Journal of Psychosomatic Research
Volume 59, Issue 6 , Pages 375-383 , December 2005

Applying a stepped-care approach to the treatment of obesity

  • Robert A. Carels

      Affiliations

    • Corresponding Author InformationCorresponding author. Department of Psychology, Bowling Green State University, Bowling Green, OH 43403, USA. Tel.: +1 419 372 9405; fax: +1 419 372 6013
  • ,
  • Lynn Darby
  • ,
  • Holly M. Cacciapaglia

      Affiliations

    • Authors contributed equal effort to this manuscript.
  • ,
  • Olivia M. Douglass

      Affiliations

    • Authors contributed equal effort to this manuscript.
  • ,
  • Jessica Harper

      Affiliations

    • Authors contributed equal effort to this manuscript.
  • ,
  • Mary E. Kaplar

      Affiliations

    • Authors contributed equal effort to this manuscript.
  • ,
  • Krista Konrad

      Affiliations

    • Authors contributed equal effort to this manuscript.
  • ,
  • Sofia Rydin

      Affiliations

    • Authors contributed equal effort to this manuscript.
  • ,
  • Karin Tonkin

      Affiliations

    • Authors contributed equal effort to this manuscript.

Received 24 January 2005

References 

  1. Peeters A, Barendregt JJ, Mackenbach JP, Al Mamun A, Bonneux L. Obesity in adulthood and its consequences for life expectancy: a life-table analysis. Ann Intern Med. 2003;138:24–32
  2. Haaga DA. Introduction to the special section on stepped care models in psychotherapy. J Consult Clin Psychol. 2000;68(4):547–548
  3. NHLBI Obesity Education Initiative Task Force Members . Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: the evidence report. 1998;NIH publication No. 98-4083
  4. Sobell MB, Sobell LC. Stepped care as a heuristic approach to the treatment of alcohol problems. J Consult Clin Psychol. 2000;68(4):573–579
  5. Abrams DB. Treatment issues in tobacco dependence: towards a stepped-care model. Tob Control. 1993;2:s17–s37
  6. NHLBI . The sixth report of the joint national committee on prevention, detection, and evaluation, and treatment of high blood pressure. In: Washington (DC): NIH; 1997;p. 1–70[no. 98-4080]
  7. Expert Panel on Detection . Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Pressure in Adults. JAMA. 2001;285(19):2486–2497
  8. Orleans CT. Treating nicotine dependence in medical settings: a stepped-care model. In:  Orleans CT,  Slade J editor. Nicotine addiction: principles and management. New York: Oxford; 1993;p. 145–161
  9. Wadden TA, Brownell KD, Foster G. Obesity: managing the global epidemic. J Consult Clin Psychol. 2002;70(3):510–525
  10. Perri MG, Fuller PR. Success and failure in the treatment of obesity: where do we go from here?. Med Exerc Nutr Health. 1995;4:255–272
  11. Perri MG, Corsica JA. Improving the maintenance of weight lost in behavioral treatment of obesity editors. In:  Wadden TA,  Stunkard AJ editor. Handbook of obesity treatment. New York: Guilford Press; 2002;p. 357–379
  12. Wadden T, Letizia K. Predictors of attrition and weight loss in patients treated by moderate and severe caloric restriction. In:  Wadden T,  Vanitallie T editor. Treatment of the seriously obese patient. New York: Guilford; 1992;p. 383–410
  13. Wing RR. Behavioral weight control. In:  Wadden T,  Stunkard A editor. Handbook of obesity treatment. New York: Guilford; 2002;p. 301–317
  14. Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393–403
  15. Birchwood MT, Pauline Jackson C. Early intervention in psychosis: the critical period hypothesis. Br J Psychiatry. 1998;172:53–59
  16. Smith SS, Jorenby DE, Fiore MC, Anderson FE, Mielke MM, Beach KE, et al. Strike while the iron is hot: can stepped care treatments resurrect relapsing smokers?. J Consult Clin Psychol. 2001;69(3):429–439
  17. Zhu SH, Stretch V, Balabanis M, Rosbrook B, Sadler G, Pierce JP. Telephone counseling for smoking cessation: effects of single-session and multiple session interventions. J Consult Clin Psychol. 1996;64:202–211
  18. Black DR, Threfall WE. A stepped approach to weight control: a minimal intervention and a bibliotherapy problem-solving paradigm. Behav Ther. 1986;17:144–157
  19. D'Zurilla TJ. Problem-solving therapy: a social competence approach to clinical intervention. New York: Springer; 1999;
  20. Perri MG, Nezu AM, Viegener BJ. Improving the long-term management of obesity: theory, research, and clinical guidelines. New York: Wiley; 1992;
  21. Black DR, Sherba DS. Contracting to problem solve vs. contracting to practice behavioral weight loss skills. Behav Ther. 1983;14:100–109
  22. Black DR. A minimal intervention program and a problem-solving program for weight control. Cogn Ther Res. 1987;11:107–120
  23. D'Zurilla TJ, Goldfried MR. Problem solving and behavior modification. J Abnorm Psychol. 1971;78:107–126
  24. D'Zurilla TJ, Nezu AM. Social problem-solving in adults. In:  Kendall PC editors. Advances in cognitive–behavioral research and therapy. New York: Academic Press; 1982;p. 201–274
  25. Nezu AM. Social problem solving and depression: a literature review and a proposal of a pluralistic model. Clin Psychol Rev. 1987;7:121–144
  26. Perri MG, Richards CS, Schultheis K. Behavioral self-control and smoking reduction: a study of self-initiated attempts to reduce smoking. Behav Ther. 1977;8:360–365
  27. Perri MG, Nezu AM, McKelvey WF, Shermer RL, Renjilian DA, Viegener BJ. Relapse prevention training and problem solving therapy in the long-term management of obesity. J Consult Clin Psychol. 2001;69(4):722–726
  28. Locke EA, Latham GP. Building a practically useful theory of goal setting and task motivation. Am Psychol. 2002;57(9):705–717
  29. Brownell KD. The LEARN Program for weight management. Dallas (Tex): American Health Publishing Company; 2000;
  30. Andersen R, Wadden T, Bartlett S, Zemel B, Verde T, Franckowiak S. Effects of lifestyle activity vs. structured aerobic exercise in obese women. JAMA. 1999;281(4):335–340
  31. Wadden T, Foster G, Letizia K. One-year behavioral treatment of obesity: comparison of moderate and sever caloric restriction and the effects of weight maintenance therapy. J Consult Clin Psychol. 1994;62:165–171
  32. Carels RA, Darby LA, Douglass OM, Cacciapaglia HM, Rydin S. Education on the glycemic index of foods fails to improve treatment outcomes in a behavioral weight loss program. Eat Behav. 2005;6:145–150
  33. Carels RA, Darby LA, Cacciapaglia HM, Douglass OM. Reducing cardiovascular risk factors in postmenopausal women through a lifestyle change intervention. J Womens Health. 2004;13(4):412–426
  34. D'Zurilla TJ, Nezu AM, Maydeu-Olivares A. Social problem-solving inventory—revised (SPSI-R) manual. North Tonawand (NY): Multi-Health Systems; 2002;
  35. American College of Sports Medicine . ACSM's guidelines for exercise testing and prescription. Baltimore: Williams & Wilkins; 2000;
  36. Balke B. Biodynamics: humans. In:  Glasser O editors. Medical physics. Chicago: Year Book; 1960;p. 50–51
  37. Paffenbarger R, Wing RR, Hyde R. Physical activity as an index of heart attack risk in college alumni. Am J Epidemiol. 1978;108:161–175
  38. Pereira MA, FitzGerald SJ, Gregg EW, Joswiak ML, Ryan WJ, Suminski RR, et al. A collection of physical activity questionnaires for health-related research. Med Sci Sports Exerc. 1997;29(6):S1–S205
  39. Fehling P, Smith D, Warner S, Dalsky G. Comparison of accelerometers with oxygen consumption in older adults during exercise. Med Sci Sports Exerc. 1999;31:171–175
  40. Utter A, Nieman D, Ward A, Butterworth D. Use of the leg-to-leg bioelectrical impedance method in assessing body composition change in obese women. Am J Clin Nutr. 1999;69:603–607
  41. Dubbert P, Wilson G. Goal-setting and spouse involvement in the treatment of obesity. Behav Res Ther. 1984;22(3):227–242
  42. Wing R, Polley B. Obesity. In:  Baum A,  Revenson T,  Singer J editor. Handbook of health psychology. Mahwah (NJ): Lawrence Erlbaum; 2001;p. 263–279
  43. Trabulsi J, Schoeller DA. Evaluation of dietary assessment instruments against doubly labeled water, a biomarker of habitual energy intake. Am J Endocrinol Metab. 2001;281:E891–E899

PII: S0022-3999(05)00179-0

doi: 10.1016/j.jpsychores.2005.06.060

Journal of Psychosomatic Research
Volume 59, Issue 6 , Pages 375-383 , December 2005