A neglected variabl-e in the search for factors that promote long-term weight loss is the influence of significant others. sixty-eight overweight \^romen \^/ere assigned to five treatment conditions: l_) cooperative spouse: spouses attended all therapy sessions with the subjects and were trained in model-ing, monitoring, and reinfoïcement techniques; 2) wives alone: subjects underwent the basic behavioralprogram by themselves; 3) nonparticipating spouse: spouses were told not to particpate in any way in the subjectsr behavioral program; 4) al-ternative treatment: subjects discussed personality dynamics and their rel-ationship to weight ross; and 5) d.elayed treatment control-.There were no significant differences in weight ross among any of the conditions at posttreatment. of the three behavioral-conditions, only the co-operative spouse cond.ition lost significantly more weight than the alternative treatment at the 3-,6-, and l-2-month follovr-ups; the nonparticipating spouse condition lost more weiqht than the alternative treatment at the final follow-up. The co-operative spouse condítion lost significantry more weight than the wives alone condiÈion at the l2-month fol-Io\d-up. Both the co-operative spouse and the nonparticipating spouse conditions maintained their weiqht Iosses at the final follow-up, while the wives alone condition regained some weight. The absence of significant differences between lþs çe-6nara-tive spouse and the nonparticipating spouse conditions suggests that insÈructing spouses not to saboÈage their wives' efforts may be as effective for long-term maintenanca aq e¡rìr¡alr¡ +-aining thixn to aid their wives. Pretreatment wej-ghts \^/ere negatively associated \nrith the weight reduction quotient at the 3-and 6-month foIlow-ups, while ¡:-i.;ì,:-: );1, the number of pounds overweight was negatively associated with the weight reduction quotient at the 6-month follow-up. Of the measures of behavior change, spouse support was positively associated with outcome at the 6-month follow-up. rt was al_so found that subiects who consumed a smaller nunber of calories rel-ative to their prescribed.
Effectiveness and cost-effectiveness of a behavioral self-help manual for weight reduction were evaluated through the use of 126 community subjects. Over 10 weeks, four groups used the behavioral manual and four groups used an alternate manual under varying degrees of therapist guidance, and one group served as a delayed-treatment control. Results at posttreatment and 3-, 6-, and 16-month follow-ups supported the behavioral manual's effectiveness in producing modest weight loss. The manual could be applied under varying degrees of therapist guidance without significant differences in effectiveness but with significantly increased cost-effectiveness as therapist contact decreased.
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