| Inclusion criteria for Phase I |
| BMI of 25-45 kg/m2
|
| Age 25 or older |
| Taking prescription medication for hypertension and/or dyslipidemia |
| Personal physician permission required if diabetes present or if participant had a prior CVD event (CVD event within past 12 months is an exclusion) |
| Non-positive stress test or other diagnostic test for CAD required if diabetic or if history of CVD. The stress test can be waived for participants who enter WLM currently engaging in vigorous physical activity |
| Willing not to use weight loss medications for the duration of the trial |
| Able and willing to give informed consent and participate in the interventions |
| Access to telephone and the internet |
| Demonstrated ability to access a specific web site |
| Demonstrated ability to receive and respond to email |
| Able to keep a complete 5-day food record during screening |
| Exclusion criteria for Phase I |
| Medical Exclusions |
| Contraindication to weight loss (e.g., malignancy or other serious illness) |
| Cardiovascular event within the past 12 months |
| Current symptoms of angina, unless we have both physician permission and a non-positive stress test or other diagnostic test for CAD |
| Evidence of active cancer diagnosis (except for non-melanoma skin cancer) or treatment in past 2 years, defined as any diagnosis or any treatment within the past 2 years |
| Medication treated diabetes. |
| If unmedicated diabetes, eligible if HgbA1C <8 and with both MD permission and a non-positive stress test or other diagnostic test for CAD. The stress test can be waived for participants who enter WLM currently engaging in vigorous physical activity |
| Self-reported history of renal disease (other than kidney stones) |
| Psychiatric hospitalization within the last 2 years |
| Consumption of more than 21 alcoholic drinks per week or binge drinking |
| Weight loss of > 20 lbs in the last 3 months |
| Any history of gastric bypass surgery or fundoplication for obesity, or scheduled surgery for this purpose |
| Liposuction in the past 12 months |
| Medications |
| Use of prescription weight loss medications in the 3 months prior to screening. |
| Current use of medications for treatment of psychosis or manic-depressive illness |
| Other |
| Planning to leave the area within three years |
| Pregnant, breast feeding, or planning pregnancy prior to the end of participation |
| Current participation in another clinical trial |
| Weight Loss Maintenance Trial staff member or household member of a Weight Loss Maintenance Trial staff person |
