The development and evaluation of a behavioral weight-reduction program.

The development of a comprehensive weight-reduction program and its implementation in the clinic are described. The program consisted of explicit instructions on food monitoring, stimulus control, chaining, exercise, and self-reinforcement. The results of pilot research indicated that the program produced reliable weight loss and that its implementation in a group format was more positive. A formal experiment evaluated the effectiveness of program components in a 2 x 2 factorial design after ten weeks of treatment and at three-month and one-year follow-ups. There was significant weight loss with no main or interaction effects. At follow-up, those exposed to exercise and/or contingency management better maintained their weight loss or continued to lose. Data on the implementation of the program in a clinical setting are presented and these results compare favorably with reports from other clinics using behavior modification. It is suggested that our more positive results may be related to an emphasis on activity and life-style change in addition to changing eating behavior.