A stepped approach to weight control: A minimal intervention and a bibliotherapy problem-solving program

Subjects' differential response to treatment supported the use of a multi-level approach as a possible low-cost public health intervention for the treatment of obesity.

Abstract

Twenty-six moderately obese subjects participated in a stepped approach to weight control. A minimal intervention program was presented in Step 1 and a bibliotherapy problem-solving program in Step 2. At the end of the year of treatment and the 3-month follow-up, 4 subjects needed only Step 1 and lost an average of 30.0 pounds (SD=12.5). Twenty-two subjects needed to use both Steps 1 and 2; 11 of them complied well with the bibliotherapy program and lost 24.8 pounds (SD=11.2) whereas 11 complied poorly and lost 15.7 pounds (SD=11.5). High compliers lost significantly more weight than low compliers and, at the end of treatment and follow-up, were significantly lower in percentage overweight. All subjects lost an average of 22.1 pounds (SD=12.4) and were modestly overweight by the end of follow-up (M=20.7, SD=14.3); six of these subjects reached their calculated ideal weight. Individual data were examined for subjects who were on the minimal intervention program only, for successful subjects who completed the bibliotherapy program, and for subjects who reached ideal weight or relapsed. It was concluded that subjects' differential response to treatment supported the use of a multi-level approach as a possible low-cost public health intervention for the treatment of obesity.