Randomized trial of two mind-body interventions for weight-loss maintenance

Objective: Regain of weight after initial weight loss constitutes a major factor contributing to the escalating obesity epidemic. The objective of this study was to determine the feasibility and clinical impact of two mind-body interventions for weight-loss maintenance. Design: Randomized, balanced, controlled trial. Setting: Large-group model health maintenance organization. Participants: Overweight and obese adults were recruited to a 12-week behavioral weight-loss program. Participants meeting threshold weight loss and attendance requirements were eligible for randomization. Interventions: The three weight-loss maintenance interventions were qigong (QI), Tapas Acupressure Technique® (TAT®) (registered trademark of Tapas Fleming, L.Ac.), and a self-directed support (SDS) group as an attention control. Outcomes: The main outcome measure was weight loss maintenance at 24 weeks postrandomization. Patient interviews explored additional benefits of the interventions, as well as barriers and facilitators to compliance. Results: Eighty-eight percent (88%) of randomized patients completed the study. There were no significant study-related adverse events. At 24 weeks, the TAT group maintained 1.2 kg more weight loss than the SDS group did (p = 0.09), and 2.8 kg more weight loss than the QI group did (p = 0.00), only regaining 0.1 kg. A separation test (0.05 level, 0.95 power) indicated that TAT merits further study. A secondary analysis revealed that participants reporting a previous history of recurrent unsuccessful weight loss were more likely to regain weight if assigned to the SDS arm, but this effect was suppressed in both the QI and TAT groups (p = 0.03). Although QI participants reported important general health benefits, the instruction sequence was too brief, given the complexity of the intervention. Conclusions: TAT warrants further research for weight-loss maintenance. Any further research on qigong should use a modification of our protocol.