Does behaviour therapy work for dietitians? An experimental evaluation of the effects of three procedures in a weight reduction clinic.

An experiment was carried out to evaluate the effect of introducing three procedures, associated with behaviour therapy, into a conventional National Health Service dietetic weight reduction clinic, without any extra resources or staff training. One hundred and sixty obese women entered the study and were randomly allocated to one of the eight combinations of three treatments in a 2 X 2 X 2 factorial design. The three procedures were (a) keeping a diet diary (self-monitoring), (b) receiving leaflets describing and recommending cue avoidance and (c) being seen in a group. Sixty-nine women completed 16 weeks of treatment, and of these 58 were followed up 1 year later. The mean overall weight loss was 5.25 kg at the end of treatment and 3.98 kg at follow-up. Weight loss was found to be greater for those women treated in groups and the greatest losses were found in those who were seen in groups and also provided with leaflets. There was no significant effects of the experiment on either weight loss at follow-up or reported compliance with the dietary regime of the 26 subjects who returned completed diaries to the dietitian. Possible explanations of these results are discussed, together with their implications for service provision.