ABSTRACT Background: There is very low-quality evidence that the transtheoretical stages of change model combined with physical activity or diet, or both, can result in significant improvements in dietary and physical activity habits. Objective: To evaluate the association between stages of change on weight reduction, after a nutritional intervention, in patients with cardiovascular risk. Methods: In a randomized controlled clinical trial, patients >18 years old with body mass index ≥25 kg/m2 and at least two cardiovascular risk factors were distributed to an intervention or control group. The intervention group received, according to stage of change, a multidisciplinary intervention formed by a nutritionist, a psychologist, a chef and a physiotherapist to improve healthy eating, while the control group was given a nutritional prescription. Stage of change from the transtheoretical model, anthropometric variables, physical activity, and 24-hour recall of food intake were measured at baseline and 12 months postintervention. The main outcomes were change in weight, waist and hip circumferences. Results: We included 188 subjects (intervention group= 93, control group= 95), where 75% were female, 68.6% had obesity, and mean age 50.3±13. After 12-months, subjects in the intervention group that were ready to change showed a greater decrease in weight and energy intake, with differences between ready to change vs not ready to change subjects and an interaction between intervention group and ready to change. Conclusions: An intervention with a multidisciplinary team can be as effective as the current standard of care in promoting weight loss when taking into account baseline stage of change.