Rationale: In the quest for effective weight loss strategies, many diets and programs have been compared and evaluated for effectiveness. Available data on long-term trials with sustained weight loss are limited and often lack rigorous review. Comprehensive cardiac rehabilitation (CR) programs include weight reduction, but studies are few and CR programs traditionally show weight stabilization instead of weight loss. Modest reductions in excess weight (<5%) have clinically significant effects on improving risk factors in vascular disease. Based on retrospective analysis of CR programs, it has been suggested that weight loss would be realized with more emphasis placed on weight management expectations.

Objectives: To determine if the CCHIM program, with behavior change interventions, leads to pronounced weight loss for patients. Outcomes of body weight, waistline, and body fat percentage changes are primary outcomes measured at baseline, program discharge (3 months), and follow-up (6 months).

Methodology: One hundred ten patients, 64 men (mean age 61) and 44 women (mean age 62) with risk factors for, or with established vascular disease (coronary artery disease and/or cerebrovascular disease), completed the CCHIM program. CCHIM is a 12-week program with a multidisciplinary team providing clinical assessment, risk factor management, education, exercise, nutrition, and behavior change programs. Patients attend weekly supervised exercise sessions (1-2 x per week) and are given a home exercise plan. Weekly intervention with the program dietitian, a personal nutrition plan for low-fat, high-fibre, energy-balanced eating, and behavior change strategies are incorporated. Expectations for increasing exercise and improving nutrition profile are emphasized throughout the program along with interactive goal setting. Anthropometric measures at 0, 3, and 6 months were compared.

Results: Weight loss was greater for women, with a mean loss at program discharge of 3.5 kg (-4.1%) and an additional mean loss of 3.36 kg at the 6-month follow-up, representing a mean total 8.3% weight decrease. Men had a mean 2.24-kg weight loss at discharge with a 0.45-kg gain at 6 months. Average waist changes for women went from 103 cm to 97 cm at discharge and to 93.5 at 6 months representing a 9% decrease. Men had an average waist percentage decrease of 2% at 6 months. Mean body fat percentage decrease in women was 6% and in men 4.5 % at 6 months.

Conclusions: Targeting weight management led to significant weight loss in women compared to men which was not only sustained but further decreased at 6 months. Incorporating interactive goal-setting and having weight management expectations in a cardiac rehabilitation and prevention program can promote loss of excess weight. Impact of weight loss will be investigated in relation to long-term sustainability and risk factor modification as data are further assessed.