Standard Behavior Therapy (SBT) is a therapy where overwight patients learn to conceptualize the problem, the barriers to losing weight, and the consequences of making poor diet and exercise choices. Patients are taught to monitor their food intake and physical activity. Even as knowledge continues to increase through the media, our doctors, and SBT- obesity rates are still increasing. These strategies rely on participants to make behavioral changes on their own.
Dr. Rena Wing and Robert Jeffrey tested to see if a more direct approach in helping patients make changes by provisioning meals in appropriate portion sizes. In their study, patients had an average BMI of 31, were not already on a special diet and were free of serious disease. Participants were broken into five groups. The first group was a control group who received no intervention but attended 6, 12 and 18 month assessments. The second group received Standard Behavioral Therapy (SBT) group which involved attending weekly group sessions for twenty weeks followed by monthly group sessions and weekly weigh ins. They were assigned 1000 or 1500 daily calories goals and were instructed record their daily food intake, limit fat intake as well as to increase exercise. The third group received the intense SBT of above plus food provision. They received five prepackaged breakfasts and dinners each week. Menus of what they should eat for lunch were provided. A typical prepackaged breakfast included cereal, milk and juice. Typical dinners included lean meat, a starch and vegetables. The fourth group received the intense SBT plus a financial incentive. The incentives included receiving $25 per week for reaching weight loss goals and maintaining their weight. The fifth group received SBT as well as the meal replacements and the financial incentives. The study found that those that received the food provisions (meal replacements) lost 31% more weight than those that received the SBT alone. This study also found no effect of financial incentives.
Not only did those that receive meal replacements lose more weight they were significantly more likely to continue attending weight loss meetings. They also were more likely to have regular eating patterns and had lowered their cardiovascular risk factors. This may indicate that the simplicity of having meals provided leads to better adherence. Maybe it is easier to comply than to not comply which may factor in the significant increase in weight loss and success of meal replacements.
Before beginning any weight loss program, please consult your physician.