Impact of sleep, screen time, depression and stress on weight change in the intensive weight loss phase of the LIFE study

• Published in: International Journal of Obesity 2012-01, Vol.36 (1), p.86-92
• Main Authors: Elder, C R, Gullion, C M, Funk, K L, DeBar, L L, Lindberg, N M, Stevens, V J
• Format: Article
• Language: English
• Subjects: Adult and adolescent clinical studies; Behavior Therapy - methods; Biological and medical sciences; Body Mass Index; Body size; Body weight loss; Care and treatment; Computers; Depression; Depression - epidemiology; Depression - psychology; Depression - therapy; Depression, Mental; Diet; Diet, Reducing; Dietary intake; Epidemiology; Female; Follow-Up Studies; Food intake; Health Promotion and Disease Prevention; Humans; Hypertension; Insomnia; Internal Medicine; Intervention; Life Style; Logistic Models; Male; Medical sciences; Medicine; Medicine & Public Health; Metabolic Diseases; Middle Aged; Mood disorders; Obesity; Obesity - epidemiology; Obesity - psychology; Obesity - therapy; original-article; Patient Selection; Physical exercise; Physiological aspects; Prevention and actions; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Public Health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Screen time; Sleep; Sleep disorders; Stress; Stress, Psychological - complications; Television; Time Factors; Time measurement; United States - epidemiology; Weight control; Weight Loss; Weight loss measurement; Weight Reduction Programs
• ISSN: 0307-0565; 1476-5497
• DOI: 10.1038/ijo.2011.60

Background: The LIFE study is a two-phase randomized clinical trial comparing two approaches to maintaining weight loss following guided weight loss. Phase I provided a nonrandomized intensive 6-month behavioral weight loss intervention to 472 obese (body mass index 30–50) adult participants. Phase II is the randomized weight loss maintenance portion of the study. This paper focuses on Phase I measures of sleep, screen time, depression and stress. Methods: The Phase I intervention consisted of 22 group sessions led over 26 weeks by behavioral counselors. Recommendations included reducing dietary intake by 500 calories per day, adopting the Dietary Approaches to Stop Hypertension (DASH) dietary pattern and increasing physical exercise to at least 180 min per week. Measures reported here are sleep time, insomnia, screen time, depression and stress at entry and post-weight loss intervention follow-up. Results: The mean weight loss for all participants over the intensive Phase I weight loss intervention was 6.3 kg (s.d. 7.1). Sixty percent ( N =285) of participants lost at least 4.5 kg (10 lbs) and were randomized into Phase II. Participants ( N =472) attended a mean of 73.1% (s.d. 26.7) of sessions, completed 5.1 (s.d. 1.9) daily food records/week, and reported 195.1 min (s.d. 123.1) of exercise per week. Using logistic regression, sleep time (quadratic trend, P =0.030) and lower stress ( P =0.024) at entry predicted success in the weight loss program, and lower stress predicted greater weight loss during Phase I ( P =0.021). In addition, weight loss was significantly correlated with declines in stress ( P =0.048) and depression ( P =0.035). Conclusion: Results suggest that clinicians and investigators might consider targeting sleep, depression and stress as part of a behavioral weight loss intervention.