Background Weight regain after intentional loss is common. Most evidence-based weight management programs focus on short-term loss rather than long-term maintenance. Objective To evaluate the benefit of coaching in an electronic health record (EHR)-based weight maintenance intervention. Design Randomized controlled trial. (ClinicalTrials.gov: NCT01946191). Setting Practices affiliated with an academic medical center. Participants Adult outpatients with body mass index (BMI) of 25 kg/m2 or higher, intentional weight loss of at least 5% in the previous 2 years, and no bariatric procedures in the previous 5 years. Intervention Participants were randomly assigned to EHR tools (tracking group) versus EHR tools plus coaching (coaching group). The EHR tools included weight, diet, and physical activity tracking flow sheets; standardized surveys; and reminders. The coaching group received 24 months of personalized coaching through the EHR patient portal, with 24 scheduled contacts. Measurements The primary outcome was weight change at 24 months. Secondary outcomes included 5% weight loss maintenance and changes in BMI, waist circumference, number of steps per day, health-related quality of life, physical function, blood pressure, and satisfaction. Results Among 194 randomly assigned participants (mean age, 53.4 years [SD, 12.2]; 143 [74%] women; 171 [88%] white), 157 (81%) completed the trial. Mean baseline weight and BMI were 85.8 kg (SD, 19.1) and 30.4 kg/m2 (SD, 5.9). At 24 months, mean weight regain (± SE) was 2.1 ± 0.62 kg and 4.9 ± 0.63 kg in the coaching and tracking groups, respectively. The between-group difference in weight change at 24 months was significant (-2.86 kg [95% CI, -4.60 to -1.11 kg]) in the linear mixed model. At 24 months, 65% of participants in the coaching group and 50% in the tracking group maintained weight loss of at least 5%. Limitation Single-site trial, which limits generalizability. Conclusion Among adults with intentional weight loss of at least 5%, use of EHR tools plus coaching resulted in less weight regain than EHR tools alone. Primary Funding Source Agency for Healthcare Research and Quality and National Institutes of Health.

中文翻译：

---

基于电子病历的教练对体重维持的影响：一项随机试验。

背景故意减肥后体重恢复很常见。大多数基于证据的体重管理计划都将重点放在短期减肥上，而不是长期维护上。目的评估基于电子健康记录（EHR）的体重维持干预中教练的益处。设计随机对照试验。（ClinicalTrials.gov：NCT01946191）。附属于学术医学中心的设置惯例。参与者成人门诊患者的体重指数（BMI）为25 kg / m2或更高，在过去2年中故意减肥至少5％，并且在过去5年中没有进行减肥手术。干预参与者被随机分配到EHR工具（跟踪组）与EHR工具加辅导（教练组）之间。EHR工具包括体重，饮食和身体活动跟踪流程图；标准化调查；和提醒。教练组通过EHR患者门户网站接受了24个月的个性化教练，并安排了24位联系人。测量主要结果是24个月时体重变化。次要结果包括维持5％的体重减轻以及BMI，腰围，每天的步数，健康相关的生活质量，身体功能，血压和满意度等方面的变化。结果在194名随机分配的参与者中（平均年龄53.4岁[SD，12.2]； 143名[74％]妇女； 171名[88％]白人），有157名（81％）完成了试验。平均基线体重和BMI为85.8 kg（SD，19.1）和30.4 kg / m2（SD，5.9）。在24个月时，教练组和追踪组的平均体重恢复（±SE）分别为2.1±0.62 kg和4.9±0.63 kg。两组在24个月时体重变化的差异显着（-2.86千克[95％CI，-4.60至-1.11 kg]）。在24个月时，教练组中65％的参与者和追踪组中50％的参与者保持了至少5％的体重减轻。局限性单点试验，限制了推广性。结论在有意减肥至少达5％的成年人中，使用EHR工具加上教练可使体重恢复较单独使用EHR工具少。医疗研究与质量和国家卫生研究院的主要资金来源机构。与仅使用EHR工具相比，使用EHR工具加上辅导可减少体重减轻。医疗研究与质量和国家卫生研究院的主要资金来源机构。与仅使用EHR工具相比，使用EHR工具加上辅导可减少体重减轻。医疗研究与质量和国家卫生研究院的主要资金来源机构。