Accountability (attendance and phone calls) is critical for patient success in a weight management program.

Objective: Regular attendance has become an accepted component in most weight management programs. In addition, structured phone calls (from patients to program staff) can be used for extra accountability mid week for maintenance patients learning to change difficult lifestyle health behaviors.

Method: Data from 666 maintenance patients enrolled during 1999 in three clinics using the HMR^® Program for Weight Management™ was analyzed retrospectively for the impact of attendance and phone calls on patient success. Patients were grouped by high, medium, or low compliance for attendance and phone calls individually. These scores were then combined into a single “accountability” score and again grouped by high, medium, or low compliance.

Results: In comparing the highest (n=216) vs. the lowest (n=207) compliers, significant differences were noted between weight change (p<.05) and all behavioral variables (p<.01). High compliers gained less weight during the study period (+.4 vs. +3.9 lbs), did more physical activity (2091 vs. 1137 calories per week), kept more food records (79.8% vs. 41.7% of time enrolled) and more summary records (85.9% vs. 50.5% of time enrolled), ate more vegetables and fruits (34.7 vs. 18.5 servings per week), and used a greater number of meal replacements (20.9 vs. 9.2 per week) than low compliers. There was no significant difference between high vs. low compliant patients in the average weeks enrolled in maintenance during the study period (22 vs. 20 weeks).

Conclusion: In summary, maintaining a high level of patient accountability for behavior change is a significant factor in patient success. Using structured phone calls (calls in which patients provide specific data about behavioral variables being recorded) along with regular attendance may provide an additional way to maintain increased patient accountability in a weight management program. Furthermore, there is evidence of a “compliance” factor. Clinicians should be aware that patients who comply with basic program commitments (e.g., attendance/phone calls), tend to also comply with other behavioral variables, leading to increased success in maintenance.