title: Step-down approach to behavioural weight loss treatment: a pilot of a randomised clinical trial.
abstract: BACKGROUND
  In a stepped-down approach, patients begin with a more intensive treatment and are stepped down to a less intensive treatment based on achieving treatment goals. This study compared a standard behavioural weight loss programme (BWLP) to a stepped-down approach to treatment.
  
  
  METHODS
  Fifty-two overweight/obese adults (Age: M = 47 years, SD = 13.5; female = 67%) participated in an 18-week BWLP. Half of them were randomly assigned to be stepped down from weekly group meetings based on completion of weight loss goals (3%) every 6 weeks, while the other half remained in their groups regardless of weight loss.
  
  
  RESULTS
  There was a significant difference favouring the BWLP in the proportion of participants who met or exceeded their 3% weight loss goal during the first six weeks. While not statistically significant by the end of treatment, the BWLP participants lost nearly 3% more body weight than stepped-down participants (SC = 4.9% vs. BWLP = 7.8%; p = .10). Greater self-monitoring was associated with increased likelihood of stepped-care eligibility and higher percent weight loss at the end of treatment (p < .01).
  
  
  CONCLUSIONS
  There was little evidence to support the efficacy of the stepped-down approach for behavioural weight loss treatment employed in this investigation.
authors.affiliation: a Department of Psychology , Bowling Green State University , Bowling Green , OH , USA .
authors.forename: Robert A
authors.initials: RA
authors.lastname: Carels
authors.forename: Debra A
authors.initials: DA
authors.lastname: Hoffmann
authors.forename: Nova
authors.initials: N
authors.lastname: Hinman
authors.forename: Jacob M
authors.initials: JM
authors.lastname: Burmeister
authors.forename: Afton
authors.initials: A
authors.lastname: Koball
authors.forename: Lisham
authors.initials: L
authors.lastname: Ashrafioun
authors.forename: Marissa W
authors.initials: MW
authors.lastname: Oehlhof
authors.forename: Erin
authors.initials: E
authors.lastname: Bannon
authors.forename: Michelle
authors.initials: M
authors.lastname: Leroy
authors.forename: Lynn
authors.initials: L
authors.lastname: Darby
mesh_terms: D000328:Adult; D001521:Behavior Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000628:therapy; D050177:Overweight / Q000628:therapy*; D010865:Pilot Projects; D016896:Treatment Outcome; D015431:Weight Loss; D061217:Weight Reduction Programs / Q000379:methods*