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behavior_based_weightloss
Written by October 7, 2011

Gina Cortese-Shipley, MS

Associate Director of Education
The Cooper Institute

Once again, behaviorally based treatments found effective for weight loss

Millions of Americans are looking for "what works" in weight loss. And millions (that may be a slight exaggeration) of researchers and practitioners are saying, "why aren't you listening?"! Maybe American's haven't gotten the memo or are looking for more of a quick and easy fix, but yet another recent publication concludes, "Behaviorally based treatments are safe and effective for weight loss and maintenance."1

In an effort to help update the 2003 U.S. Preventive Services Task Force recommendations regarding clinician screening and intervention for obesity, researchers analyzed 38 behavior-based studies, 18 studies that included a behavioral component plus orlistat (a weight-loss drug), and three studies that combined a behavioral program with metformin (typically prescribed to treat type 2 diabetes). In particular, researchers wanted to determine 1)whether primary care screening programs to identify obesity or overweight in adults improved health or physiologic outcomes or resulted in weight loss, 2)whether primary care feasible or referable weight-loss interventions (behaviorally based with or without medications) improved health outcomes, physiological outcomes, resulted in short-term or long-term weight loss, or caused harm. Results from the studies showed:

  • Behaviorally based programs resulted in 6.6-pound greater weight loss in intervention than control participants after 12 and 18 months, with more treatment sessions associated with greater loss
  • Limited data suggest weight-loss maintenance for 1 year or more
  • Orlistat plus behavioral intervention resulted in 6.6-pound more weight loss than did placebo after 12 months
  • Metformin resulted in less weight loss
  • Data on effects of weight-loss treatment on long-term health outcomes (e.g., death, cardiovascular disease) were insufficient
  • Weight-loss treatment reduced diabetes incidence in participants with prediabetes
  • Effects on intermediate outcomes (e.g., blood cholesterol and pressure) were mixed and small
  • Data on serious harms were insufficient
  • Medications commonly caused withdrawals due to gastrointestinal symptoms

Over the years we've published a number of blogs related to the effectiveness of behavioral interventions:

Weight Loss Programs Should Not be Written Off

Which Weight Loss Programs Work?

Dieters Lose Weight when their Doctors Send them to Weight Watchers

What Works for Weight Loss May Not Work for Maintenance of Weight Lost

Still need more to be convinced? Maybe testimonials will help. The National Weight Control Registry is tracking over 10,000 individuals who have lost significant amounts of weight and kept it off for long periods of time. Many of these people have used behavioral programs and strategies like keeping track of their weight, food, and physical activity, setting goals, and addressing barriers to change.

Share your thoughts on how practitioners can do more to promote behaviorally based treatments for weight loss. We need to do more to spread the message!

1LeBlanc, E. S., O'Connor, E., & Whitlock, E. P. (2011). Effectiveness of primary care-relevant treatment for obesity in adults: a systematic evidence review for the U.S. Preventive Services Task Force. Ann Intern Med, 155(7), 434-447.

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