title: Use of personal trainers and financial incentives to increase exercise in a behavioral weight-loss program.
abstract: Exercise is the best predictor of long-term weight loss. This study evaluated two strategies for improving exercise adherence and long-term weight loss in obese outpatients. Obese men and women (N = 193) were randomized to 1 of 5 treatment groups for 18 months: standard behavior therapy (SBT); SBT with supervised walks (SW) 3 times per week; SBT + SW with personal trainers (PT), who walked with participants, made phone reminders, and did make-up SW; SBT + SW with monetary incentives (I) for completing SW; and SBT + SW + PT + I. Both PT and I enhanced attendance at SWs, the combination producing the best adherence. Increased walk attendance did not result in higher overall energy expenditure, however, and long-term weight loss was also not improved. Post hoc analyses suggest that the level of exercise needed for successful long-term weight loss is much higher than that usually recommended in behavioral treatment programs.
authors.affiliation: Division of Epidemiology, University of Minnesota School of Public Health, Minneapolis 55454-1015, USA. jeffery@epivax.epi.umn.edu
authors.forename: R W
authors.initials: RW
authors.lastname: Jeffery
authors.forename: R R
authors.initials: RR
authors.lastname: Wing
authors.forename: C
authors.initials: C
authors.lastname: Thorson
authors.forename: L R
authors.initials: LR
authors.lastname: Burton
mesh_terms: D000328:Adult; D001521:Behavior Therapy / Q000379:methods / Q000592:standards; D005081:Exercise Therapy / Q000379:methods / Q000592:standards; D005260:Female; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009765:Obesity / Q000628:therapy*; D010349:Patient Compliance; D012201:Reward; D016896:Treatment Outcome