Applying a stepped-care approach to the treatment of obesity.
OBJECTIVE
In a stepped-care (SC) approach to treatment, more intensive interventions are implemented when less intensive interventions prove to be insufficient. It was hypothesized that a behavioral weight loss program with SC (BWLP+SC) would evidence superior treatment outcomes when compared with a BWLP without SC (BWLP).


METHODS
Forty-four obese, sedentary adults were randomly assigned to a BWLP+SC [i.e., problem-solving therapy (PST)] or a BWLP.


RESULTS
Participants in the BWLP+SC lost significantly more weight and body fat, reported greater physical activity and greater improvements in diet, and were more likely to achieve their within-treatment weight loss goals than BWLP participants. Participants in the BWLP+SC who received PST (BWLP+SC [PST]) also evidenced superior treatment outcomes including superior weight loss maintenance (through 12 months posttreatment) compared with BWLP participants matched on SC eligibility [BWLP (SC matched)].


CONCLUSIONS
BWLP+SC may improve treatment outcomes and participant motivation to achieve preestablished weight loss goals.
Carels
Robert A
RA
Department of Psychology, Bowling Green State University, OH 43403, USA. rcarels@bgnet.bgsu.edu
Darby
Lynn
L
Cacciapaglia
Holly M
HM
Douglass
Olivia M
OM
Harper
Jessica
J
Kaplar
Mary E
ME
Konrad
Krista
K
Rydin
Sofia
S
Tonkin
Karin
K
D001294:Attitude to Health; D001521:Behavior Therapy / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009043:Motor Activity; D009765:Obesity / Q000175:diagnosis / Q000178:diet therapy*; D011340:Problem Solving; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D015431:Weight Loss