TOPS: Take Off Pounds Sensibly Program Enables Sustained Weight Loss

Nia S. Mitchell, MD, MPH Assistant Professor Division of General Internal Medicine Department of Medicine University of Colorado Anschutz Medical CampusMedicalResearch.com Interview with:
Nia S. Mitchell, MD, MPH
Assistant Professor
Division of General Internal Medicine
Department of Medicine
University of Colorado Anschutz Medical Campus

Medical Research: What is the background for this study? What are the main findings?

Dr. Mitchell: Despite decades of obesity research two issues remain elusive in weight management: significant, long-term weight loss and weight loss maintenance and widely accessible programs. There are numerous weight loss programs out there, but there is little evidence of the long-term effectiveness of many programs. Furthermore, these programs may not be accessible to the general population because they are too expensive and may not be geographically available.

I chose to evaluate the Take Off Pounds Sensibly (TOPS) program because I thought it had the potential to address these issues. TOPS is a nationally-available, nonprofit, low-cost, peer-led weight loss program. It costs only $92 per year–$32 is the annual fee plus local chapter dues that average about $5 per month–and any four people can start a TOPS chapter, so it can be implemented and disseminated widely.

The main objective of this study was to determine the weight change for individuals who consecutively renewed their membership in TOPS. We looked at people who joined TOPS from 2005 to 2011, so they could have been followed for up to seven years. We found that people who join TOPS and consecutively renew their annual membership can lose a clinically significant amount of weight and maintain the weight loss for up to seven years. Clinically significant weight loss is defined as weight loss of at least 5% of initial weight, because with a 5% weight loss people with weight-related medical conditions, such as diabetes, can see an improvement in their conditions. Therefore, a diabetic who weighs 200 pounds may see an improvement in her blood sugar control if she loses 10 pounds.

In our study, fifty percent of individuals had clinically significant weight loss in their first year in the program, and 62% of those renewed their annual membership consecutively for seven years had clinically significant weight loss at seven years. This was exciting because many people who lose weight tend to gain it back. I often say that the unfortunate natural history of weight loss tends to be weight re-gain. However, the majority of these individuals maintained a clinically significant weight loss.

Medical Research: What should clinicians and patients take away from your report?

Dr. Mitchell: Because long-term weight loss is difficult to achieve, clinicians and patients should consider TOPS as an option to help manage weight

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Mitchell: Future studies should determine the efficacy of the TOPS program, that is, they should compare TOPS to a control group.

I also think future studies should determine if there are certain factors that may be associated with weight loss success in the TOPS program. For example, certain age groups may do better than others.

It would also be important to follow up with individuals that do not renew their membership in the program to find out what happened with their weight and why they chose not to continue.

Citation:

Nia S. Mitchell, Sarit Polsky, Victoria A. Catenacci, Anna L. Furniss, Allan V. Prochazka. Up to 7 Years of Sustained Weight Loss for Weight-Loss Program Completers. American Journal of Preventive Medicine, 2015; DOI: 10.1016/j.amepre.2015.02.011

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MedicalResearch.com Interview with: Nia S. Mitchell, MD, MPH, Assistant Professor, Division of General Internal Medicine, Department of Medicine, & University of Colorado Anschutz Medical Campus (2015). TOPS: Take Off Pounds Sensibly Program Enables Sustained Weight Loss MedicalResearch.com

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