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Int. J. Environ. Res. Public Health 2018, 15(2), 211; https://doi.org/10.3390/ijerph15020211

Long-Term Weight Loss Effects of a Behavioral Weight Management Program: Does the Community Food Environment Matter?

1
College of Nursing, University of Illinois at Chicago, Chicago, IL 60612, USA
2
Edward Hines Jr. Veterans Affairs Hospital, Hines, IL 60141, USA
3
School of Public and Environmental Affairs, Indiana University, Bloomington, IN 47405, USA
4
Department of Sociology & Criminology, Pennsylvania State University, University Park, PA 16802, USA
5
Department of Anthropology, Pennsylvania State University, University Park, PA 16802, USA
6
School of Public Health, University of Illinois at Chicago, IL 60612, USA
*
Author to whom correspondence should be addressed.
Received: 1 August 2017 / Revised: 27 October 2017 / Accepted: 29 October 2017 / Published: 26 January 2018
(This article belongs to the Special Issue Food Environment, Diet, and Health)
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Abstract

This study examined whether community food environments altered the longer-term effects of a nationwide behavioral weight management program on body mass index (BMI). The sample was comprised of 98,871 male weight management program participants and 15,385 female participants, as well as 461,302 and 37,192 inverse propensity-score weighted matched male and female controls. We measured the community food environment by counting the number of supermarkets, convenience stores, and fast food restaurants within a 1-mile radius around each person’s home address. We used difference-in-difference regression models with person and calendar time fixed effects to estimate MOVE! effects over time in sub-populations defined by community food environment attributes. Among men, after an initial decrease in BMI at 6 months, the effect of the program decreased over time, with BMI increasing incrementally at 12 months (0.098 kg/m2, p < 0.001), 18 months (0.069 kg/m2, p < 0.001), and 24 months (0.067 kg/m2, p < 0.001). Among women, the initial effects of the program decreased over time as well. Women had an incremental BMI change of 0.099 kg/m2 at 12 months (p < 0.05) with non-significant incremental changes at 18 months and 24 months. We found little evidence that these longer-term effects of the weight management program differed depending on the community food environment. Physiological adaptations may overwhelm environmental influences on adherence to behavioral regimens in affecting longer-term weight loss outcomes. View Full-Text
Keywords: obesity; weight maintenance; weight loss; weight loss intervention; weight loss maintenance; food store; restaurant; accessibility; neighborhood; food access; MOVE! obesity; weight maintenance; weight loss; weight loss intervention; weight loss maintenance; food store; restaurant; accessibility; neighborhood; food access; MOVE!
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Zenk, S.N.; Tarlov, E.; Wing, C.; Matthews, S.A.; Tong, H.; Jones, K.K.; Powell, L.M. Long-Term Weight Loss Effects of a Behavioral Weight Management Program: Does the Community Food Environment Matter? Int. J. Environ. Res. Public Health 2018, 15, 211.

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