Trial reportAnnals of behavioral medicine : a publication of the Society of Behavioral Medicine2022
BestFIT Sequential Multiple Assignment Randomized Trial Results: A SMART Approach to Developing Individualized Weight Loss Treatment Sequences.
Trial report in Annals of behavioral medicine : a publication of the Society of Behavioral Medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02368002 (Evaluating Options for Non-Responders), which is not on this map. Cited by 20 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Evaluating Options for Non-Responders: A SMART Approach to Enhancing Weight Loss
Who cites it
20 citing papers in PubMed, 3 syntheses or guidelines pooled it, 20 citations in OpenAlex.
- Individual participant data meta-analysis of eating behaviour traits as effect modifiers in acceptance and commitment therapy-based weight management interventions.International journal of obesity (2005) · 2025Pooled it
- The use of sequential multiple assignment randomized trials (SMARTs) in physical activity interventions: a systematic review.BMC medical research methodology · 2024Pooled it
- Health-promotion interventions targeting multiple behaviors: A meta-analytic review of general and behavior-specific processes of change.Psychological bulletin · 2024Pooled it
- The Adaptive Physical Activity Study in Stroke (TAPAS): A Feasibility Sequential Multiple Assignment Randomized Trial.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026Trial
- Adaptive dietary and exercise strategies for weight loss in Adults with Prediabetes Trial (ADAPT): a sequential multiple assignment randomized trial.The American journal of clinical nutrition · 2025Trial
- Working Women Walking Program: A Sequential Multiple Assignment Randomized Trial.Journal of physical activity & health · 2025Trial
- An Adaptive Telephone Coaching Intervention for Patients in an Online Weight Loss Program: A Randomized Clinical Trial.JAMA network open · 2024Trial
- Weight loss maintenance following an augmented intervention for early slow weight loss responders: An adaptive trial.Translational behavioral medicine · 2024Trial
- A review of use of external data and update on reporting standards in Sequential Multiple-Assignment Randomised Trials.Clinical trials (London, England) · 2026Review
- Precision in progress: a scoping review of SMART designs in adaptive behavioral interventions for individuals with a chronic physical and/or mental illness.Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · 2026Article
- Understanding obesity treatment choices: a mixed-methods study of patient preferences and shared decision-making.Translational behavioral medicine · 2026Article
- From empirical practice to precision medicine: developing a methodology for adjusting traditional Chinese medicine formula dosages based on eight multicenter clinical studies.Frontiers in pharmacology · 2026Article
- Within-trial data borrowing for sequential multiple assignment randomized trials.Biostatistics (Oxford, England) · 2025Article
- Acceptance and Commitment Therapy for Obesity.Current obesity reports · 2025Review
- Results of a pilot sequential multiple assignment randomized trial using counseling to augment a digital weight loss program.Obesity science & practice · 2024Article
- Does intervention sequence impact self-regulatory and behavioral outcomes in an adaptive trial among adults with prediabetes?Health psychology and behavioral medicine · 2024Article
- Is Type 2 Diabetes Mellitus a Behavioural Disorder? An Evidence Review for Type 2 Diabetes Mellitus Prevention and Remission through Lifestyle Modification.TouchREVIEWS in endocrinology · 2023Review
- Optimizing adaptive stepped-care interventions to change adults' health behaviors: A systematic review.Journal of clinical and translational science · 2023Review
- The Sequential Multiple Assignment Randomized Trial for Controlling Infectious Diseases: A Review of Recent Developments.American journal of public health · 2023Review
- Association of childhood abuse with behavioral weight-loss outcomes: Examining the mediating effect of binge eating severity.Obesity (Silver Spring, Md.) · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundState-of-the-art behavioral weight loss treatment (SBT) can lead to clinically meaningful weight loss, but only 30-60% achieve this goal. Developing adaptive interventions that change based on individual progress could increase the number of people who benefit. PURPOSE: Conduct a Sequential Multiple Assignment Randomized Trial (SMART) to determine the optimal time to identify SBT suboptimal responders and whether it is better to switch to portion-controlled meals (PCM) or acceptance-based treatment (ABT).
methodThe BestFIT trial enrolled 468 adults with obesity who started SBT and were randomized to treatment response assessment at Session 3 (Early TRA) or 7 (Late TRA). Suboptimal responders were re-randomized to PCM or ABT. Responders continued SBT. Primary outcomes were weight change at 6 and 18 months.
resultsPCM participants lost more weight at 6 months (-18.4 lbs, 95% CI -20.5, -16.2) than ABT participants (-15.7 lbs, 95% CI: -18.0, -13.4), but this difference was not statistically significant (-2.7 lbs, 95% CI: -5.8, 0.5, p = .09). PCM and ABT participant 18 month weight loss did not differ. Early and Late TRA participants had similar weight losses (p = .96), however, Early TRA PCM participants lost more weight than Late TRA PCM participants (p = .03).
conclusionsResults suggest adaptive intervention sequences that warrant further research (e.g., identify suboptimal responders at Session 3, use PCMs as second-stage treatment). Utilizing the SMART methodology to develop an adaptive weight loss intervention that would outperform gold standard SBT in a randomized controlled trial is an important next step, but may require additional optimization work. CLINICAL TRIAL INFORMATION: ClinicalTrials.gov identifier; NCT02368002.
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Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.