Weight-loss and exercise study compares center- and home-based programs

University of Central Florida study seeks to determine whether women who follow weight-loss and exercise programs at home fare as well as those who go to a center to work out and meet with counselors

Joy Ungerer has improved her health and lost excess weight by walking on a treadmill at an exercise center. Janet Brewer walks, too – either at a mall or in her neighborhood – and has watched the readings on her bathroom scale drop as well.

The two women are among the first participants in a University of Central Florida study that seeks to find out whether women who follow weight-loss and exercise programs at home fare as well as those who go to a center to work out and meet with counselors. The study, conducted in the School of Nursing, is funded by a five-year, $2 million grant from the National Institute of Nursing Research at the National Institutes of Health.

The study, which began in January 2004, compares two weight-loss and exercise programs that are identical except for their locations and delivery of treatment. “Center-based” participants attend classes and walk for exercise at a center established in the Central Florida Research Park, adjacent to UCF’s Orlando campus. “Home-based” participants learn by reading and talking to consultants over the phone. They walk for exercise at self-selected locations. All of the participants are postmenopausal women who are 50 to 65 years old and healthy. They are nonsmokers who initially were 20 to 50 pounds overweight.

“Recent data suggest that a home-based program may be as effective as a center-based one for weight reduction,” said Professor Karen Dennis, the lead researcher for the project. “This is the first study to compare the effectiveness of the two different settings in supporting weight loss in postmenopausal women.”

Dennis said alternatives to traditional medical center or office visits are needed for those who want to lose weight under medical supervision. “In a nation with an unrelenting epidemic of obesity, the need for treatment far exceeds the capacity of the health-care system to provide care on an individual basis,” she added.

Dennis has found that many people will not, for personal or financial reasons, enroll in intensive, time-consuming weight-loss programs. They need a program that works within the time constraints imposed by their work schedules and family commitments, which leads to considerable interest in home-based approaches to weight loss and exercise.

In designing the center- and home-based programs, Dennis included the five components of weight-loss treatment known to be successful: behavior modification, changes in thinking about diet and food, social support, nutrition and exercise. Her research team includes a dietician, exercise physiologist, psychologist, statistician and nurse practitioner.

During the first six months, all of the study participants learn new eating and exercise strategies. They receive support through meetings or phone calls from research team members and maintain food and exercise logs. Home-based women are paired with “buddies” from the same program. During the following six months, the participants reduce the number of contacts with team members. The researchers continue to monitor the participants’ success during the second year.

Janet Brewer ended up in the home-based group when the participants were randomly assigned to one of the two programs. She started to monitor everything she ate and to walk routinely for exercise. She recorded all of the ways she exercised: bicycling, gardening, swimming, cleaning up after the hurricanes and the program’s requisite 45-minute walks three times a week. Once a week, she spoke on the phone with a dietician for 20 minutes. She also maintained food and exercise logs, which she submitted by mail.

“When I started, I measured, weighed and recorded every bite I took. It was a challenge,” Brewer said with a laugh. “I ate cold meals for the first few weeks.”

Brewer has lost more than 23 pounds and has gained confidence in her ability to stick with a new way of eating. She also has realized that the center-based program would never have fit into her schedule.

Joy Ungerer, a retired Orlando resident who followed the center-based program, used the same dietary strategies as Brewer but attended weekly, hourlong meetings at the center. She submitted the same types of logs as Brewer in person and walked for 45 minutes on a treadmill at the center three times a week.

She has lost 38 pounds during the past year, and her blood sugar and cholesterol levels have dropped to much healthier levels. She said she feels terrific about her accomplishments.

“The program showed me that you can eat anything, as long as it’s in moderation,” said Ungerer, who has become adept at selecting healthy food from restaurant menus. “It’s really not a diet, it’s a way of life.”

Postmenopausal women who are interested in participating in the study can call 407-823-1837.