Comparison of established and innovative weight-reduction treatment procedures.

A central component of a commonly used weight-loss procedure developed by Stuart (1967), which emphasizes situational engineering (SE), was compared to eating behavior control (EBC), a treatment employing reinforcement of changes in eating habits. A third treatment encouraged development of individuals' own applications of a model of self-control and attempted to provide effective feedback regarding progress toward weight-loss goals. This self-initiated treatment (SI) was designed to be less directive than many behavioral treatment packages and to be more realistic about the expectations of subjects and the actual eating habits of overweight and normalweight people. Following baseline, treatment lasted six weeks and followup lasted 16 weeks. While all treatments produced weight losses, EBC surpassed SE during treatment. SI losses during treatment did not differ from SE or EBC, but SI was the only group that lost weight throughout followup, indicating the possible utility of more subtle, less directive interventions than those that have often been associated with behavioral approaches. The results of SE question the applicability to clinical procedures of the external cue hypersensitivity theory of obesity (Schachter and Rodin, 1974), to which SE is closely related.