title: Promoting healthy weight with "stability skills first": a randomized trial.
abstract: OBJECTIVE
  Although behavioral weight-loss interventions produce short-term weight loss, long-term maintenance remains elusive. This randomized trial examined whether learning a novel set of "stability skills" before losing weight improved long-term weight management. Stability skills were designed to optimize individuals' current satisfaction with lifestyle and self-regulatory habits while requiring the minimum effort and attention necessary.
  
  
  METHODS
  Overweight/obese women (N = 267) were randomly assigned to one of two 6-month interventions and assessed at baseline and at 6, 12, and 18 months. Maintenance First women participated first in an 8-week stability skills maintenance module and then in a standard 20-week behavioral weight-loss program. Weight Loss First women participated first in a standard 20-week behavioral weight-loss program and then in a standard 8-week problem-solving skills maintenance module. There was no intervention staff contact during the 12-month follow-up period (6-18 months).
  
  
  RESULTS
  As designed, Maintenance First participants lost the same percentage of initial weight during the 6-month intervention period as Weight Loss First participants (M = -8.6%, SD = 5.7, vs. M = -9.1%, SD = 6.9; t = -0.6, p = .52). However, Maintenance First participants regained significantly less weight during the 12-month follow-up period (6-18 months) than Weight Loss First participants (M = 3.2 lb, SD = 10.4, vs. M = 7.3 lb, SD = 9.9 [M = 1.4 kg, SD = 4.7, vs. M = 3.3 kg, SD = 4.5]; t = 3.3, p = .001, d = 0.4).
  
  
  CONCLUSIONS
  Learning stability skills before losing weight was successful in helping women to maintain weight loss without intervention staff contact during follow-up. These results can inform the study design of future innovative interventions.
authors.affiliation: Stanford Prevention Research Center, Stanford University School of Medicine, CA 94305-5411, USA. mkiernan@stanford.edu
authors.forename: Michaela
authors.initials: M
authors.lastname: Kiernan
authors.forename: Susan D
authors.initials: SD
authors.lastname: Brown
authors.forename: Danielle E
authors.initials: DE
authors.lastname: Schoffman
authors.forename: Katherine
authors.initials: K
authors.lastname: Lee
authors.forename: Abby C
authors.initials: AC
authors.lastname: King
authors.forename: C Barr
authors.initials: CB
authors.lastname: Taylor
authors.forename: Nina C
authors.initials: NC
authors.lastname: Schleicher
authors.forename: Michael G
authors.initials: MG
authors.lastname: Perri
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D050177:Overweight / Q000523:psychology* / Q000628:therapy; D011613:Psychotherapy / Q000379:methods*; D016896:Treatment Outcome; D015431:Weight Loss