In the ongoing battle against obesity, a new study sheds light on the critical role of sustained support in maintaining weight loss, challenging assumptions about the necessity of intensified interventions during periods of heightened risk. Published in the esteemed journal JAMA Network Open on September 22, 2025, this randomized controlled trial, led by senior research scientist Dr. Kathryn M. Ross of the Advocate Aurora Research Institute and Wake Forest University School of Medicine, provides compelling evidence that regular, monthly phone support is as effective as adaptive, risk-triggered contact for long-term weight-loss maintenance.
The study enrolled 255 adults with obesity who had already achieved a clinically significant reduction in body weight—losing at least 5% of their initial body mass via a structured 16-week weight-loss program. This foundational weight loss is widely recognized as a milestone associated with meaningful improvements in metabolic health. Following this initial phase, all participants received consistent phone-based support from trained health coaches, a modality proven conducive to behavior modification and enhanced adherence to weight management regimens.
Crucially, the trial delineated two distinct modes of delivering this ongoing support. The control group received phone check-ins on a fixed monthly schedule, while the experimental group received calls adaptively, triggered only when an algorithm identified a heightened risk of weight regain. This algorithm incorporated data streams from digital scales and smartphone applications that monitored participants’ progress in near real-time, aiming to apply resources more efficiently by intensifying intervention exactly when a lapse seemed imminent.
After a substantial follow-up period of 20 months, results defied initial hypotheses that tailored, adaptive support would outperform standardized monthly calls. Both cohorts sustained an average weight loss of approximately 8% relative to baseline measurements, surpassing typical expectations for long-term maintenance, where weight regain is notoriously common. Moreover, approximately 60% of all participants maintained at least a 5% reduction from their starting weight, underscoring the durability of the intervention regardless of the support delivery method.
These findings disrupt a prevailing narrative in weight management that additional or intensified support activated by risk algorithms offers superior outcomes. Instead, the study suggests a more straightforward approach—regular, scheduled engagement—may prove equally effective in some contexts. Dr. Ross emphasized the importance of these findings, noting “ongoing support really does help people maintain their weight loss over time – outcomes in both groups were better than we expected.”
From a technical perspective, the study leveraged sophisticated digital health tools, combining biometric feedback with behavioral coaching. Participants utilized smartphone applications synced to digital scales, enabling continuous, objective monitoring of weight fluctuations. This data integration allowed for the creation of predictive models estimating the likelihood of weight regain, a methodological advance in personalized obesity care. Nonetheless, the algorithm’s current iteration did not translate to improved outcomes, highlighting a critical area for further refinement.
The research aligns with a growing paradigm shift viewing obesity as a chronic disease necessitating long-term management, analogous to hypertension or diabetes. This chronic care model advocates for sustained, proactive patient engagement rather than episodic interventions, aligning with broader public health strategies prioritizing continuous support frameworks. Dr. Ross expressed hope that this study will act as a catalyst for healthcare providers and clinics to institutionalize such ongoing support systems as standard care.
Financially supported by the National Institutes of Health and involving contributions from multidisciplinary experts with grants from prominent agencies such as the National Institute of Diabetes and Digestive and Kidney Diseases, the National Science Foundation, and the U.S. Department of Defense, the study exemplifies the caliber of integrative research needed to unravel the complexities of obesity treatment. Transparency was maintained through declarations of conflicting interests, reinforcing the integrity of the findings.
Importantly, the utilization of health coaches played a significant role in the intervention’s success. These professionals provided tailored guidance and motivation, fostering accountability and reinforcing behavioral change strategies essential to weight loss maintenance. While digital tools facilitated monitoring, the human element of coaching remained indispensable, reflecting a nuanced interaction between technology and personalized care.
The results prompt reconsideration of resource allocation in weight management programs. Given that adaptive calls triggered by risk algorithms did not yield superior results, healthcare systems might prioritize consistent, scheduled outreach that ensures sustained patient engagement without necessitating complex predictive analytics. This insight has tangible implications for designing scalable, cost-effective obesity care models.
Future investigations, as envisioned by the research team, will focus on enhancing algorithmic precision to better identify subtle risk profiles and moments of vulnerability. This refinement could potentially enable truly adaptive interventions to realize their hypothesized advantages. The work opens exciting avenues integrating data science, behavioral psychology, and clinical practice to optimize chronic disease management across diverse populations.
In summary, this landmark study provides robust evidence that ongoing monthly support is a cornerstone of successful long-term weight maintenance for people with obesity. Contrary to expectations, increasing support frequency adaptively during high-risk periods does not confer additional benefits. These findings advocate for health policies that implement sustained regular contact in obesity care, emphasizing a chronic disease framework, and harnessing technology alongside human coaching to combat one of the most pervasive health challenges globally.
Subject of Research: People
Article Title: Adaptive vs Monthly Support for Weight-Loss Maintenance
News Publication Date: 22-Sep-2025
Web References:
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2839206
http://dx.doi.org/10.1001/jamanetworkopen.2025.32681
Keywords: Obesity, Weight loss, Metabolic disorders, Nutrition disorders, Body weight
