Success in behavioral weight management program depends on treatment variables chosen.

Objective: Most articles refer to standard behavioral therapy (SBT) to describe the behavioral component of a weight management program. However, all programs are not the same and the success of patients depends on the specific behaviors included.

Method: Data from 248 maintenance patients from three clinics using the HMR® Program for Weight Management ™ were taken from an on-going database. The purpose of this study was to compare behavioral and weight change data of maintenance patients active in 1995 or 2000. Since the behavioral component of the program was changed (simplified with fewer treatment variables) from 1995 to 2000, the hypothesis was that the maintenance data would be improved. Patients who had started the weight-loss phase (medically supervised VLCD or moderately-restricted diet) either between 1/1/95–6/30/95 (n=99) or 1/1/00–6/30/00 (n=149) and then joined maintenance were included in the sample. Maintenance data were analyzed through the end of 1995 or 2000.

Results: Patients used in this comparison had equal amounts of weight loss (42 lbs.) over similar periods of time (19 vs. 20 wks). Time in maintenance during the study period was approximately equal for both groups (14 vs. 15 wks). As predicted, there was a significant difference (p=.01) in the average weight change between the 1995 and 2000 samples (+3.26 vs. +.49 lbs.). Difference in average weight change were supported by highly significant differences (p<.01) in average compliance with behavioral variables: attendance (71.2% vs. 85.4%), self-monitoring of records (58.9% vs. 79.3%), meal replacement use (6.2 vs. 21.2/wk), physical activity calories (1523 vs. 2113/wk), and vegetable and fruit intake (18 vs. 31 full-cup servings/wk).

Conclusion: In summary, changes in the behavioral program led to greater patient compliance and significantly improved outcome in maintenance. The specific behaviors that are included in a weight management program do make a difference – programs should be research-based and supported by patient data. More detailed descriptions of behavioral programs should be included with research studies.