Increasing cost-effectiveness in obesity treatment through use of self-help behavioral manuals and decreased therapist contact.

Abstract

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.

Are Unrealistic Weight Loss Goals Associated with Outcomes for Overweight Women?

“…Treatment involved eight weekly group sessions. Although the treatment was shorter than in many weight loss studies, significant weight losses can be produced by more focused formats (25, 26), and treatment length should not influence the effects of goals on weight loss.…”

Self‐help in the long‐term treatment of obesity

“…Several researchers have specifically compared the use of varying degrees of therapist contact while controlling for other variables, such as the type of self‐help manual used and the total time spent in treatment. Pezzot‐Pearce and colleagues compared the use of a behavioural manual under therapist‐administered and self‐administered conditions (41). Significant weight losses resulted, with no increase in effectiveness in the two therapist‐administered conditions despite a fourfold and 20‐fold increase in cost and investment of therapist time.…”

“…For example, certain self‐help groups may be as effective as professionally administered clinical programmes, as discussed above. In addition, it is still unknown whether individual treatment is more effective than group therapy, and limited evidence has even suggested that it is less effective (41,42). Another problem related to the development of a stepped‐care approach to weight loss is that while many variations of treatment have been found to produce early weight loss, there still exists no well‐established treatment that produces permanent weight reduction.…”

Identifying predictor variables of weight loss outcome: Implications for a stepped program and weight management

“…The efficacy of moderate intensity programs such as bibliotherapy has been reviewed previously (e.g., Rosen, 1987). Pezzot-Pearce, LeBow and Pearce (1982) found in the area of weight control that subjects who used a manual with minimal or no therapist guidance lost an average of 11 lbs by 6-month follow-up. Jeffery and Gerber (1982) also noted that subjects who participated in an active correspondence condition in the Minnesota Center of the Multiple Risk Factor Intervention Trial (MRFIT) maintained a 10-lb weight loss by 12-month follow-up.…”