title: The failure of therapist assistance and stepped-care to improve weight loss outcomes.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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).
authors: Department of Psychology, Bowling Green State University, Bowling Green, Ohio, USA. rcarels@bgsu.edu
authors: Robert A
authors: RA
authors: Carels
authors: Kathleen M
authors: KM
authors: Young
authors: Carissa B
authors: CB
authors: Coit
authors: Lynn A
authors: LA
authors: Darby
authors: Anna M
authors: AM
authors: Clayton
authors: Alexis C
authors: AC
authors: Spencer
authors: Marissa W
authors: MW
authors: Hobbs
authors: Carmen K
authors: CK
authors: Oemig
mesh_terms: D000328:Adult; D001835:Body Weight; D005260:Female; D006379:Helping Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000523:psychology / Q000628:therapy*; D050177:Overweight / Q000523:psychology / Q000628:therapy*; D017211:Treatment Failure; D016896:Treatment Outcome; D015431:Weight Loss