Development of a lifestyle intervention for the metabolic syndrome: Discovery through proof-of-concept

Lynda H. Powell*, Bradley M. Appelhans, Jennifer Ventrelle, Kelly Karavolos, Michelle L. March, Jason C. Ong, Stephanie L. Fitzpatrick, Patricia Normand, Rebecca Dawar, Rasa Kazlauskaite

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Objective: The aim was to describe the early phases of the progressive development of a lifestyle treatment for sustained remission of the metabolic syndrome (MetS) using the Obesity-Related Behavioral Intervention Trials (ORBIT) model for behavioral treatment development as a guide. Methods: Early discovery and design phases produced a 3-component (diet, physical activity, stress), group-based lifestyle treatment with an intensive 6-month phase followed by monthly, participant-led maintenance meetings. In the proof-of-concept phase, 26 participants with the MetS (age 53 ± 7 years, 77% female, and 65% ethnic minority) were recruited in a quasi-experimental design to determine if treatment could achieve the prespecified benchmark of MetS remission in ≥50% at 2.5 years. Exploratory outcomes focused on MetS components, weight, and patient-centered benefits on energy/vitality and psychosocial status. Results: MetS remission was achieved in 53.8% after a median of 2.5 years. At 2.5 years, an increase of +15.4% reported eating ≥3 servings of vegetables/day, +7.7% engaged in ≥150 minutes of moderate-to-vigorous physical activity/week; and +11.5% reported experiencing no depression in the past 2 weeks. Weight loss ≥5% was achieved by 38.5%, and energy/vitality, negative affect, and social support improved. Median group attendance over 2.5 years was 73.8%. Conclusions: It is plausible that this lifestyle program can produce a remission in the MetS, sustained through 2.5 years. After refinements to enhance precision and strength, progression to feasibility pilot testing and a randomized clinical trial will determine its efficacy as a cost-effective lifestyle option for managing the MetS in the current health care system.

Original languageEnglish (US)
Pages (from-to)929-939
Number of pages11
JournalHealth Psychology
Issue number10
StatePublished - Oct 2018


  • ORBIT model
  • intervention development
  • lifestyle
  • metabolic syndrome
  • proof-of-concept

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Applied Psychology


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