We investigated whether a postpartum lifestyle intervention reduced postpartum weight retention (PPWR) and improved body composition, and whether improved lifestyle was associated with less PPWR and improved body composition. A total of 1075 women with excessive gestational weight gain were randomized into the intervention (n = 551) or control (n = 524) group. A completion rate of 76% was reached. Anthropometrics and lifestyle data were collected at 6 weeks and 6 months postpartum. The e-health supported intervention consisted of 4 face-to-face coaching's, focusing on nutrition, exercise and mental wellbeing and using motivational interviewing and behavior change techniques. In the intervention group we observed; larger decrease in weight in women who reduced their energy intake (mean +/- SD 3.1 +/- 4.2 kg versus 2.2 +/- 3.8 kg, p = 0.05) and decreased uncontrolled eating (3.5 +/- 4.2 kg versus 1.9 +/- 3.7 kg, p <= 0.001) by the end of the intervention; larger decrease in fat percentage in women who reduced energy intake (2.3% +/- 2.9 versus 1.4% +/- 2.7, p = 0.01), enhanced restrained eating (2.2% +/- 3 versus 1.4% +/- 2.6, p = 0.02) and decreased uncontrolled eating (2.3% +/- 2.9 versus 1.5% +/- 2.7, p = 0.01) and larger decrease in waist circumference in women who reduced energy intake (4.6 cm +/- 4.8 versus 3.3 cm +/- 4.7, p = 0.01), enhanced restrained eating (4.5 cm +/- 4.8 versus 3.4 cm +/- 4.8, p = 0.05) and decreased uncontrolled eating (4.7 cm +/- 4.8 versus 3.3 cm +/- 4.8, p = 0.006), compared to those who did not. Improved energy intake, restrained eating and uncontrolled eating behavior were associated with more favorable outcomes in weight and body composition. ClinicalTrials.gov identifier NCT02989142.
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