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Testing the Effect of Multiple Weight Management Modalities for Chronic Disease Risk Reduction in a Clinical Setting

Not Applicable
Completed
Conditions
Obesity
Interventions
Behavioral: Intermittent Energy Restriction
Behavioral: Hunger Training
Behavioral: Low-Carbohydrate Diet
Registration Number
NCT03998878
Lead Sponsor
University of Arizona
Brief Summary

This project will test 3 methods of dietary changes in a weight loss clinic. Participants will be randomized to one of 3 arms: low-carbohydrate diet, intermittent energy restriction, or Hunger Training. A maximum of 30 participants will be assigned to each arm. The goal of the proposed study is to determine the feasibility, early efficacy, and patient satisfaction of each weight loss modality in a population of patients seeking care at a weight loss clinic.

Detailed Description

Adult obesity, a common condition in the United States, is a well-established risk factor for the development of chronic diseases, including diabetes, heart disease, hypertension, and many types of cancer. However, research has not determined what type of diet is best for reducing weight and achieving optimal health outcomes. In this randomized trial, participants seeking care at a weight loss clinic will be assigned to one of three diets: low-carbohydrate, intermittent energy restriction, or Hunger Training. On the low-carbohydrate diet, participants will be instructed to consume less than 30 grams of carbohydrates per day. The intermittent energy restriction protocol will require participants to choose 2 non-consecutive days per week in which they will consume 500-650 calories. Hunger Training is a relatively new approach that involves teaching people to monitor their hunger symptoms and blood glucose, and to eat only when blood glucose is below a certain level. To our knowledge, these weight loss modalities have not been compared in a single, clinical study. The goal of the proposed study is to determine the feasibility, early efficacy, and patient satisfaction of each weight loss modality in a population of patients seeking care at a weight loss clinic. The goal will be achieved though the successful completion of the following aims:

Aim 1: To determine the feasibility of recruiting, retaining and maintaining the adherence participants in a randomized clinical trial testing 3 weight loss modalities.

Aim 2: To examine and compare the effect of 3 weight loss modalities on changes in anthropometric measures and metabolic and cancer-related health markers.

Aim 3: To evaluate and compare patients' perceived satisfaction with each weight loss modality.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
9
Inclusion Criteria
  • Overweight/obese as indicated by BMI >27
  • Age ≥ 18
  • HbA1C <8.0
  • Fluent in English
Exclusion Criteria
  • Cognitive state that precludes informed consent or adherence to study protocols
  • Pregnant, breast-feeding, or planning to become pregnant within 6 months
  • A1C ≥ 8.0
  • Taking an anti-obesity medication
  • Insulin-dependence
  • prior metabolic surgery
  • current laparoscopic adjustable gastric band ("lap band") use
  • Experience of substantial weight changes (±5 kg or ±10 lbs) in the past 3 months

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Intermittent Energy RestrictionIntermittent Energy RestrictionParticipants choose 2 non-consecutive days per week in which they will consume 500-650 calories.
Hunger TrainingHunger TrainingParticipants monitor their hunger symptoms and blood glucose, and eat only when blood glucose is below a certain threshold level.
Low-Carbohydrate DietLow-Carbohydrate DietParticipants will be instructed to consume less than 30 grams of carbohydrates per day.
Primary Outcome Measures
NameTimeMethod
Rate of Retention1 year

Feasibility of retaining participants in a randomized dietary intervention in a clinic setting as measured by the number of participants completing all study visits

Change in BMIbaseline to 3 months

Participant BMI will be measured

Change in C-Reactive Protein (CRP)baseline to 3 months

Participant CRP will be measured

Change in Fasting Glucosebaseline to 3 months

Participant fasting glucose will be measured

Change in Low Density Lipoprotein (LDL)baseline to 3 months

Participant LDL will be measured

Change in Insulin-like Growth Factor 2 (IGF-2)baseline to 3 months

Participant IGF-2 will be measured

Change in Adiponectinbaseline to 3 months

Participant adiponectin will be measured

Rate of Recruitment1 year

Feasibility of recruiting participants into a randomized dietary intervention in a clinic setting as measured by the total number of individuals who are screened as eligible and enrolled into the study

Adherence to the Intervention1 year

Feasibility of maintaining participant adherence in a randomized dietary intervention in a clinic setting will be measured by attendance at scheduled clinic visits

Change in Fasting Insulinbaseline to 3 months

Participant fasting insulin will be measured

Change in Insulin-like Growth Factor Binding Protein 3 (IGFBP-3)baseline to 3 months

Participant IGFBP-3 will be measured

Change in Weightbaseline to 3 months

Participant weight will be measured

Change in HbA1cbaseline to 3 months

Participant HbA1c will be measured

Change in High Density Lipoprotein (HDL)baseline to 3 months

Participant HDL will be measured

Change in Insulin-like Growth Factor 1 (IGF-1)baseline to 3 months

Participant IGF-1 will be measured

Change in Leptinbaseline to 3 months

Participant leptin will be measured

Change in Total Cholesterolbaseline to 3 months

Participant total cholesterol will be measured

Change in Triglyceridesbaseline to 3 months

Participant triglycerides will be measured

Participant Satisfaction3 months

Participants will complete a questionnaire at the end of the study to assess the acceptability of and satisfaction with the weight loss diet intervention they received. We will assess overall satisfaction, enjoyment, likeliness to recommend, and ease of following the diet. Aggregated scores will be compared across weight loss modality.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

University of Arizona

🇺🇸

Tucson, Arizona, United States

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