# Evaluating the EVO treatment optimized for resource constraints: Elements Vital to treat Obesity

> **NIH NIH R01** · NORTHWESTERN UNIVERSITY · 2022 · $586,957

## Abstract

PROJECT SUMMARY
High prevalence of obesity contributes to stagnant mortality rates, increased health care spending, decreased
employment, and lower wages. Current gold standard treatments are costly and burdensome, limiting
accessibility to the majority of the public and having little effect on this public health crisis. Many attempts have
been made to improve the delivery of the successful Diabetes Prevention Program (DPP), shown to produce
an average of 6.5kg weight loss over 6 months. However, research to date has lacked a systematic
optimization of the DPP treatment package, resulting in packages that have essential parts missing, continue
to be burdensome for the patient, or do not produce enough weight loss. The proposed work represents the
next step in an efficient, systematic process to identify active treatment components with the goal of
assembling a treatment package that can produce sufficient weight loss at a reduced cost and burden. Our
prior trial, Opt-IN, was a highly efficient, fully powered full factorial randomized trial designed to test main
effects and interactions of additional treatment components (e.g., text messages, meal replacements), when
added to a minimal intervention of self-monitoring, psychoeducation, diet and physical activity goals, and
biweekly coaching calls. The results supported that significant weight loss could be attained from a minimal
level of intervention with no additional components. One notable finding demonstrated that 24 coaching
sessions was no better than receiving 12 sessions, significantly reducing potential cost of an intervention.
While the Opt-IN trial was designed to test contribution of components, a full head-to-head randomized
controlled trial will need to be conducted between the newly optimized intervention (EVO: Elements Vital to
treat Obesity) and the current gold standard DPP. Furthermore, full economic analyses that use concurrent
clinical trial data from weight loss treatments is lacking, and as such, we intend to do so to inform future
dissemination, implementation, and/or further optimization of treatments. Aim 1 is to test whether weight loss
from baseline to 6 months achieved by EVO is non-inferior to DPP. Aim 2 will focus on conducting a full
economic evaluation consistent with current guidelines. Finally, exploratory aims will investigate weight loss
maintenance at 12 months as well as change in self-regulation, moderators (i.e., Age, Sex, Socioeconomic
status) and mediators (i.e., self-monitoring adherence, self-efficacy) of treatment effects.

## Key facts

- **NIH application ID:** 10437676
- **Project number:** 5R01DK125749-03
- **Recipient organization:** NORTHWESTERN UNIVERSITY
- **Principal Investigator:** Angela Fidler Pfammatter
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $586,957
- **Award type:** 5
- **Project period:** 2020-07-15 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10437676

## Citation

> US National Institutes of Health, RePORTER application 10437676, Evaluating the EVO treatment optimized for resource constraints: Elements Vital to treat Obesity (5R01DK125749-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10437676. Licensed CC0.

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