“We know that one-size-fits-all type solutions do not work for everyone, and as nutrition scientists, it is our responsibility to provide options for weight management that are both effective and easy to follow,” said Sai Krupa Das, PhD, Senior Scientist, Jean Mayer USDA Human Nutrition Research Center on Aging and Professor, Friedman School of Nutrition Science and Policy, Tufts University, Boston, Mass. Das is the lead and corresponding author of the study.
The Centers for Disease Control and Prevention recommend offering lifestyle interventions for healthy weight management in workplaces since the majority of adults are employed and rising health care costs incentivize employers to support employee health. However, systematic reviews have indicated that most lifestyle interventions tested in employees, as well as commercial lifestyle interventions suited for scaled use in workplaces, have not achieved significant weight loss. Researchers observe that one potential explanation is that burdensome core features such as daily food logging limit participant adherence. Another factor is the widespread availability of unhealthy food at workplaces.
The HWL approach addresses biological antecedents of food intake (hunger, food cravings, and food preferences), and develops intrinsic motivation for behavior changes leading to weight loss, topics that receive limited emphasis in traditional lifestyle interventions.
Twelve workplaces in the Boston area were randomized to an 18-month intervention with or without meal replacements by a commercial provider. Workplaces were cluster randomized in a 2:1 ratio with eight intervention sites and four control sites stratified by workplace type (e.g., commercial organizations, nonprofits). Participants within intervention sites were individually randomized to HWL or HWL and meal replacements, with the group weight loss program delivered in person or by videoconference.
Participants were employees with overweight or obesity. More than 80% of participants were female, an average age of 48, with a body mass index of 33 kg/m2. To recruit employees, emails were sent out by the organizations informing them of the study. Researchers conducted onsite information sessions with prospective participant screenings. Approximately 260 individuals enrolled in the HWL and HWL meal replacements groups, while 76 participants were in the control group. Recruitment took place between September 2015 and February 2016 with the trial completed in February 2018.
Results were measured at the workplaces by a research team that had no role in intervention delivery. Assessments were conducted at baseline and 6 months in all participants and at 12 and 18 months in intervention participants. Results showed that at the 6-month mark, weight loss among participants was 8.8% in the HWL group and 8.0% in the HWL with meal replacements group with improvements in general health, vitality and sleep in both groups. Weight loss greater than 5% was maintained at the 18-month mark for both groups.
“The study results show how significant and scalable weight reduction is achievable in the workforce community. Rather than focusing on food logging and exercise, the use of a revised health behavior change model makes impactful changes. Clinically meaningful weight loss was shown among participants, along with lower dropout rates and sustained weight reduction at 18 months. Additionally, the results demonstrate the effectiveness and flexibility of delivering a low-cost intervention by videoconference,” said Florencia Ziemke, MD, dABOM; Founder and CEO, Evexia Medical. Ziemke was not associated with the study.
Stay Healthy to Work Better
Ziemke added that promoting health in the workforce can improve physical, mental, emotional health; boost productivity, increase engagement, decrease health care costs and improve staff retention. “These results are a first step and very promising for future studies,” she said.