# Stepped Care for Weight Loss Maintenance

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2024 · $417,884

## Abstract

PROJECT SUMMARY/ABSTRACT
Weight loss maintenance remains the Achilles' heel of obesity management. Extended intervention contact
reduces weight regain. However, continued counseling in practice is rare. Digital health interventions can
address barriers to providing in-person maintenance counseling. Our long-term goal is to develop more
effective weight loss maintenance strategies that are accessible, patient-centered, and tailored to meet
individuals' needs. To accomplish this goal, the proposed trial will examine whether, after 16 weeks of initial
weight loss, a stepped-care, digital health intervention improves the maintenance of a >5% weight loss. Phase
I
lifestyle
phase,
(UC);
(STEP).
SELF
is a non-randomized, 16-week, weight-loss phase during which all participants wil receive the same group
intervention designed to induce a > 5% weight l oss. In Phase II, a 52-week weight-loss maintenance
180 adults with obesity who have lost >5% will be randomized to one of three interventions: usual care
daily self-monitoring of weight, diet, and physical activity with digital tools (SELF); or 
The UC group will receive monthly, emailed weight loss maintenance education. Participants in the
group will have access to a digital health intervention that uses:
l
stepped care
daily remote monitoring of weight,
physical activity, and calorie intake; and automated, personalized text-messaging to
adherence.
13
additionally
(Step
percentage
weeks,
transition
encourage behaviora
begin with access to the digital health program (Step 1). Participants who, after the first
weeks, have not maintained their 5% weight loss or have regained 2 percentage points of their weight, will
receive monthly visits with a counselor to promote behavioral adherence and address barriers
2). Participants who, at 26 weeks, have not maintained a > 5% weight loss or have regained 2
points with Step 2 will transition to twice-monthly counseling (Step 3). Participants who, at 39
still have not maintained a > 5% weight l oss or have regained 2 percentage points with Step 3 will
to a partial meal replacement plan for the last 13 weeks (Step 4).
l
STEP will
Our primary aim is to determine if
SELF and STEP result in better maintenance of weight loss compared to UC. Our secondary aims are to
examine differences in self-weighing frequency, eating behaviors, and physical activity, and examine if STEP,
relative to SELF, produces greater improvements in weight, self-weighing frequency, eating behaviors, and
physical activity.
each
We will also conduct an economic analysis to evaluate the incremental cost effectiveness of
intervention per unit decrease in weight (kg).The expected outcome of the study is to demonstrate the
efficacy of a digital health intervention for weight loss maintenance, providing a solution to many challenges
that interfere with successful delivery of obesity treatment. We also expect to show the efficacy of a stepped
care model for weight loss maintenance, providing a
individuals...

## Key facts

- **NIH application ID:** 10920359
- **Project number:** 5R01NR020197-02
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** ARIANA MARIE CHAO
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $417,884
- **Award type:** 5
- **Project period:** 2023-09-05 → 2028-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10920359

## Citation

> US National Institutes of Health, RePORTER application 10920359, Stepped Care for Weight Loss Maintenance (5R01NR020197-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10920359. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*