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Step-down approach to behavioural weight loss treatment: a pilot of a randomised clinical trial

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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).

Conclusion : There was little evidence to support the efficacy of the stepped-down approach for behavioural weight loss treatment employed in this investigation.
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Keywords: obesity; stepped-care; weight loss

Document Type: Research Article

Affiliations: 1: Department of Psychology, Bowling Green State University, Bowling Green, OH, USA. 2: Department of Kinesiology, Bowling Green State University, Bowling Green, OH, USA.

Publication date: October 1, 2013

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