The central role of lifestyle change in long-term weight management.

Lifestyle change--most notably, modification of eating behavior, physical activity, and psychologic factors like attitudes, goals, and emotions--is the central determinant of whether people will lose weight and maintain the loss. Even when medical intervention appears to be the primary treatment, as with pharmacotherapy, behavior plays the determining role in successful weight loss. For example, the likelihood that a patient will take his or her prescribed medication is influenced by thoughts, attitudes, behaviors, and social environment. The patient who is dissatisfied with the moderate weight loss produced by most treatments, and hence is prone to relapse, is affected by the same factors. Methods are available to help people develop the self-management skills necessary to produce long-term lifestyle change (1-3). As individuals internalize a new set of attitudes and behaviors, resisting old habits and acquiring new ones become easier. Only then will there be any reasonable chance of long-term weight-loss success.