NUTRITIONAL SCIENCE Weight maintenance over 12 months after weight loss resulting from participation in a 12-week randomised controlled trial comparing all meal provision to self- directed diet in overweight adults C. Whitham,* D. D Mellor,† S. Goodwin,* M. Reid*‡ & S. L. Atkin* *HONEI Project, University of Hull, Hull, UK †Division of Nutritional Sciences, The University of Nottingham, Sutton Bonington, UK ‡Department of Psychology, University of Hull, Hull, UK Keywords meal provision, meal replacement, self-care after weight loss, weight loss, weight maintenance. Correspondence D. D. Mellor, Division of Nutritional Sciences, The University of Nottingham, Sutton Bonington Campus, Sutton Bonington, Loughborough LE12 5RD, UK. Tel.: +44 (0)115 951 6098 Fax: +44 (0)115 951 6122 E-mail: duane.mellor@notttingham.ac.uk How to cite this article Whitham C., Mellor D.D., Goodwin S., Reid M. & Atkin S.L. (2014) Weight maintenance over 12 months after weight loss resulting from participation in a 12-week randomised controlled trial comparing all meal provision to self-directed diet in overweight adults. J Hum Nutr Diet. 27, 384–390 doi:10.1111/jhn.12178 Abstract Background: The results of weight maintenance after initial weight loss are reported infrequently, although, when they have been reported, the out- comes are generally poor and weight regain is common. Methods: After an initial 12-week randomised intervention comparing all meal provision against a self-directed energy restriction, participants re-con- sented to participate in a follow-on study. Participants were given the option to choose to continue with the same dietary intervention (either all meal provision (provided free of charge) or self-directed diet) or change to the other diet for a further 12 weeks. Participants were followed up at 4- weekly intervals during both intervention periods (a total of 24 weeks), with a final follow up at 12 months. Results: Eighty-five out of 86 individuals who completed the original 12- week randomised phase chose to continue on to the follow-up study. No significant differences in further weight loss between groups (P = 0.138) [mean (SEM): À3.4% (1.1%) for all meal provision only; À3.4% (0.6%) self-directed then all meal provision; À1.1% (1.2%) all meal provision then self-directed] were seen after a further 12 weeks. Meal provision for a total of 24 weeks resulted in 67% of individuals losing at least 10% body weight. The groups switching from self-directed dieting to meal provision (or vice versa) were the only groups to have a lower mean weight at 12 months than at the start of the follow-on study. Conclusions: Structured support for 24 weeks followed by 28 weeks of self- care can result in weight maintenance, with initial weight loss maintained at 12 months from enrolling on a 12-week weight loss intervention, with a 12-week follow-on period. Introduction Obesity prevalence is a major public health problem that has become a threat to global and economic development (Alwan et al., 2011). In the UK, 25% of UK adults are obese and a further 44% of men and 33% of women are overweight [National Health Service (NHS) Information Centre, 2011]. It is widely acknowledged that many weight management programmes and interventions can demonstrate short-term efficacy (NHS Information Cen- tre, 2011). However, there are limited data available on successful longer-term weight management interventions, 384 ª 2013 The British Dietetic Association Ltd. Journal of Human Nutrition and Dietetics