Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

A randomised control trial comparing lifestyle groups, individual counselling and written information in the management of weight and health outcomes over 12 months

International Journal of Obesity volume 30, pages 1557–1564 (2006)Cite this article

Abstract

Objective:

To investigate the effect of an 8-week group-based cognitive behaviour therapy lifestyle intervention with monthly follow-up to 6 months and further follow up at 12 months on change in weight and other weight-related variables, change in physical activity and change in health and well being compared to individualised dietetic treatment or giving an information booklet only (BO).

Design:

A randomised controlled trial of two intervention groups, a group-based cognitive behaviour therapy lifestyle intervention, Fat Booters Incorporated – (FBI) and individualised dietetic treatment (IDT) and control group receiving an information booklet only (BO). The intervention groups involved weekly contact for 8 weeks with monthly follow-up to 6 months and further follow-up at 12 months, conducted in real practice setting.

Subjects:

A total of 176 adults with body mass index (BMI)>27 kg/m2, mean (±s.d.) age 48±13 years, mean BMI 34±5.5 kg/m2.

Main outcome measures:

Weight, percent body fat, waist circumference, physical activity, health status, self-efficacy and satisfaction with life were measured at baseline, 3, 6 and 12 months.

Results:

A statistically significant difference between groups was observed for weight change over time (P=0.05). The change in weight (mean±s.e.) for the FBI group was significantly greater than the BO group at 3 and 12 months (−2.8±0.7 compared to −1.0±0.6 kg, P<0.05 and −2.9±0.9 compared to +0.5±0.9 kg, P<0.005, respectively). Change in weight in the IDT group did not differ from the FBI group at any time point. For all groups, waist circumference was significantly less than baseline at all time points (P<0.001). Significant differences in self-efficacy were observed over time (P=0.02), with both intervention groups having greater self-efficacy than the BO group. Significant drop-outs occurred over time for all three groups.

Conclusions:

A cognitive behaviour-based lifestyle intervention was more effective than providing an information booklet alone and as effective as intensive individualised dietetic intervention in weight loss and improvements in self-efficacy.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Swinburn BO, Caterson I, Seidell JC, James WPT . Diet, nutrition and the prevention of excess weight gain and obesity. Public Health Nutr 2004; 7: 123–146.

    CAS  PubMed  Google Scholar 

  2. Cameron AJ, Welborn TA, Zimmet PZ, Dunstan DW, Owen N, Salmon J et al. Overweight and obesity in Australia: the 1999–2000 Australian diabetes, obesity and lifestyle study (AusDiab). MJA 2003; 178: 427–432.

    PubMed  Google Scholar 

  3. AIHW (Australian Institute of Health and Welfare) Mathers C, Vos T, Stevenson C . The Burden of Disease and Injury in Australia AIHW Cat NO. PHE 17. AIHW: Canberra, 1999, http://www.aihw.gov.au.

    Google Scholar 

  4. Department of Health and Ageing. About overweight and obesity. 2004, www.seniors.gov.au/internet/wcms/publishing.nsf/content/health-pubhlth-strateg-hlthwt-obesity.htm.

  5. Glenny AM, O’Meara S, Melville A, Sheldon TA, Wilson C . The treatment and prevention of obesity: a systematic review of the literature. Int J Obes Relat Metab Disord 1997; 21: 715–737.

    Article  CAS  Google Scholar 

  6. Ayyad C, Anderson T . Long-term efficacy of dietary treatment of obesity: a systematic review of studies published between 1931 and 1999. Obes Rev 2000; 1: 113–119.

    Article  CAS  Google Scholar 

  7. Pan XR, Li GW, Hu YH, Wang JX, Yang WY, An ZX et al. Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. Diabet Care 1997; 20: 537–544.

    Article  CAS  Google Scholar 

  8. Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Eng J Med 2002; 346: 393–403.

  9. Tuomilehto J, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Ilanne-Pakikka P et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Eng J Med 2001; 344: 1343–1350.

    Article  CAS  Google Scholar 

  10. Catford JC, Caterson ID . Snowballing obesity: Australians will get run over if they just sit there. MJA 2003; 179: 577–579.

    PubMed  Google Scholar 

  11. National Health and Medical Research Council (NHMRC). Clinical Practice Guidelines for the Management of Overweight and Obesity in Adults and Children. Commonwealth of Australia: Canberra, 2003.

  12. National Institutes of Health (NIH). Identification, Evaluation and Treatment of Overweight and Obesity in Adults. NHLBI: Washington, DC, 1998.

  13. Bauman AE, Fardy HJ, Harris PG . Getting it right: why bother with patient-centred care? MJA 2003; 179: 253–256.

    PubMed  Google Scholar 

  14. Von Korff M, Glasgow RE, Sharpe M . Organising care for chronic illness. BMJ 2002; 325: 92–94.

    Article  Google Scholar 

  15. Heschka S, Anderson JW, Atkinson RL, Greenway FL, Hill JO, Phinney SD et al. Weight loss with self-help compared with a structured commercial program: a randomised trial. JAMA 2003; 289: 1792–1798.

    Article  Google Scholar 

  16. Noakes M, Foster PR, Keogh JB, Clifton PM . Meal replacements are as effective as structured weight-loss diets for treating obesity in adults with features of metabolic syndrome. J Nutr 2004; 134: 1894–1900.

    Article  CAS  Google Scholar 

  17. Li Z, Maglione M, Tu W, Mojica W, Arterburn D, Shugarman LR et al. Meta-analysis: pharmacologic treatment of obesity. Ann Int Med 2005; 142: 532–553.

    Article  CAS  Google Scholar 

  18. Glasgow RE, Lichtenstein E, Marcus AC . Why don’t we see more translation of ehlth promotion research into practice? Rethinking the efficiacy-to-effectiveness transition. Am J Public Health 2003; 98: 1261–1266.

    Article  Google Scholar 

  19. Payne J . The Key to Healthy Eating. Queensland University of Technology: Brisbane, 1997.

    Google Scholar 

  20. Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 2003; 35: 1381–1395.

    Article  Google Scholar 

  21. Ainsworth BE, Haskell WL, Whitt MC, Irwin ML, Swartz AM, Strath SJ et al. Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc 2000; 32: S498–S504.

    Article  CAS  Google Scholar 

  22. Goldberg DP, Gater R, Sartorius N, Ustun TB, Piccinelli M, Gureje O et al. The validity of two versions of GHQ in the WHO study of mental illness in general health care. Psychol Med 1997; 27: 191–197.

    Article  CAS  Google Scholar 

  23. Scholz U, Dona BG, Sud S, Schwarzer R . Is general self-efficacy a universal construct? Psychometric findings from 25 countries? Eur J Psychol Assess 2002; 18: 1015–5759.

    Article  Google Scholar 

  24. Schwarzer R . Social_cognitive predictors of health behaviour: action self efficacy and coping self efficacy. Health Psychol 2000; 19: 487–495.

    Article  CAS  Google Scholar 

  25. Deiner E, Emmons RA, Larsen RJ, Griffin S . The satisfaction with life scale. J Personality Assess 1985; 49: 71–75.

    Article  Google Scholar 

  26. Pavott W, Diener E, Colvin CR, Sandvik E . Further validation of the satisfaction with life scale: evidence for the cross-method convergence of well-being measures. J Personality Assess 1991; 57: 149–161.

    Article  Google Scholar 

  27. Ash S, Reeves MM, Yeo S, Morrison G, Carey D, Capra S . Effect of intensive dietetic interventions on weight and glycaemic control in overweight men with type 2 diabetes: a randomised trial. Int J Obes Relat Metab Disord 2003; 27: 797–802.

    Article  CAS  Google Scholar 

  28. Leibbrand R, Fichter MM . Maintenance of weight loss after obesity treatment: is continuous support necessary? Behav Res Therapy 2002; 40: 1275–1289.

    Article  CAS  Google Scholar 

  29. Caterson ID . What should we do about overweight and obesity? MJA 1999; 171: 599–600.

    CAS  PubMed  Google Scholar 

  30. Delahanty LM, Sonnenberg LM, Hayden D, Nathan DM . Clinical and cost outcomes of medical nutrition therapy for hypercholesterolemia: a controlled trial. J Am Diet Assoc 200; 101: 1012–1023.

    Article  Google Scholar 

  31. Franz MJ, Splett PL, Monk A, Barry B, McClain K, Weaver T et al. Cost-effectiveness of medical nutrition therapy provided by dietitians for persons with non-insulin-dependent diabetes mellitus. J Am Diet Assoc 1995; 95: 1018–1024.

    Article  CAS  Google Scholar 

  32. Pirozzo S, Summerbell C, Cameron C, Glasziou P . Advice on low-fat diets for obesity (Cochrane Review). In: The Cochrane Database of Systematic Reviews 2002. Issue 2. Art. No:CD003640.DOI:10.1002/14651858, CD3640.

  33. Rutter A, Vuillemin A, Ooijendijk WTM, Sjotrom M, Stahl T, VandemAuwelle Y et al. Physical activity monitoring in Europe. The European Physical Activity Surveillance System (EUPASS) approach and indicator testing. Public Health Nutr 2003; 6: 377–384.

    Google Scholar 

  34. AIHW Armstrong T, Baumann A, Davies J . Physical Activity Patterns of Australian Adults. Results of the 1999 National Physical Activity Survey. AIHW: Canberra, 2000, http://www.aihw.gov.au.

    Google Scholar 

Download references

Acknowledgements

We wish to thank the Princess Alexandra Hospital Research and Development Foundation for assistance with funding and the following staff at the Princess Alexandra Hospital and Health Service District and The Wesley Hospital, who participated in the trial: Wendy Chang, Kylie Clavarino, Susie Croaker, Lisa Farlow, Bev Gallagher, Ingrid Hickman, Helen Porteous, Louise Smith and Shelley Wilkinson.

Author information

Authors and Affiliations

  1. Princess Alexandra Hospital and Health Service District, Woolloongabba, Brisbane, Australia

    S Ash, M Reeves, T Dover, A Vivanti & C Leong

  2. The Wesley Hospital, Chasely St, Auchenflower, Brisbane, Australia

    J Bauer & T O'Moore Sullivan

  3. Centre for Diabetes and Endocrine Research, School of Medicine, University of Queensland, Queensland, Australia

    T O'Moore Sullivan

  4. Centre for Health Research, Queensland University of Technology, Australia

    S Ash, M Reeves, J Bauer, A Vivanti & S Capra

Authors
  1. S Ash
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M Reeves
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J Bauer
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. T Dover
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A Vivanti
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. C Leong
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. T O'Moore Sullivan
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. S Capra
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S Ash.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ash, S., Reeves, M., Bauer, J. et al. A randomised control trial comparing lifestyle groups, individual counselling and written information in the management of weight and health outcomes over 12 months. Int J Obes 30, 1557–1564 (2006). https://doi.org/10.1038/sj.ijo.0803263

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijo.0803263

Keywords

Search

Advanced search

Quick links