Effects of four maintenance programs on the long-term management of obesity.

Abstract

This study evaluated the effectiveness of four posttreatment programs designed to enhance the longterm maintenance of weight loss. Mildly and moderately obese adults (N = 123) were randomly assigned to one of the following five conditions: (a) behavior therapy only; (b) behavior therapy plus a posttreatment therapist-contact maintenance program; (c) behavior therapy plus posttreatment therapist contact plus a social influence maintenance program; (d) behavior therapy plus posttreatment therapist contact plus an aerobic exercise maintenance program; or (e) behavior therapy plus posttreatment therapist contact plus both the aerobic exercise and social influence maintenance programs. All posttreatment programs were conducted in 26 biweekly sessions during the year following behavioral treatment for obesity. At an 18-month follow-up evaluation, all four conditions thai combined behavior therapy with a posttreatmem maintenance program yielded significantly greater long-term weight losses than behavior therapy alone. The tendency for obese people to regain the weight they have lost in treatment represents an important clinical and research problem. After treatment, obese clients frequently abandon weight loss techniques, experience relapses, and regain weight (Bennett, 1986; Foreyt, 1987; Perri, 1987). In a review of recent behavioral programs for obesity, Brownell and Wadden (1986) calculated that, during the year following treatment, participants on average regained 36% of the weight they had lost initially. These findings have led reviewers of the obesity treatment literature such as Jeffery (1987) to conclude that "the most pressing continuing challenge is maintaining weight loss. .. obesity should be viewed as a chronic condition requiring longterm supportive care" (p. 20). Booster sessions, monetary contracts, ongoing support groups, and mail and telephone follow-ups have been evaluated as potential remedies to the maintenance problem. Empirical support for the effectiveness of these procedures has been equivocal (e.g., Kramer, Jeffery. Snell, & Forster, 1986; Perri et al., 1987). More promising findings have been obtained with multifaceted maintenance programs that have included frequent therapist contacts coupled with training targeted to the specific This research was supported in part by a Veterans Administration

Monitoring weight daily blocks the freshman weight gain: a model for combating the epidemic of obesity

“…There is considerable data demonstrating that individuals who are successful at losing and maintaining their weight have more communication with their researcher than those who lose contact. [17][18][19][20][21] It seems unlikely, however, that simply communicating electronically via e-mail over the Internet was the distinguishing feature because the use of the Internet has been found to be no more effective at maintaining weight than direct contact. 22 Finally, it is possible that the students used the information provided to them by the TMS as an early indicator of a small error in their energy balance.…”

Weight maintenance, behaviors and barriers among previous participants of a university-based weight control program

“…These positive findings may be reflective of the large initial weight losses (16 kg) and the length of treatment, which on average consisted of weekly meetings for 1 year with the majority of that time being focused specifically on weight maintenance. It is well established that longer treatments lead to better long-term results, 26,27 particularly if maintenance treatment involves frequent self-monitoring and positive reinforcement 23 or effective problem-solving therapy. 28 Our results suggest that an extended weight loss maintenance treatment may be effective for not only decreasing weight regain during treatment, but also within the 1-2 years after contact with the treatment program ends.…”

Update in Internal Medicine

“…Obesity-Research demonstrates that weight reduction programs that combine diet, exercise, and behavioral training result in an average weight loss of approximately 20 pounds over 20 weeks, with sustained weight loss in two-thirds of persons at 1-year followup (21). Behavioral scientists have determined that successful weight reduction interventions emphasize both diet and exercise, utilize behavioral strategies that include self-monitoring of eating behavior, and include structured relapse prevention.…”