Our Weight Control Study was designed to explore TIVR, a novel telephone-based technology, as a tool to promote and maintain weight loss and reduce relapse rates after successful weight reduction in patients who are obese. Participants in this study were recruited from completers of the Weight Control Program directed by Dr. Elena Ramirez, Ph.D., Director of the Vermont Center for Cognitive Behavioral Therapy.
At the conclusion of the 18-week manualized group Behavioral Therapy or CBT, patients were consented, assessed for eligibility, and then randomized to one of two study conditions:
Research participants assigned to the TIVR condition were required to call an automated telephone system (IVR) daily for 6 months to report weight, caloric intake totals, nutritional values and length of time spent exercising.
Additionally, participants were offered Didactic Review of Skills and Guided Behavioral Rehearsal of Pain Coping Skills learned during the 18 weeks of Group Behavioral Therapy (BT). Participants also received confidential and personalized monthly messages that were created and recorded by Dr. Ramirez to the TIVR. All participants were assessed at the conclusion of the six-month TIVR trial, and 6 months later (i.e.12 months post BT).
In addition to the telephone Weight control TIVR, participants were invited to participate in an objective measure of changes in body size, body composition, and metabolism that may occur as a result of weight loss and maintenance.
This portion of the study involved 4 visits to the General Clinical Research Center (GCRC) at Fletcher Allen. These assessments consisted of a physical exam, blood pressure, height, weight, waist circumference. Volunteers also had blood drawn to analyze their glucose and cholesterol levels as well as other risk factors for heart disease and diabetes. Finally, patients also had a Dual Energy X-ray Absorptiometry (DEXA) which tested the density of their bone structure and the quantity of muscle and fat in their body.
Previous weight loss research suggests that continued assistance post BT can prolong and amplify therapeutic impact. Our own research suggests that TIVR is a cost-effective means of prolonging and amplifying therapeutic effect in chronic illness such as persistent pain and alcohol dependence. Therefore, we adapted the Therapeutic Interactive Voice Response (TIVR) as a Behavioral Therapy (BT) adjunct for patients with obesity. Our pilot results demonstrated that the TIVR is helpful in weight relapse prevention by enhancing the beneficial effects of 18-week behavioral therapy weight loss program.
This study was supported by a New Research Initiative (NRI) funded by the University of Vermont.
Currently, a grant proposal has been submitted to the NIH/NIDDK to replicate the preliminary findings in a large-scale randomized controlled study.