods: Twelve work sites were randomized to an 18-month intervention (n = 8; randomization within work sites to HWL, HWL + MR) or 6-month wait-listed control (n = 4). Participants were employees with overweight or obesity (N = 335; age = 48 [SD 10] years; BMI = 33 [6] kg/m2 ; 83% female). HWL was group-delivered in person or by videoconference. The primary outcome was 6-month weight change; secondary outcomes included weight and cardiometabolic risk factors measured at 6, 12, and 18 months in intervention groups. Results: Mean 6-month weight change was -8.8% (95% CI: -11.2% to -6.4%) for enrollees in HWL and -8.0% (-10.4% to -5.5%) for HWL + MR (p < 0.001 for both groups vs. controls), with no difference between interventions (p = 0.40). Clinically meaningful weight loss (5%) was maintained at 18 months in both groups (p < 0.001). Conclusions: A new lifestyle intervention approach, deliverable by videoconference with or without MR, supported clinically impactful weight loss in employees.