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Weight loss treatment influences untreated spouses and the home environment: evidence of a ripple effect



To examine whether a weight loss program delivered to one spouse has beneficial effects on the untreated spouse and the home environment.


We assessed untreated spouses of participants in three sites of Look AHEAD, a multicenter randomized controlled trial evaluating the impact of intentional weight loss on cardiovascular outcomes in overweight individuals with type 2 diabetes. Participants and spouses (n=357 pairs) were weighed and completed measures of diet and physical activity at 0 and 12 months. Spouses completed household food and exercise environment inventories. We examined differences between spouses of participants assigned to the intensive lifestyle intervention (ILI) or to the enhanced usual care (DSE; diabetes support and education).


Spouses of ILI participants lost −2.2±4.5 kg vs −0.2±3.3 kg in spouses of DSE participants (P<0.001). In addition, more ILI spouses lost 5% of their body weight than DSE spouses (26 vs 9%, P<0.001). Spouses of ILI participants also had greater reductions in reported energy intake (P=0.007) and percent of energy from fat (P=0.012) than DSE spouses. Spouse weight loss was associated with participant weight loss (P<0.001) and decreases in high-fat foods in the home (P=0.05).


The reach of behavioral weight loss treatment can extend to a spouse, suggesting that social networks can be utilized to promote the spread of weight loss, thus creating a ripple effect.

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This ancillary study was supported by the National Institute of Nursing Research NR07960. The parent trial was supported by the Department of Health and Human Services through the following cooperative agreements from the National Institutes of Health: DK57136, DK57149, DK56990, DK57177, DK57171, DK57151, DK57182, DK57131, DK57002, DK57078, DK57154, DK57178, DK57219, DK57008, DK57135 and DK56992. The following federal agencies also contributed support National Institute of Diabetes and Digestive and Kidney Diseases; National Heart, Lung, and Blood Institute; National Institute of Nursing Research; National Center on Minority Health and Health Disparities; Office of Research on Women's Health and the Centers for Disease Control and Prevention. This research was supported in part by the Intramural Research Program of the National Institute of Diabetes and Digestive and Kidney Diseases. All researchers are independent of the funding agencies.The study represents the collective efforts of the Home Environment Research Group (noted below) as well as the Look AHEAD Research Group. The full list of acknowledgments has been previously published in the Look AHEAD 1-year result paper.

Home Environment Research Group

The Miriam Hospital/Brown Medical School: Renee Bright, MS (Program coordinator); Vincent Pera, MD (Co-investigator); Deborah Tate, PhD (Co-investigator); Kara Gallagher, PhD (Co-investigator); Amy Bach, PhD; Barbara Bancroft, RN, MS; Anna Bertorelli, MBA, RD; Richard Carey, BS; Tatum Charron, BS; Heather Chenot, MS; Kimberley Chula-Maguire, MS; Pamela Coward, MS, RD; Lisa Cronkite, BS; Julie Currin, MD; Maureen Daly, RN; Caitlin Egan, MS; Erica Ferguson, BS, RD; Linda Foss, MPH; Jennifer Gauvin, BS; Don Kieffer, PhD; Lauren Lessard, BS; Deborah Maier, MS; JP Massaro, BS; Tammy Monk, MS; Rob Nicholson, PhD; Erin Patterson, BS; Suzanne Phelan, PhD; Hollie Raynor, PhD, RD; Douglas Raynor, PhD; Natalie Robinson, MS, RD; Deborah Robles; Jane Tavares, BS.

The University of Alabama at Birmingham: Cora E Lewis, MD, MSPH (Principal investigator); Sheikilya Thomas MPH (Program coordinator); Monika Safford, MD (Co-investigator); Charlotte Bragg, MS, RD, LD; Amy Dobelstein; Stacey Gilbert, MPH; Stephen Glasser, MD; Sara Hannum, MA; Anne Hubbell, MS; Jennifer Jones, MA; DeLavallade Lee; Ruth Luketic, MA, MBA, MPH; Karen Marshall; L. Christie Oden; Janet Raines, MS; Cathy Roche, RN, BSN; Janet Truman; Nita Webb, MA; Audrey Wrenn, MAEd.

University of Minnesota: Carolyn Thorson, CCRP (Program coordinator); John P Bantle, MD (Co-investigator); J Bruce Redmon, MD (Co-investigator); Richard S Crow, MD (Co-investigator); Scott Crow, MD (Co-investigator); Susan K Raatz, PhD, RD (Co-investigator); Carolyne Campbell; Jeanne Carls, MEd; Tara Carmean-Mihm, BA; Emily Finch, MA; Anna Fox, MA; Elizabeth Hoelscher, MPH, RD, CHES; La Donna James; Vicki A Maddy, BS, RD; Therese Ockenden, RN; Birgitta I. Rice, MS, RPh CHES; Tricia Skarphol, BS; Ann D Tucker, BA; Mary Susan Voeller, BA; Cara Walcheck, BS, RD

Look AHEAD staffs are listed alphabetically by site.

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Correspondence to A A Gorin.

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Gorin, A., Wing, R., Fava, J. et al. Weight loss treatment influences untreated spouses and the home environment: evidence of a ripple effect. Int J Obes 32, 1678–1684 (2008).

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  • weight loss
  • ripple effect
  • social network
  • home environment

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