Weight Loss Interventions: Behavioral Versus Stepped Care

A recent study evaluated the effect of a stepped-care weight loss intervention (STEP) compared with a standard behavioral weight loss intervention (SBWI).¹ This clinical trial randomized overweight and obese adults (n = 363) with a body mass index of 25 to 40 to either SBWI (n = 165) or STEP (n = 198). The SBWI group was assigned to a fixed program, whereas the STEP program could be modified every 3 months in response to observed weight loss. The primary end point of the study was mean change in weight over 18 months.

Results showed that, overall, 71.6% of subjects experienced a decrease in weight loss over the 18-month period. In the SBWI group, weight decreased from 93.1 kg (95% confidence interval, 91.0-95.2 kg) to 85.6 kg (95% CI, 83.4-87.7 kg) (P <.001). Subjects in the STEP group experi- enced a weight decrease from 92.7 kg (95% CI, 90.8-94.6 kg) to 86.4 kg (95% CI, 84.5-88.4 kg) (P <.001). The percentage change in weight from baseline to 18 months was -8.1% (95% CI, -9.4% to -6.9%) in the SBWI group (P <.001) com- pared with -6.9% (95% CI, -8.0% to -5.8%) in the STEP group (P <.001). The study’s authors concluded that the use of SBWI resulted in a grea- ter mean weight loss than STEP over 18 months.

Dr. Reed received her doctor of pharmacy degree from the University of the Sciences in Philadelphia, Pennsylvania, and currently works as a medical editor in the greater Philadelphia area.

References

1. Jakicic JM, Tate DF, Lang W, et al. Effect of a stepped-care intervention approach on weight loss in adults: a randomized clinical trial. JAMA. 2012;307(24):2617-2626.