Problem Area: Psychological Treatments
Treatment: Behavioral Treatment for Obesity
2015 EST Status: Treatment pending re-evaluation Very strong: High-quality evidence that treatment improves symptoms and functional outcomes at post-treatment and follow-up; little risk of harm; requires reasonable amount of resources; effective in non-research settings
Strong: Moderate- to high-quality evidence that treatment improves symptoms OR functional outcomes; not a high risk of harm; reasonable use of resources
Weak: Low or very low-quality evidence that treatment produces clinically meaningful effects on symptoms or functional outcomes; Gains from the treatment may not warrant resources involved
Insufficient Evidence: No meta-analytic study could be identified
Insufficient Evidence: Existing meta-analyses are not of sufficient quality
Treatment pending re-evaluation
1998 EST Status: Strong Research Support Strong: Support from two well-designed studies conducted by independent investigators.
Modest: Support from one well-designed study or several adequately designed studies.
Controversial: Conflicting results, or claims regarding mechanisms are unsupported.
Strength of Research Support
- Basic premise: Eating and activity behaviors are reinforced by cues and consequences that can be internal (e.g., thoughts and feelings) or external (e.g., environment, behaviors). Selectively modifying these internal and external factors can facilitate positive changes in diet and exercise. In addition, providing measurable goals and methods to monitor progress towards such goals can promote behavior change.
- Essence of therapy: Weight loss requires expending more energy than one is taking in. For most, this involves altering both eating and exercise habits. The treatment is designed to help individuals decrease energy intake and increase energy expenditure by providing clear eating and exercise goals, and ways to monitor these behaviors. Self-monitoring enhances awareness of health behaviors, thus making them more susceptible to change. The treatment also includes modifying the cues and consequences that control eating and activity behaviors.
- Length: 25-44 sessions
Editors: Evan Forman, PhD; Stephanie Goldstein, BS
Note: The resources provided below are intended to supplement not replace foundational training in mental health treatment and evidence-based practice
Treatment Manuals / Outlines
- Look AHEAD Counselor Information (Look AHEAD Research Group)
- Look AHEAD Counselor Manual (Look AHEAD Research Group)
- Diabetes Prevention Program Counselor Manual: Core Sessions (Diabetes Prevention Program Research Group)
- Diabetes Prevention Program Counselor Manual: After Core Sessions (Diabetes Prevention Program Research Group)
Books Available for Purchase Through External Sites
- Cognitive-Behavioral Treatment for Obesity: A Clinician’s Guide (Cooper, Fairburn, & Hawker)
- Handbook of Obesity Treatment (Wadden & Stunkard)
- The Learn Program for Weight Management (Brownell)
- Look AHEAD Session Outlines (Look AHEAD Research Group)
Measures, Handouts and Worksheets
- Look AHEAD Patient Materials (Look AHEAD Research Group)
- Look AHEAD: Planning Ahead for Life Events (Look AHEAD Research Group)
- Diabetes Prevention Program Patient Manual: Core Sessions (Diabetes Prevention Program Research Group)
- Diabetes Prevention Program Patient Manual: After Core Sessions (Diabetes Prevention Program Research Group)
- Diabetes Prevention Program Patient Manual: Optional (Diabetes Prevention Program Research Group)
- Lifestyle Manual for Youth & Adolescents (TODAY Lifestyle Program)
- Lifestyle Manual for Family Support (TODAY Lifestyle Program)
- Lifestyle Change Logging Forms for Youth & Adolescents (TODAY Lifestyle Program)
- Lifestyle Posters for Youth & Adolescents (TODAY Lifestyle Program)
- The Cognitive Behavioral Workbook for Weight Management: A Step-by-Step Program (Laliberte, McCabe, & Taylor)
Important Note: The books listed above are based on empirically-supported in-person treatments. They have not necessarily been evaluated empirically either by themselves or in conjunction with in-person treatment. We list them as a resource for clinicians who assign them as an adjunct to conducting in-person treatment.
- Look AHEAD (Action for Health in Diabetes): Design and methods for a clinical trial of weight loss for the prevention of cardiovascular disease in type 2 diabetes (Look AHEAD Research Group, 2003)
- 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study (Diabetes Prevention Program Research Group, 2009)
- Comparison of strategies for sustaining weight loss: The weight loss randomized controlled trial (Svetkey et al., 2008)
- Food provision vs structured meal plans in the behavioral treatment of obesity (Wing et al., 1996)
- Testing a new cognitive behavioural treatment for obesity: A randomized controlled trial with three-year follow-up (Cooper et al., 2010)
Meta-analyses and Systematic Reviews
- Weight-loss outcomes: A systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up (Franz et al., 2007)
- Long-term weight-loss maintenance: A meta-analysis of US studies (Anderson et al., 2001)
Other Treatment Resources
- Action for Health In Diabetes: Look AHEAD Clinical Trial (Look AHEAD Research Group)