NCT06785064

Brief Summary

The purpose of this study is to find out what combination of components, if any, offers the best support for keeping weight off after someone loses weight. Long term weight loss maintenance is a challenge for many people who lose weight. There are many strategies, or components, people may use to avoid regain, but investigators do not know if there is a best, or optimal, combination of such components that can be done without adding a lot of cost or other burdens for people.

  • The primary goal of this clinical trial is to identify the optimal package that maximizes weight loss maintenance.
  • The study also wants to understand the reasons why these components may work and if certain components help specific sub-groups of people. Participants will engage in a 16-week Phase 1 Weight Loss Program. Participants who lose 5% or more of their weight during that program will continue to Phase 2 Extended Care and be randomly assigned to 0, 1, 2, 3, or all of four methods of weight loss maintenance. They will use their assigned package for 12 months. Researchers will compare 16 different possible combinations of components and learn which of the 16 packages offers the best support for keeping weight off. The four components participants could be assigned to in Phase 2 are:
  • Reduced Food Variety: Limiting the variety of foods participants eat by having them choose a few high-calorie, low nutrient foods to eat regularly
  • Home-based Resistance Training: Engaging in exercises that build strength from the comfort of the participant's own home
  • Buddy Training and Support: Having a friend or "buddy" get trained to support the participant
  • Acceptance and Commitment (ACT) Workshops: Having participants learn skills to handle tough thoughts and feelings about weight control in a healthy way

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
544

participants targeted

Target at P75+ for not_applicable

Timeline
34mo left

Started Dec 2025

Typical duration for not_applicable

Geographic Reach
1 country

1 active site

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress13%
Dec 2025Feb 2029

First Submitted

Initial submission to the registry

January 15, 2025

Completed
5 days until next milestone

First Posted

Study publicly available on registry

January 20, 2025

Completed
11 months until next milestone

Study Start

First participant enrolled

December 2, 2025

Completed
3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

November 30, 2028

Expected
3 months until next milestone

Study Completion

Last participant's last visit for all outcomes

February 28, 2029

Last Updated

January 7, 2026

Status Verified

January 1, 2026

Enrollment Period

3 years

First QC Date

January 15, 2025

Last Update Submit

January 6, 2026

Conditions

Keywords

weight loss maintenanceweight lossweight changehealth behaviorreduced food varietyACT workshopbuddy supporthome-based resistance trainingweight training

Outcome Measures

Primary Outcomes (1)

  • Change in weight from time of randomization to 12 months

    The primary outcome of the study is the change in weight measurement from the time of randomization (after Phase 1 initial weight loss/the beginning of Phase 2) until the follow up visit 12 months later. Participants' body weight will be measured to the nearest 0.1 kg at each point using a calibrated electronic scale. The change between these two measures will be calculated.

    12 months

Study Arms (16)

Package 1: No WLM Components

NO INTERVENTION

Participants will receive education and support for weight loss maintenance only.

Package 2: One WLM Component - BTS

ACTIVE COMPARATOR

Participants will receive education and support for weight loss maintenance and Buddy Training and Support.

Behavioral: Buddy Training and Support (BTS)

Package 3: One WLM Component - HBRT

ACTIVE COMPARATOR

Participants will receive education and support for weight loss maintenance and Home-based Resistance Training

Behavioral: Home-based Resistance Training (HBRT)

Package 4: Two WLM Components - HBRT+BTS

ACTIVE COMPARATOR

Participants will receive education and support for weight loss maintenance as well as Home-based Resistance Training and Buddy Training and Support.

Behavioral: Home-based Resistance Training (HBRT)Behavioral: Buddy Training and Support (BTS)

Package 5: One WLM Component - ACT

ACTIVE COMPARATOR

Participants will receive education and support for weight loss maintenance as well as Acceptance and Commitment (ACT) Workshops.

Behavioral: Acceptance and Commitment (ACT) Workshops

Package 6: Two WLM Components - BTS+ACT

ACTIVE COMPARATOR

Participants will receive education and support for weight loss maintenance as well as Buddy Training and Support and ACT Workshops.

Behavioral: Buddy Training and Support (BTS)Behavioral: Acceptance and Commitment (ACT) Workshops

Package 7: Two WLM Components - HBRT+ACT

ACTIVE COMPARATOR

Participants will receive education and support for weight loss maintenance as well as Home-based Resistance Training and ACT Workshops.

Behavioral: Home-based Resistance Training (HBRT)Behavioral: Acceptance and Commitment (ACT) Workshops

Package 8: Three WLM Components - HBRT+BTS+ACT

ACTIVE COMPARATOR

Participants will receive education and support for weight loss maintenance as well as Home-based Resistance Training, Buddy Training and Support, and ACT Workshops.

Behavioral: Home-based Resistance Training (HBRT)Behavioral: Buddy Training and Support (BTS)Behavioral: Acceptance and Commitment (ACT) Workshops

Package 9: One WLM Component - RFV

ACTIVE COMPARATOR

Participants will receive education and support for weight loss maintenance as well as Reduced Food Variety.

Behavioral: Reduced Food Variety (RFV)

Package 10: Two WLM Components - RFV+BTS

ACTIVE COMPARATOR

Participants will receive education and support for weight loss maintenance as well as Reduced Food Variety and Buddy Training and Support

Behavioral: Reduced Food Variety (RFV)Behavioral: Buddy Training and Support (BTS)

Package 11: Two WLM Components - RFV+HBRT

ACTIVE COMPARATOR

Participants will receive education and support for weight loss maintenance as well as Reduced Food Variety and Home-based Resistance Training.

Behavioral: Reduced Food Variety (RFV)Behavioral: Home-based Resistance Training (HBRT)

Package 12: Three WLM Components - RFV+HBRT+BTS

ACTIVE COMPARATOR

Participants will receive education and support for weight loss maintenance as well as Reduced Food Variety, Home-based Resistance Training, and Buddy Training and Support.

Behavioral: Reduced Food Variety (RFV)Behavioral: Home-based Resistance Training (HBRT)Behavioral: Buddy Training and Support (BTS)

Package 13: Two WLM Components - RFV+ACT

ACTIVE COMPARATOR

Participants will receive education and support for weight loss maintenance as well as Reduced Food Variety and ACT Workshops.

Behavioral: Reduced Food Variety (RFV)Behavioral: Acceptance and Commitment (ACT) Workshops

Package 14: Three WLM Components - RFV+BTS+ACT

ACTIVE COMPARATOR

Participants will receive education and support for weight loss maintenance as well as Reduced Food Variety, Buddy Training and Support, and ACT Workshops.

Behavioral: Reduced Food Variety (RFV)Behavioral: Buddy Training and Support (BTS)Behavioral: Acceptance and Commitment (ACT) Workshops

Package 15: Three WLM Components - RFV+HBRT+ACT

ACTIVE COMPARATOR

Participants will receive education and support for weight loss maintenance as well as Reduced Food Variety, Home-based Resistance Training, and ACT Workshops.

Behavioral: Reduced Food Variety (RFV)Behavioral: Home-based Resistance Training (HBRT)Behavioral: Acceptance and Commitment (ACT) Workshops

Package 16: Four WLM Components: RFV+HBRT+BTS+ACT

EXPERIMENTAL

Participants will receive education and support for weight loss maintenance as well as Reduced Food Variety, Home-based Resistance Training, Buddy Training and Support, and ACT Workshops.

Behavioral: Reduced Food Variety (RFV)Behavioral: Home-based Resistance Training (HBRT)Behavioral: Buddy Training and Support (BTS)Behavioral: Acceptance and Commitment (ACT) Workshops

Interventions

Participants engaged in reduced food variety (RFV) will be asked to choose a few high-calorie, low nutrient main meals and snacks to eat regularly. At the beginning of each month, they will choose one main meal (entrée) to eat at least 2 times a week and one snack food to eat at least 4 times a week within the month. They will have the option to keep or change their main meal and snack options from month to month.

Package 10: Two WLM Components - RFV+BTSPackage 11: Two WLM Components - RFV+HBRTPackage 12: Three WLM Components - RFV+HBRT+BTSPackage 13: Two WLM Components - RFV+ACTPackage 14: Three WLM Components - RFV+BTS+ACTPackage 15: Three WLM Components - RFV+HBRT+ACTPackage 16: Four WLM Components: RFV+HBRT+BTS+ACTPackage 9: One WLM Component - RFV

Participants assigned to receive home-based resistance training (also called strength training or lifting weights) will be asked to engage in at-home exercises that strengthen muscles at least 2 days each week (≤45 minutes per home session) and track their progress. They will be asked to attend 6, 1-hour group-based skills training workshops (in-person and/or remotely via Zoom) during the first two months of Phase 2 to learn these skills. They will receive exercise plans and equipment (sets of dumbbells, a rack to hold the dumbbells, and an exercise mat) needed to complete exercises.

Also known as: Strength Training, Resistance Training, Weight Lifting, Lifting Weights
Package 11: Two WLM Components - RFV+HBRTPackage 12: Three WLM Components - RFV+HBRT+BTSPackage 15: Three WLM Components - RFV+HBRT+ACTPackage 16: Four WLM Components: RFV+HBRT+BTS+ACTPackage 3: One WLM Component - HBRTPackage 4: Two WLM Components - HBRT+BTSPackage 7: Two WLM Components - HBRT+ACTPackage 8: Three WLM Components - HBRT+BTS+ACT

Participants assigned to buddy training and support will be asked to identify an eligible friend or family member who is over 18 years old that can be their "buddy". Study staff will contact the buddy to be sure they are eligible, willing, and have all the details they need. The participant's buddy will be asked to attend up to 6 training sessions with the study staff, so they can learn the best ways to support the participant during the program. After the buddy completes training, they will be asked to check in with the participant 1-2 times each week about their progress.

Also known as: Buddy Support
Package 10: Two WLM Components - RFV+BTSPackage 12: Three WLM Components - RFV+HBRT+BTSPackage 14: Three WLM Components - RFV+BTS+ACTPackage 16: Four WLM Components: RFV+HBRT+BTS+ACTPackage 2: One WLM Component - BTSPackage 4: Two WLM Components - HBRT+BTSPackage 6: Two WLM Components - BTS+ACTPackage 8: Three WLM Components - HBRT+BTS+ACT

Participants assigned to receive Acceptance and Commitment (ACT) Workshops will be asked to attend 6, 1-hour group-based skills training workshops (in-person and/or remotely via Zoom) during the first three months of Phase 2. These workshops will help them develop skills to handle tough thoughts about weight control, keep their values in mind, and be mindful of their decisions and the impact of their decisions related to weight control. They will also be asked to apply ACT skills regularly during the rest of Phase 2.

Also known as: ACT Workshop
Package 13: Two WLM Components - RFV+ACTPackage 14: Three WLM Components - RFV+BTS+ACTPackage 15: Three WLM Components - RFV+HBRT+ACTPackage 16: Four WLM Components: RFV+HBRT+BTS+ACTPackage 5: One WLM Component - ACTPackage 6: Two WLM Components - BTS+ACTPackage 7: Two WLM Components - HBRT+ACTPackage 8: Three WLM Components - HBRT+BTS+ACT

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Age \>18 years
  • Body mass index (BMI) \>30 kg/m2
  • Has regular access to internet (to access Zoom videoconferencing platform)
  • If indicated during screening, willing to obtain medical clearance for exercise from their healthcare provider prior to enrollment

You may not qualify if:

  • Current or recent (past 6 months) use of prescription weight loss medications
  • Weight loss \>10 pounds in past 6 months (other than postpartum)
  • Pregnancy or anticipating pregnancy
  • Another household member already participating in the study
  • Participation in another randomized research project
  • Uncontrolled hypertension (blood pressure \>160/100 mm Hg at screening)
  • Any of the following other medical conditions: myocardial infarction or cerebrovascular accident within the last 6 months; unstable angina within the past 6 months; NYHA Class III or IV congestive heart failure; type 1 diabetes; and chronic lung diseases that limit physical activity
  • Unable to identify potential buddy (i.e., adult friend or family member) for extended care intervention phase
  • Residing \>50 miles from the university (to attend assessment visits)
  • Planning to relocate out of the area in the next 18 months
  • Does not have internet access
  • Unwilling or unable to do any of the following: give informed consent; read/understand English; accept random assignment

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

University of Alabama at Birmingham

Birmingham, Alabama, 35205, United States

RECRUITING

MeSH Terms

Conditions

Body Weight ChangesWeight LossHealth Behavior

Interventions

Resistance TrainingPalliative Care

Condition Hierarchy (Ancestors)

Body WeightSigns and SymptomsPathological Conditions, Signs and SymptomsBehavior

Intervention Hierarchy (Ancestors)

Exercise TherapyRehabilitationAftercareContinuity of Patient CarePatient CareTherapeuticsPhysical Therapy ModalitiesPhysical Conditioning, HumanExerciseMotor ActivityMovementMusculoskeletal Physiological PhenomenaMusculoskeletal and Neural Physiological PhenomenaHealth ServicesHealth Care Facilities Workforce and Services

Central Study Contacts

Gareth Dutton

CONTACT

Amy Dobelstein

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
FACTORIAL
Model Details: Investigators used the multiphase optimization strategy (MOST) as the ideal approach for the proposed study as, with the four proposed intervention components, identifying an optimal intervention through a single randomized controlled trial (RCT) with multiple arms or through multiple RCTs would be methodologically inefficient and resource-intensive. Given this, investigators rely on the eloquent and rigorous MOST-based optimization design, which leverages factorial experimentation to identify an optimal set of intervention component(s). In a factorial experiment, the goal is not to compare individual experimental conditions (in this case, 16 conditions), but to use combinations of conditions to estimate the main and interaction effects of the intervention components. Thus, numerous intervention components can be evaluated simultaneously while utilizing the entire randomized sample.
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Professor

Study Record Dates

First Submitted

January 15, 2025

First Posted

January 20, 2025

Study Start

December 2, 2025

Primary Completion (Estimated)

November 30, 2028

Study Completion (Estimated)

February 28, 2029

Last Updated

January 7, 2026

Record last verified: 2026-01

Locations