Comparative effectiveness of three doses of weight-loss counseling: two-year findings from the rural LITE trial

Obesity (Silver Spring). 2014 Nov;22(11):2293-300. doi: 10.1002/oby.20832.


Objective: To evaluate the effects and costs of three doses of behavioral weight-loss treatment delivered via Cooperative Extension Offices in rural communities.

Methods: Obese adults (N = 612) were randomly assigned to low, moderate, or high doses of behavioral treatment (i.e., 16, 32, or 48 sessions over two years) or to a control condition that received nutrition education without instruction in behavior modification strategies.

Results: Two-year mean reductions in initial body weight were 2.9% (95% Credible Interval = 1.7-4.3), 3.5% (2.0-4.8), 6.7% (5.3-7.9), and 6.8% (5.5-8.1) for the control, low-, moderate-, and high-dose conditions, respectively. The moderate-dose treatment produced weight losses similar to the high-dose condition and significantly larger than the low-dose and control conditions (posterior probability > 0.996). The percentages of participants who achieved weight reductions ≥ 5% at two years were significantly higher in the moderate-dose (58%) and high-dose (58%) conditions compared with low-dose (43%) and control (40%) conditions (posterior probability > 0.996). Cost-effectiveness analyses favored the moderate-dose treatment over all other conditions.

Conclusions: A moderate dose of behavioral treatment produced two-year weight reductions comparable to high-dose treatment but at a lower cost. These findings have important policy implications for the dissemination of weight-loss interventions into communities with limited resources.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Behavior Therapy / economics
  • Behavior Therapy / methods*
  • Cost-Benefit Analysis
  • Counseling / economics
  • Counseling / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Obesity / economics
  • Obesity / therapy*
  • Patient Education as Topic / methods
  • Rural Population
  • Treatment Outcome
  • Weight Loss
  • Young Adult