title: Impact of addressing reasons for weight loss on behavioral weight-control outcome.
abstract: BACKGROUND
  One way to improve weight control may be to place greater emphasis on the main reasons why individuals want to lose weight.
  
  
  OBJECTIVE
  To evaluate the effects of emphasizing physical appearance, health, or both on behavioral weight-control outcome.
  
  
  METHODS
  RCT. Data were collected from 2003 to 2005 and analyzed in 2009.
  
  
  METHODS
  203 women aged 18-55 years (M=41.8, SD=9.2) and BMI>27 and <40 (M=34.2, SD=3.7) who rated both appearance and health as important reasons for weight loss, enrolled at a university medical center.
  
  
  METHODS
  A 6-month weekly behavioral intervention alone (Standard) was compared to an enhanced focus on physical appearance (Appearance), health benefits of weight loss (Health), or both appearance and health (Combined). The 6-month period of acute intervention was followed by six monthly booster sessions.
  
  
  METHODS
  The primary outcome was change in body weight (kg). Additional outcomes included the Multidimensional Body-Self Relations Questionnaire, Medical Outcomes Study Short Form-36, and questions about satisfaction with weight, appearance, and health. Assessments were conducted at 0, 6, 12, and 18 months.
  
  
  RESULTS
  Appearance demonstrated significantly greater weight loss compared to Standard at 6 months (p=0.0107). Combined demonstrated greater weight loss compared to Standard at 6 and 12 months (p's=0.0034 and 0.0270, respectively). Although addressing motivators differentially affected satisfaction at 6 months, satisfaction was unrelated to weight outcome over the following year.
  
  
  CONCLUSIONS
  Behavioral interventions incorporating components with a focus on physical appearance were associated with improved short-term weight loss. The mechanism for this effect is unclear and warrants further study.
authors.affiliation: Western Psychiatric Institute and Clinic, Medical Center, University of Pittsburgh, Pennsylvania 15213, USA. kalarchianma@upmc.edu
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Kalarchian
authors.forename: Michele D
authors.initials: MD
authors.lastname: Levine
authors.forename: Mary L
authors.initials: ML
authors.lastname: Klem
authors.forename: Lora E
authors.initials: LE
authors.lastname: Burke
authors.forename: Julia N
authors.initials: JN
authors.lastname: Soulakova
authors.forename: Marsha D
authors.initials: MD
authors.lastname: Marcus
mesh_terms: D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D001521:Behavior Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009042:Motivation; D009765:Obesity / Q000523:psychology / Q000628:therapy*; D011795:Surveys and Questionnaires; D013997:Time Factors; D015431:Weight Loss; D055815:Young Adult