title: Applying a stepped-care approach to the treatment of obesity.
abstract: 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.
authors.affiliation: Department of Psychology, Bowling Green State University, OH 43403, USA. rcarels@bgnet.bgsu.edu
authors.forename: Robert A
authors.initials: RA
authors.lastname: Carels
authors.forename: Lynn
authors.initials: L
authors.lastname: Darby
authors.forename: Holly M
authors.initials: HM
authors.lastname: Cacciapaglia
authors.forename: Olivia M
authors.initials: OM
authors.lastname: Douglass
authors.forename: Jessica
authors.initials: J
authors.lastname: Harper
authors.forename: Mary E
authors.initials: ME
authors.lastname: Kaplar
authors.forename: Krista
authors.initials: K
authors.lastname: Konrad
authors.forename: Sofia
authors.initials: S
authors.lastname: Rydin
authors.forename: Karin
authors.initials: K
authors.lastname: Tonkin
mesh_terms: 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