The maintenance of treatment effects in the long-term management of obesity

This article reviews the efficacy of strategies designed to improve the maintenance of treatment effects in the long-term management of obesity. Included are the results from controlled trials that evaluated strategies such as extended therapy, relapse prevention training, monetary incentives, food provision, and peer support as well as the use of very-low-calorie diets and pharmacotherapy. Improved maintenance of weight loss was observed in behavior therapy extended beyond 6 months and in long-term pharmacotherapy (dexfenfluramine or the combination of fenfluramine + phentermine) used in conjunction with behavior therapy or dietary counseling. Following the termination of longterm therapy, a regaining of weight was observed across all treatment modalities. These findings are discussed in terms of a "continuous-care" model of obesity management.