A Postpartum Weight Loss-focused Stepped-care Intervention in a Military Population: A Randomized Controlled Trial
Abstract Objective Postpartum weight retention is associated with adverse health among both civilian and military women. Purpose The current study evaluated a stepped-care weight management intervention, Moms Fit 2 Fight, adapted for use in a pregnant and postpartum military population. Methods Acti...
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| Veröffentlicht in: | Annals of behavioral medicine 2023-09, Vol.57 (10), p.836-845 |
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| creator | Pérez-Muñoz, Andrea Hare, Marion E Andres, Aline Klesges, Robert C Wayne Talcott, Gerald Little, Melissa A Waters, Teresa M Harvey, Jean R Bursac, Zoran Krukowski, Rebecca A |
| description | Abstract
Objective
Postpartum weight retention is associated with adverse health among both civilian and military women.
Purpose
The current study evaluated a stepped-care weight management intervention, Moms Fit 2 Fight, adapted for use in a pregnant and postpartum military population.
Methods
Active duty women and other TRICARE beneficiaries (N = 430) were randomized to one of three conditions: gestational weight gain only (GWG-only) intervention (n =144), postpartum weight loss only (PPWL-only) intervention (n =142), or a combined GWG + PPWL intervention (n = 144). Those participants who received the PPWL intervention (i.e., the PPWL-only and GWG+PPWL conditions) were combined consistently with the pre-registered protocol and compared to those participants who did not receive the PPWL intervention in the primary analyses. Primary outcome data (i.e., postpartum weight retention) were obtained at 6-months postpartum by unblinded data collectors, and intent-to-treat analyses were conducted.
Results
Retention at 6-months postpartum was 88.4%. Participants who received the PPWL intervention retained marginally less weight (1.31 kg) compared to participants that received the GWG-only intervention (2.39 kg), with a difference of 1.08 kg (p = .07). None of the measured covariates, including breastfeeding status, were significantly associated with postpartum weight retention. Of the participants who received the PPWL intervention, 48.1% participants returned to their pre-pregnancy weight at 6-months postpartum, with no significant differences compared to those who received the GWG-only intervention.
Conclusions
A behavioral intervention targeting diet and physical activity during the postpartum period had a trend for reduced postpartum weight retention.
Clinical Trial information
The trial is registered on clinicaltrials.gov (NCT 03057808).
Lay Summary
Since postpartum weight retention is associated with negative health outcomes among women in the military and women in the general population, the Moms Fit 2 Fight study evaluated a stepped-care weight management intervention among active duty women and other military health insurance beneficiaries. Participants (N = 430) were recruited in their first trimester of pregnancy and randomized to one of three conditions: pregnancy weight gain-only intervention, postpartum weight loss (PPWL)-only intervention, or a combined pregnancy weight gain and PPWL intervention. Participants who received the PPWL intervention (i.e |
| doi_str_mv | 10.1093/abm/kaad014 |
| format | Article |
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Objective
Postpartum weight retention is associated with adverse health among both civilian and military women.
Purpose
The current study evaluated a stepped-care weight management intervention, Moms Fit 2 Fight, adapted for use in a pregnant and postpartum military population.
Methods
Active duty women and other TRICARE beneficiaries (N = 430) were randomized to one of three conditions: gestational weight gain only (GWG-only) intervention (n =144), postpartum weight loss only (PPWL-only) intervention (n =142), or a combined GWG + PPWL intervention (n = 144). Those participants who received the PPWL intervention (i.e., the PPWL-only and GWG+PPWL conditions) were combined consistently with the pre-registered protocol and compared to those participants who did not receive the PPWL intervention in the primary analyses. Primary outcome data (i.e., postpartum weight retention) were obtained at 6-months postpartum by unblinded data collectors, and intent-to-treat analyses were conducted.
Results
Retention at 6-months postpartum was 88.4%. Participants who received the PPWL intervention retained marginally less weight (1.31 kg) compared to participants that received the GWG-only intervention (2.39 kg), with a difference of 1.08 kg (p = .07). None of the measured covariates, including breastfeeding status, were significantly associated with postpartum weight retention. Of the participants who received the PPWL intervention, 48.1% participants returned to their pre-pregnancy weight at 6-months postpartum, with no significant differences compared to those who received the GWG-only intervention.
Conclusions
A behavioral intervention targeting diet and physical activity during the postpartum period had a trend for reduced postpartum weight retention.
Clinical Trial information
The trial is registered on clinicaltrials.gov (NCT 03057808).
Lay Summary
Since postpartum weight retention is associated with negative health outcomes among women in the military and women in the general population, the Moms Fit 2 Fight study evaluated a stepped-care weight management intervention among active duty women and other military health insurance beneficiaries. Participants (N = 430) were recruited in their first trimester of pregnancy and randomized to one of three conditions: pregnancy weight gain-only intervention, postpartum weight loss (PPWL)-only intervention, or a combined pregnancy weight gain and PPWL intervention. Participants who received the PPWL intervention (i.e., the participants who received the PPWL-only intervention or the combined intervention) were compared to the participants who did not receive the PPWL intervention, based on weight retention at 6-months postpartum. Participants who received the PPWL intervention retained marginally less weight compared to participants that did not receive the PPWL intervention. Thus, this behavioral intervention targeting diet and physical activity during the postpartum period had a trend for reducing postpartum weight retention, which may be beneficial for achieving military fitness standards and avoiding escalating obesity over multiple pregnancies.
Graphical Abstract
Graphical Abstract
Participants who received a postpartum weight management intervention had lower weight retention at 6 months postpartum compared participants who only received a weight management intervention during pregnancy, although these differences did not reach statistical significance.</description><identifier>ISSN: 0883-6612</identifier><identifier>ISSN: 1532-4796</identifier><identifier>EISSN: 1532-4796</identifier><identifier>DOI: 10.1093/abm/kaad014</identifier><identifier>PMID: 37061829</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><subject>Body Mass Index ; Female ; Gestational Weight Gain ; Humans ; Life Style ; Military Personnel ; Obesity - epidemiology ; Overweight ; Postpartum Period ; Pregnancy ; Pregnancy Complications ; Regular ; Weight Loss</subject><ispartof>Annals of behavioral medicine, 2023-09, Vol.57 (10), p.836-845</ispartof><rights>Society of Behavioral Medicine 2023. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. 2023</rights><rights>Society of Behavioral Medicine 2023. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c376t-4dfecffd0cc44910d0af1b20c346cdb75726963fa32ef5cb919c6b92f1e2f2da3</citedby><cites>FETCH-LOGICAL-c376t-4dfecffd0cc44910d0af1b20c346cdb75726963fa32ef5cb919c6b92f1e2f2da3</cites><orcidid>0000-0003-2889-0968 ; 0000-0003-1314-5092 ; 0000-0002-3823-5177 ; 0000-0002-0562-4010 ; 0000-0003-2611-2193 ; 0000-0001-9306-0907 ; 0000-0001-9193-2783 ; 0000-0002-9981-1430 ; 0000-0002-3774-0788</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,1578,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37061829$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pérez-Muñoz, Andrea</creatorcontrib><creatorcontrib>Hare, Marion E</creatorcontrib><creatorcontrib>Andres, Aline</creatorcontrib><creatorcontrib>Klesges, Robert C</creatorcontrib><creatorcontrib>Wayne Talcott, Gerald</creatorcontrib><creatorcontrib>Little, Melissa A</creatorcontrib><creatorcontrib>Waters, Teresa M</creatorcontrib><creatorcontrib>Harvey, Jean R</creatorcontrib><creatorcontrib>Bursac, Zoran</creatorcontrib><creatorcontrib>Krukowski, Rebecca A</creatorcontrib><title>A Postpartum Weight Loss-focused Stepped-care Intervention in a Military Population: A Randomized Controlled Trial</title><title>Annals of behavioral medicine</title><addtitle>Ann Behav Med</addtitle><description>Abstract
Objective
Postpartum weight retention is associated with adverse health among both civilian and military women.
Purpose
The current study evaluated a stepped-care weight management intervention, Moms Fit 2 Fight, adapted for use in a pregnant and postpartum military population.
Methods
Active duty women and other TRICARE beneficiaries (N = 430) were randomized to one of three conditions: gestational weight gain only (GWG-only) intervention (n =144), postpartum weight loss only (PPWL-only) intervention (n =142), or a combined GWG + PPWL intervention (n = 144). Those participants who received the PPWL intervention (i.e., the PPWL-only and GWG+PPWL conditions) were combined consistently with the pre-registered protocol and compared to those participants who did not receive the PPWL intervention in the primary analyses. Primary outcome data (i.e., postpartum weight retention) were obtained at 6-months postpartum by unblinded data collectors, and intent-to-treat analyses were conducted.
Results
Retention at 6-months postpartum was 88.4%. Participants who received the PPWL intervention retained marginally less weight (1.31 kg) compared to participants that received the GWG-only intervention (2.39 kg), with a difference of 1.08 kg (p = .07). None of the measured covariates, including breastfeeding status, were significantly associated with postpartum weight retention. Of the participants who received the PPWL intervention, 48.1% participants returned to their pre-pregnancy weight at 6-months postpartum, with no significant differences compared to those who received the GWG-only intervention.
Conclusions
A behavioral intervention targeting diet and physical activity during the postpartum period had a trend for reduced postpartum weight retention.
Clinical Trial information
The trial is registered on clinicaltrials.gov (NCT 03057808).
Lay Summary
Since postpartum weight retention is associated with negative health outcomes among women in the military and women in the general population, the Moms Fit 2 Fight study evaluated a stepped-care weight management intervention among active duty women and other military health insurance beneficiaries. Participants (N = 430) were recruited in their first trimester of pregnancy and randomized to one of three conditions: pregnancy weight gain-only intervention, postpartum weight loss (PPWL)-only intervention, or a combined pregnancy weight gain and PPWL intervention. Participants who received the PPWL intervention (i.e., the participants who received the PPWL-only intervention or the combined intervention) were compared to the participants who did not receive the PPWL intervention, based on weight retention at 6-months postpartum. Participants who received the PPWL intervention retained marginally less weight compared to participants that did not receive the PPWL intervention. Thus, this behavioral intervention targeting diet and physical activity during the postpartum period had a trend for reducing postpartum weight retention, which may be beneficial for achieving military fitness standards and avoiding escalating obesity over multiple pregnancies.
Graphical Abstract
Graphical Abstract
Participants who received a postpartum weight management intervention had lower weight retention at 6 months postpartum compared participants who only received a weight management intervention during pregnancy, although these differences did not reach statistical significance.</description><subject>Body Mass Index</subject><subject>Female</subject><subject>Gestational Weight Gain</subject><subject>Humans</subject><subject>Life Style</subject><subject>Military Personnel</subject><subject>Obesity - epidemiology</subject><subject>Overweight</subject><subject>Postpartum Period</subject><subject>Pregnancy</subject><subject>Pregnancy Complications</subject><subject>Regular</subject><subject>Weight Loss</subject><issn>0883-6612</issn><issn>1532-4796</issn><issn>1532-4796</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1rFDEYh4NY2rX25F1ykoKMzcdsMvEiy1K1sEXRiseQyUebNjMZk0yh_etN2bXUS09v4H143h_5AfAGow8YCXqi-uHkRimDcPsCLPCSkqblgr0EC9R1tGEMkwPwKudrhBBtMdsHB5QjhjsiFiCt4PeYy6RSmQf42_rLqwI3MefGRT1na-DPYqfJmkarZOHZWGy6tWPxcYR-hAqe--CLSndVM81BPSw-whX8oUYTB39fBes4lhRDqM-L5FV4DfacCtke7eYh-PX59GL9tdl8-3K2Xm0aTTkrTWuc1c4ZpHXbCowMUg73BGnaMm16vuSECUadosS6pe4FFpr1gjhsiSNG0UPwaeud5n6wRtfUSQU5JT_UvDIqL__fjP5KXsZbiVErug7zajjeGVL8M9tc5OCztiGo0cY5S9IhLDhHXFT0_RbVqX5esu7xDkbyoSZZa5K7mir99mm0R_ZfLxV4twXiPD1r-guCP59a</recordid><startdate>20230913</startdate><enddate>20230913</enddate><creator>Pérez-Muñoz, Andrea</creator><creator>Hare, Marion E</creator><creator>Andres, Aline</creator><creator>Klesges, Robert C</creator><creator>Wayne Talcott, Gerald</creator><creator>Little, Melissa A</creator><creator>Waters, Teresa M</creator><creator>Harvey, Jean R</creator><creator>Bursac, Zoran</creator><creator>Krukowski, Rebecca A</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-2889-0968</orcidid><orcidid>https://orcid.org/0000-0003-1314-5092</orcidid><orcidid>https://orcid.org/0000-0002-3823-5177</orcidid><orcidid>https://orcid.org/0000-0002-0562-4010</orcidid><orcidid>https://orcid.org/0000-0003-2611-2193</orcidid><orcidid>https://orcid.org/0000-0001-9306-0907</orcidid><orcidid>https://orcid.org/0000-0001-9193-2783</orcidid><orcidid>https://orcid.org/0000-0002-9981-1430</orcidid><orcidid>https://orcid.org/0000-0002-3774-0788</orcidid></search><sort><creationdate>20230913</creationdate><title>A Postpartum Weight Loss-focused Stepped-care Intervention in a Military Population: A Randomized Controlled Trial</title><author>Pérez-Muñoz, Andrea ; Hare, Marion E ; Andres, Aline ; Klesges, Robert C ; Wayne Talcott, Gerald ; Little, Melissa A ; Waters, Teresa M ; Harvey, Jean R ; Bursac, Zoran ; Krukowski, Rebecca A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c376t-4dfecffd0cc44910d0af1b20c346cdb75726963fa32ef5cb919c6b92f1e2f2da3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Body Mass Index</topic><topic>Female</topic><topic>Gestational Weight Gain</topic><topic>Humans</topic><topic>Life Style</topic><topic>Military Personnel</topic><topic>Obesity - epidemiology</topic><topic>Overweight</topic><topic>Postpartum Period</topic><topic>Pregnancy</topic><topic>Pregnancy Complications</topic><topic>Regular</topic><topic>Weight Loss</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pérez-Muñoz, Andrea</creatorcontrib><creatorcontrib>Hare, Marion E</creatorcontrib><creatorcontrib>Andres, Aline</creatorcontrib><creatorcontrib>Klesges, Robert C</creatorcontrib><creatorcontrib>Wayne Talcott, Gerald</creatorcontrib><creatorcontrib>Little, Melissa A</creatorcontrib><creatorcontrib>Waters, Teresa M</creatorcontrib><creatorcontrib>Harvey, Jean R</creatorcontrib><creatorcontrib>Bursac, Zoran</creatorcontrib><creatorcontrib>Krukowski, Rebecca A</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Annals of behavioral medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pérez-Muñoz, Andrea</au><au>Hare, Marion E</au><au>Andres, Aline</au><au>Klesges, Robert C</au><au>Wayne Talcott, Gerald</au><au>Little, Melissa A</au><au>Waters, Teresa M</au><au>Harvey, Jean R</au><au>Bursac, Zoran</au><au>Krukowski, Rebecca A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Postpartum Weight Loss-focused Stepped-care Intervention in a Military Population: A Randomized Controlled Trial</atitle><jtitle>Annals of behavioral medicine</jtitle><addtitle>Ann Behav Med</addtitle><date>2023-09-13</date><risdate>2023</risdate><volume>57</volume><issue>10</issue><spage>836</spage><epage>845</epage><pages>836-845</pages><issn>0883-6612</issn><issn>1532-4796</issn><eissn>1532-4796</eissn><abstract>Abstract
Objective
Postpartum weight retention is associated with adverse health among both civilian and military women.
Purpose
The current study evaluated a stepped-care weight management intervention, Moms Fit 2 Fight, adapted for use in a pregnant and postpartum military population.
Methods
Active duty women and other TRICARE beneficiaries (N = 430) were randomized to one of three conditions: gestational weight gain only (GWG-only) intervention (n =144), postpartum weight loss only (PPWL-only) intervention (n =142), or a combined GWG + PPWL intervention (n = 144). Those participants who received the PPWL intervention (i.e., the PPWL-only and GWG+PPWL conditions) were combined consistently with the pre-registered protocol and compared to those participants who did not receive the PPWL intervention in the primary analyses. Primary outcome data (i.e., postpartum weight retention) were obtained at 6-months postpartum by unblinded data collectors, and intent-to-treat analyses were conducted.
Results
Retention at 6-months postpartum was 88.4%. Participants who received the PPWL intervention retained marginally less weight (1.31 kg) compared to participants that received the GWG-only intervention (2.39 kg), with a difference of 1.08 kg (p = .07). None of the measured covariates, including breastfeeding status, were significantly associated with postpartum weight retention. Of the participants who received the PPWL intervention, 48.1% participants returned to their pre-pregnancy weight at 6-months postpartum, with no significant differences compared to those who received the GWG-only intervention.
Conclusions
A behavioral intervention targeting diet and physical activity during the postpartum period had a trend for reduced postpartum weight retention.
Clinical Trial information
The trial is registered on clinicaltrials.gov (NCT 03057808).
Lay Summary
Since postpartum weight retention is associated with negative health outcomes among women in the military and women in the general population, the Moms Fit 2 Fight study evaluated a stepped-care weight management intervention among active duty women and other military health insurance beneficiaries. Participants (N = 430) were recruited in their first trimester of pregnancy and randomized to one of three conditions: pregnancy weight gain-only intervention, postpartum weight loss (PPWL)-only intervention, or a combined pregnancy weight gain and PPWL intervention. Participants who received the PPWL intervention (i.e., the participants who received the PPWL-only intervention or the combined intervention) were compared to the participants who did not receive the PPWL intervention, based on weight retention at 6-months postpartum. Participants who received the PPWL intervention retained marginally less weight compared to participants that did not receive the PPWL intervention. Thus, this behavioral intervention targeting diet and physical activity during the postpartum period had a trend for reducing postpartum weight retention, which may be beneficial for achieving military fitness standards and avoiding escalating obesity over multiple pregnancies.
Graphical Abstract
Graphical Abstract
Participants who received a postpartum weight management intervention had lower weight retention at 6 months postpartum compared participants who only received a weight management intervention during pregnancy, although these differences did not reach statistical significance.</abstract><cop>US</cop><pub>Oxford University Press</pub><pmid>37061829</pmid><doi>10.1093/abm/kaad014</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-2889-0968</orcidid><orcidid>https://orcid.org/0000-0003-1314-5092</orcidid><orcidid>https://orcid.org/0000-0002-3823-5177</orcidid><orcidid>https://orcid.org/0000-0002-0562-4010</orcidid><orcidid>https://orcid.org/0000-0003-2611-2193</orcidid><orcidid>https://orcid.org/0000-0001-9306-0907</orcidid><orcidid>https://orcid.org/0000-0001-9193-2783</orcidid><orcidid>https://orcid.org/0000-0002-9981-1430</orcidid><orcidid>https://orcid.org/0000-0002-3774-0788</orcidid></addata></record> |
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| identifier | ISSN: 0883-6612 |
| ispartof | Annals of behavioral medicine, 2023-09, Vol.57 (10), p.836-845 |
| issn | 0883-6612 1532-4796 1532-4796 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10498817 |
| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE |
| subjects | Body Mass Index Female Gestational Weight Gain Humans Life Style Military Personnel Obesity - epidemiology Overweight Postpartum Period Pregnancy Pregnancy Complications Regular Weight Loss |
| title | A Postpartum Weight Loss-focused Stepped-care Intervention in a Military Population: A Randomized Controlled Trial |
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