Successful weight loss with self-help: a stepped-care approach.

In a stepped-care approach to treatment, patients are transitioned to more intensive treatments when less intensive treatments fail to meet treatment goals. Self-help programs are recommended as an initial, low intensity treatment phase in stepped-care models. This investigation examined the effectiveness of a self-help, stepped-care weight loss program. Fifty-eight overweight/obese adults (BMI ≥27 kg/m(2)) participated in a weight loss program. Participants were predominately Caucasian (93.1%) and female (89.7%) with a mean BMI of 36.6 (SD=7.1). Of those completing the program, 57% of participants (N=21) who remained in self-help maintained an 8% weight loss at follow-up. Participants who were stepped-up self-monitored fewer days and reported higher daily caloric intake than self-help participants. Once stepped-up, weight loss outcomes were equivalent between individuals who remained in self-help compared to those who were stepped-up. Individuals who were stepped-up benefited from early intensive intervention when unsuccessful at losing weight with self-help. © Springer Science+Business Media, LLC 2009