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Randomized trial of Tapas Acupressure Technique for weight loss maintenance.

Elder CR, Gullion CM, Debar LL, Funk KL, Lindberg NM, Ritenbaugh C, Meltesen G, Gallison C, Stevens VJ - BMC Complement Altern Med (2012)

Bottom Line: In the primary outcome model, there was no significant difference in weight regain between the two arms (1.72 kg (se 0.85) weight regain for TAT and 2.96 kg (se 0.96) weight regain for SS, p < 0.097) Tests of between- arm differences for secondary outcomes were also not significant.A secondary analysis showed a significant interaction between treatment and initial weight loss (p < .036), with exploratory post hoc tests showing that greater initial weight loss was associated with more weight regain for SS but less weight regain for TAT.The primary analysis showed no significant difference in weight regain between TAT and SS, while secondary and post hoc analyses indicate direction for future research.

View Article: PubMed Central - HTML - PubMed

Affiliation: Kaiser Permanente Center for Health Research, 3800 N, Interstate Ave,, Portland, OR 97227, USA. Charles.Elder@kpchr.org

ABSTRACT

Background: Obesity is an urgent public health problem, yet only a few clinical trials have systematically tested the efficacy of long-term weight-loss maintenance interventions. This randomized clinical trial tested the efficacy of a novel mind and body technique for weight-loss maintenance.

Methods: Participants were obese adults who had completed a six-month behavioral weight-loss program prior to randomization. Those who successfully lost weight were randomized into either an experimental weight-loss maintenance intervention, Tapas Acupressure Technique (TAT®), or a control intervention comprised of social-support group meetings (SS) led by professional facilitators. TAT combines self-applied light pressure to specific acupressure points accompanied by a prescribed sequence of mental steps. Participants in both maintenance conditions attended eight group sessions over six months of active weight loss maintenance intervention, followed by an additional 6 months of no intervention. The main outcome measure was change in weight from the beginning of the weight loss maintenance intervention to 12 months later. Secondary outcomes were change in depression, stress, insomnia, and quality of life. We used analysis of covariance as the primary analysis method. Missing values were replaced using multiple imputation.

Results: Among 285 randomized participants, 79% were female, mean age was 56 (standard deviation (sd) = 11), mean BMI at randomization was 34 (sd = 5), and mean initial weight loss was 9.8 kg (sd = 5). In the primary outcome model, there was no significant difference in weight regain between the two arms (1.72 kg (se 0.85) weight regain for TAT and 2.96 kg (se 0.96) weight regain for SS, p < 0.097) Tests of between- arm differences for secondary outcomes were also not significant. A secondary analysis showed a significant interaction between treatment and initial weight loss (p < .036), with exploratory post hoc tests showing that greater initial weight loss was associated with more weight regain for SS but less weight regain for TAT.

Conclusions: The primary analysis showed no significant difference in weight regain between TAT and SS, while secondary and post hoc analyses indicate direction for future research.

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Relationship of initial weight loss to weight regain, by treatment arm.
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Figure 4: Relationship of initial weight loss to weight regain, by treatment arm.

Mentions: We followed up the finding of a significant interaction between treatment arm and initial weight loss with further, post hoc analyses to estimate the TAT treatment effect at different levels of initial weight loss. A plot of the trend lines of predicted primary outcome values (Figure 4) over varying WLP weight loss in the two treatment arms, showed that TAT participants with more initial weight loss regained less weight during maintenance while SS participants with more initial weight loss regained more weight during maintenance. This suggested the post hoc hypothesis that the treatment effect was greatest in participants with the most WLP weight loss but negligible in participants with the smallest WLP loss (closest to the randomization criterion of -4.5 kg). We estimated and tested the difference between treatments (SS-TAT) in the least squares mean weight change when the covariate was fixed at each of eight values of its distribution in the study sample (10th, 15th, 20th, 25th, 75th, 80th, 85th, and 90th percentiles). Weight loss was defined as a negative number, so lower percentiles represent more weight loss.


Randomized trial of Tapas Acupressure Technique for weight loss maintenance.

Elder CR, Gullion CM, Debar LL, Funk KL, Lindberg NM, Ritenbaugh C, Meltesen G, Gallison C, Stevens VJ - BMC Complement Altern Med (2012)

Relationship of initial weight loss to weight regain, by treatment arm.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3375195&req=5

Figure 4: Relationship of initial weight loss to weight regain, by treatment arm.
Mentions: We followed up the finding of a significant interaction between treatment arm and initial weight loss with further, post hoc analyses to estimate the TAT treatment effect at different levels of initial weight loss. A plot of the trend lines of predicted primary outcome values (Figure 4) over varying WLP weight loss in the two treatment arms, showed that TAT participants with more initial weight loss regained less weight during maintenance while SS participants with more initial weight loss regained more weight during maintenance. This suggested the post hoc hypothesis that the treatment effect was greatest in participants with the most WLP weight loss but negligible in participants with the smallest WLP loss (closest to the randomization criterion of -4.5 kg). We estimated and tested the difference between treatments (SS-TAT) in the least squares mean weight change when the covariate was fixed at each of eight values of its distribution in the study sample (10th, 15th, 20th, 25th, 75th, 80th, 85th, and 90th percentiles). Weight loss was defined as a negative number, so lower percentiles represent more weight loss.

Bottom Line: In the primary outcome model, there was no significant difference in weight regain between the two arms (1.72 kg (se 0.85) weight regain for TAT and 2.96 kg (se 0.96) weight regain for SS, p < 0.097) Tests of between- arm differences for secondary outcomes were also not significant.A secondary analysis showed a significant interaction between treatment and initial weight loss (p < .036), with exploratory post hoc tests showing that greater initial weight loss was associated with more weight regain for SS but less weight regain for TAT.The primary analysis showed no significant difference in weight regain between TAT and SS, while secondary and post hoc analyses indicate direction for future research.

View Article: PubMed Central - HTML - PubMed

Affiliation: Kaiser Permanente Center for Health Research, 3800 N, Interstate Ave,, Portland, OR 97227, USA. Charles.Elder@kpchr.org

ABSTRACT

Background: Obesity is an urgent public health problem, yet only a few clinical trials have systematically tested the efficacy of long-term weight-loss maintenance interventions. This randomized clinical trial tested the efficacy of a novel mind and body technique for weight-loss maintenance.

Methods: Participants were obese adults who had completed a six-month behavioral weight-loss program prior to randomization. Those who successfully lost weight were randomized into either an experimental weight-loss maintenance intervention, Tapas Acupressure Technique (TAT®), or a control intervention comprised of social-support group meetings (SS) led by professional facilitators. TAT combines self-applied light pressure to specific acupressure points accompanied by a prescribed sequence of mental steps. Participants in both maintenance conditions attended eight group sessions over six months of active weight loss maintenance intervention, followed by an additional 6 months of no intervention. The main outcome measure was change in weight from the beginning of the weight loss maintenance intervention to 12 months later. Secondary outcomes were change in depression, stress, insomnia, and quality of life. We used analysis of covariance as the primary analysis method. Missing values were replaced using multiple imputation.

Results: Among 285 randomized participants, 79% were female, mean age was 56 (standard deviation (sd) = 11), mean BMI at randomization was 34 (sd = 5), and mean initial weight loss was 9.8 kg (sd = 5). In the primary outcome model, there was no significant difference in weight regain between the two arms (1.72 kg (se 0.85) weight regain for TAT and 2.96 kg (se 0.96) weight regain for SS, p < 0.097) Tests of between- arm differences for secondary outcomes were also not significant. A secondary analysis showed a significant interaction between treatment and initial weight loss (p < .036), with exploratory post hoc tests showing that greater initial weight loss was associated with more weight regain for SS but less weight regain for TAT.

Conclusions: The primary analysis showed no significant difference in weight regain between TAT and SS, while secondary and post hoc analyses indicate direction for future research.

Show MeSH
Related in: MedlinePlus