Obesity Clinical Trial
Official title:
Weight Gain Prevention in Hypertensive Smokers
To evaluate the effectiveness of lifestyle modification following a smoking cessation program in preventing weight gain among hypertensive smokers placed at medical risk by the post-cessation weight gain.
BACKGROUND:
Obesity and smoking are major risk factors for a variety of health-related disorders, such
as heart disease, stroke, certain forms of cancer, and diabetes. Recently, it has been
reported that up to 65 percent of adults in the United States are overweight or obese. The
increasing epidemic of obesity has led to many initiatives to treat obesity and to a number
of recent initiatives to prevent weight gain. Similarly, the prevalence of smoking has not
declined in the past few years, despite the availability of several clinically and
cost-effective smoking cessation programs. One unwanted effect of smoking cessation is
weight gain, which, in turn, may exacerbate weight-related health issues. Behavioral
programs, and to a lesser degree pharmacological programs, designed to reduce post-cessation
weight gain have been successful. However, given that this weight gain is typically
cosmetic, it has been determined that such programs should be targeted to those at a higher
medical risk as a result of the weight gain (e.g., individuals with hypertension). To our
knowledge, no study has evaluated a smoking cessation program, followed by a lifestyle
modification program, to prevent weight gain among those placed at medical risk by the
post-cessation weight gain, including individuals with hypertension. Some studies find an
increased prevalence of hypertension following smoking cessation. It is believed that this
is largely (but not solely) due to weight gain following cessation. However, any weight gain
in individuals with hypertension places them at risk. Body weight is the single best
predictor of adult blood pressure, and blood pressure responds to very small changes in
overall body weight.
DESIGN NARRATIVE:
This study will recruit 660 smokers with hypertension or elevated blood pressure. Given that
African Americans are at high risk for both post-cessation weight gain and hypertension, the
majority of participants recruited will be African American. Participants will be randomly
assigned to either of the following: (a) a validated smoking cessation program followed by a
validated weight control program (TONE), which consists of changes in dietary intake and
physical activity; or (b) the same smoking cessation program followed by a general health
education (contact-time control) program. A follow-up evaluation will occur 1 year following
the end of treatment.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Investigator), Primary Purpose: Prevention
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