It may sound like a new concept, but "stepped care" is used all the time in medicine. If your blood pressure is high, doctors will ask you to make some lifestyle changes and come back. If it's still up, then they step up their intervention. Researchers wondered if the same concept could work when it comes to weight loss.
"We know we can achieve weight loss short-term almost with any type of program. The real challenge is, How do you push that envelope out further and further to help people keep the weight off once they lost it?" said Dr. John Jakicic, University of Pittsburgh.
Study author Dr. John Jakicic conducted a randomized clinical trial with 363 overweight adults. Participants received similar eating and physical activity plans for 18 months. But standard intervention participants had group counseling sessions weekly.
For the "stepped-care" group, counseling frequency and other weight-loss strategies could be modified depending on weight-loss goals.
"We got about the same magnitude of weight loss in our step group at six months, but weight loss at 18 months was 7 percent versus the 8 percent in our standard group," said Jakicic.
In the study provided by the Journal of the American Medical Association, researchers say this could be helpful to insurance providers who may be more inclined to pay for these less-expensive interventions.
"If we could divert our resources to those who need more help and divert it away from people who are doing OK without all of that help, it probably makes it more manageable, more affordable and more accessible to people who are interested in participating," said Jakicic.
Researchers developed this "stepped-care" approach just for this study. They also found it was less time-consuming and less costly to those who participated.