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weight loss, exercise training, cardiac rehabilitation, behavior modification



  1. Savage, Patrick D. MS
  2. Lee, Melinda RN
  3. Harvey-Berino, Jean PhD, RD
  4. Brochu, Martin PhD
  5. Ades, Philip A. MD


BACKGROUND: Most patients with coronary heart disease are overweight. However, only minimal weight loss occurs with participation in a standard cardiac rehabilitation (CR) program.


METHODS: The study investigated 82 patients with coronary heart disease who entered an outpatient CR program and completed 36 sessions of exercise over a 12-week period. The effects of a structured, nurse-coordinated, weight loss intervention during phase 2 CR were compared with those observed in a CR control group receiving usual care.


RESULTS: The intervention group lost an average of 4.3 +/- 2.8 kg (P < .0001), as compared with a weight loss of 1.7 +/- 2.6 kg (P < .001) in the control group (P < .005 between groups). The effect of the weight loss intervention on total cholesterol (172 +/- 34 to 166 +/- 29 mg/dL) differed from the response in a control group receiving usual care (180 +/- 30 to 187 +/- 28 mg/dL) (P < .05 between groups). The weight loss group experienced a significantly greater improvement (P < .05) than the control group in the physical function score on the Medical Outcomes Study SF-36 questionnaire. A significant correlation was found between the number of weight loss sessions an individual attended and the amount of weight loss experienced (R = 0.39;P < .05).


CONCLUSIONS: The current study demonstrated that a behavioral weight loss intervention is effective in reducing body weight in a CR setting. Participants in the intervention group experienced significantly greater improvements in body weight, body mass index, and total cholesterol than a control group. Additionally, participants in the weight loss program reported greater improvements in their physical function score than the control patients.