Adult Weight Management (AWM) Multiple Behavior Therapy Strategies
Click here to see the explanation of recommendation ratings (Strong, Fair, Weak, Consensus, Insufficient Evidence) and labels (Imperative or Conditional). To see more detail on the evidence from which the following recommendations were drawn, use the hyperlinks in the Supporting Evidence Section below.
AWM: Multiple Behavior Therapy Strategies
A comprehensive weight management program should make maximum use of multiple strategies for behavior therapy (e.g. self monitoring, stress management, stimulus control, problem solving, contingency management, cognitive restructuring, and social support). Behavior therapy in addition to diet and physical activity leads to additional weight loss. Continued behavioral interventions may be necessary to prevent a return to baseline weight.
Risks/Harms of Implementing This Recommendation
Conditions of Application
No conditions specified.
Potential Costs Associated with Application
- Behavior therapy, in combination with an energy deficit, provides additional benefits in assisting patients to lose weight short term (1 year). NHLBI Evidence Category B.
- Behavior therapy's effectiveness for long term weight maintenance has not been shown in the absense of continued behavioral intervention. NHLBI Evidence Category B.
- No one behavior therapy appeared superior to any other in its effect on weight loss, rather multimodal strategies appeared to work best and those interventions with the greatest intensity appeared to be associated with the greatest weight loss. NHLBI Evidence Category A.
- Long term follow up of patients undergoing behavior therapy shows a return to baseline weight in the great majority of subjects in the absence of continued behavioral intervention. NHLBI Evidence Category B.
Recommendation Strength Rationale
- NHLBI Evidence Categories of A and B
- Risks/Harms of Implementing This Recommendation
The recommendations were created from the evidence analysis on the following questions. To see detail of the evidence analysis, click the blue hyperlinks below (recommendations rated consensus will not have supporting evidence linked).
References not graded in Academy of Nutrition and Dietetics Evidence Analysis Process
The Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report, NIH Publication No. 98-4083, September 1998, produced by the National Heart, Lung, and Blood Institute in cooperation with the National Institute of Diabetes and Digestive and Kidney Diseases.
To access the pdf of the NHLBI Clinical Guidelines click here: http://www.nhlbi.nih.gov/guidelines/obesity/e_txtbk/index.htm