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Int J Environ Res Public Health. 2018 Jan 26;15(2). pii: E211. doi: 10.3390/ijerph15020211.

Long-Term Weight Loss Effects of a Behavioral Weight Management Program: Does the Community Food Environment Matter?

Author information

1
College of Nursing, University of Illinois at Chicago, Chicago, IL 60612, USA. szenk@uic.edu.
2
College of Nursing, University of Illinois at Chicago, Chicago, IL 60612, USA. elizabeth.tarlov@va.gov.
3
Edward Hines Jr. Veterans Affairs Hospital, Hines, IL 60141, USA. elizabeth.tarlov@va.gov.
4
School of Public and Environmental Affairs, Indiana University, Bloomington, IN 47405, USA. cwing@indiana.edu.
5
Department of Sociology & Criminology and Department of Anthropology, Pennsylvania State University, University Park, PA 16802, USA. sxm27@psu.edu.
6
Department of Anthropology, Pennsylvania State University, University Park, PA 16802, USA. sxm27@psu.edu.
7
Edward Hines Jr. Veterans Affairs Hospital, Hines, IL 60141, USA. hao.tong@va.gov.
8
College of Nursing, University of Illinois at Chicago, Chicago, IL 60612, USA. kellykj@uic.edu.
9
School of Public Health, University of Illinois at Chicago, IL 60612, USA. powelll@uic.edu.

Abstract

This study examined whether community food environments altered the longer-term effects of a nationwide behavioral weight management program on body mass index (BMI). The sample was comprised of 98,871 male weight management program participants and 15,385 female participants, as well as 461,302 and 37,192 inverse propensity-score weighted matched male and female controls. We measured the community food environment by counting the number of supermarkets, convenience stores, and fast food restaurants within a 1-mile radius around each person's home address. We used difference-in-difference regression models with person and calendar time fixed effects to estimate MOVE! effects over time in sub-populations defined by community food environment attributes. Among men, after an initial decrease in BMI at 6 months, the effect of the program decreased over time, with BMI increasing incrementally at 12 months (0.098 kg/m², p < 0.001), 18 months (0.069 kg/m², p < 0.001), and 24 months (0.067 kg/m², p < 0.001). Among women, the initial effects of the program decreased over time as well. Women had an incremental BMI change of 0.099 kg/m² at 12 months (p < 0.05) with non-significant incremental changes at 18 months and 24 months. We found little evidence that these longer-term effects of the weight management program differed depending on the community food environment. Physiological adaptations may overwhelm environmental influences on adherence to behavioral regimens in affecting longer-term weight loss outcomes.

KEYWORDS:

MOVE!; accessibility; food access; food store; neighborhood; obesity; restaurant; weight loss; weight loss intervention; weight loss maintenance; weight maintenance

PMID:
29373556
PMCID:
PMC5858280
DOI:
10.3390/ijerph15020211
[Indexed for MEDLINE]
Free PMC Article

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