The failure of therapist assistance and stepped-care to improve weight loss outcomes.

Abstract

This investigation was designed to examine whether: (i) individuals could successfully lose 5% of their body weight with minimal assistance, (ii) weight loss would be improved by the addition of therapist assistance, and (iii) individuals unsuccessful at losing 5% total body weight during the minimal assistance phase (with or without therapist assistance) would benefit from a weekly weight loss group. Fifty-four overweight or obese adults (BMI > 27 kg/m(2)) initially participated in a 14-week self-help (SH) or therapist-assisted SH (TASH) weight loss program. Participants who were unsuccessful at losing 5% total body weight were stepped-up to a 3-month, group-based behavioral weight loss program (BWLP) with weekly weigh-ins. Although approximately 60% of the participants were successful at losing 5% of their total body weight (lb) during the minimal assistance phase (M = 10.6; s.d. = 11.5; P < 0.01), treatment outcome was not improved by the addition of therapist assistance. For individuals who were unsuccessful at losing 5% of total body weight during a minimal assistance phase, the addition of a group-based BWLP did not improve their weight loss. While many individuals were quite successful at losing weight with minimal assistance, other individuals evidenced difficulties losing weight, even when participating in a greater intensity intervention (i.e., BWLP group).