title: Promoting more modest weight losses: a pilot study.
abstract: OBJECTIVE
  This pilot study assessed the short- and long-term effects of a modified cognitive behavioral treatment designed to facilitate obese patients' acceptance of a 5% to 10% reduction in initial weight.
  
  
  METHODS
  Participants were 17 women with a mean age of 46.5 +/- 9.7 years and BMI of 34.7 +/- 2.9 kg/m2. They participated in a 40-week program that included four phases. The first discussed the benefits of modest weight losses and the potential adverse effects of unrealistic expectations. Phase II provided instruction in traditional cognitive behavioral methods of weight control Phase III focused on methods to improve body image and self-esteem. Phase IV addressed skills for weight maintenance. Changes in weight, self-esteem, body image, and quality of life were assessed at the end of treatment and 1 year later (week 92).
  
  
  RESULTS
  At week 40, participants lost an average of 5.7 +/- 5.3% of initial weight, which was associated with significant improvements in body image, self-esteem, and quality of life. Improvements in psychosocial status were maintained at week 92, although mean weight loss at this time had declined to 2.9 +/- 5.6% of initial weight. Increased satisfaction with body weight at week 40 was associated with significantly better maintenance of weight loss at follow-up (r = -0.70; p = 0.02).
  
  
  CONCLUSIONS
  Having participants seek only modest initial weight losses does not appear to facilitate weight maintenance. However, increasing patients' satisfaction with their body weight at the end of treatment may help improve weight maintenance. More research is needed on the relation between satisfaction with initial weight loss and long-term success.
authors.affiliation: University of Pennsylvania School of Medicine, Philadephia, PA 19104, USA. fosterg@mail.med.upenn.edu
authors.forename: Gary D
authors.initials: GD
authors.lastname: Foster
authors.forename: Suzanne
authors.initials: S
authors.lastname: Phelan
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Wadden
authors.forename: Debra
authors.initials: D
authors.lastname: Gill
authors.forename: Jenna
authors.initials: J
authors.lastname: Ermold
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Didie
mesh_terms: D000328:Adult; D001828:Body Image; D015992:Body Mass Index; D015928:Cognitive Behavioral Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000523:psychology* / Q000628:therapy*; D017060:Patient Satisfaction; D010865:Pilot Projects; D011788:Quality of Life; D012649:Self Concept; D015431:Weight Loss