Effects of exercise-focused versus weight-focused maintenance programs on the management of obesity.

This study examined the effects of two maintenance programs on exercise participation, energy expenditure, energy consumption, and weight change in 67 obese adults undergoing behavioral weight-loss treatment. Following an initial 6-month treatment phase which produced a mean weight loss of 8.8 kg, participants were assigned randomly to an exercise-focused maintenance program or to a weight-focused maintenance program. Both maintenance programs included 6 months of biweekly group sessions. The exercise-focused program included supervised group walking sessions, individual and group contingencies for exercise completion, and relapse prevention training targeted specifically at the maintenance of physical activity. The weight-focused program contained a general focus on the maintenance of weight-loss through therapist-led group problem-solving of weight-related problems presented by individual participants. At the completion of the maintenance program and at long-term follow-up, there were no significant differences between conditions in exercise participation or energy expenditure. However, during the year following initial treatment, participants in the weight-focused program demonstrated significantly greater reductions in fat consumption and significantly better maintenance of weight losses than subjects in the exercise-focused program.

Effects of a personalized system of skill acquisition and an educational program in the treatment of obesity.

This study tested whether the efficacy of behavioral treatment of obesity (BT) might be improved through the use of a personalized system of skill acquisition (PSA) with reinforcement contingent on the mastery of changes in eating and exercise behaviors. A total of 108 obese adults were randomly assigned to one of three conditions: (1) BT + PSA; (2) BT; or (3) a weight-loss educational (WLE) program. At posttreatment, the BT + PSA and BT conditions demonstrated significant beneficial changes in caloric consumption, intake of fats, and level of physical activity. Both conditions also produced equivalent reductions in body weight (Ms = 7.9 kg for BT + PSA and 9.5 kg for BT) that were significantly greater than the reduction accomplished in the WLE condition (M = 1.7 kg). These findings suggest that the addition of a PSA may not produce better outcome than standard behavioral treatment and that education alone is not sufficient to produce weight loss.