4
Weighing the Options
Criteria for evaluating weight-management programs should relate to what the programs are attempting to achieve (i.e., their stated aims), what they might be expected to achieve (i.e., the standards to which they should be held), what impact they have on an individual's health and behavior in the short run (i.e., the process and short-term outcomes), and their ultimate long-term outcomes (i.e., their impact on the individual over time). We developed criteria by first studying a simple conceptual overview of decisionmaking and its consequences. In this overview, an individual decides to go with one of a number of options and, as a result, experiences a specific outcome (see Figure 4-1).
This conceptual overview is so basic that it can be applied widely to
FIGURE 4-1
TABLE 4-1 Criteria for Evaluating Weight-Management Programs
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Criterion 1: The Match Between Program and Consumer |
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Program |
Person |
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Who is appropriate for this program? |
Should I be in this program, given my goals and characteristics? |
|
Criterion 2: The Soundness and Safety of the Program |
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Program |
Person |
|
Is my program based on sound biological and behavioral principles, and is it safe for its intended participants? |
Is the program safe and sound for me? |
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Criterion 3: Outcomes of the Program |
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|
Program |
Person |
|
What is the evidence for success of my program? |
Are the benefits I am likely to achieve from the program worth the effort and cost? |
almost any situation requiring a decision, such as selecting a book at the library or choosing from among the many weight-loss options. Nevertheless, each of the three components of the overview suggests a criterion specific to evaluating obesity-treatment programs. Our three criteria for evaluating such programs are listed in Table 4-1, and their link with the conceptual overview is presented in Figure 4-2. We have presented each criterion from the point of view of the person (since it is the individual who is at the center of decisionmaking) and of the program (which can use the criteria, for example, to ensure quality control and conduct research on program effectiveness).
The following three chapters detail our three criteria. Chapter 5 focuses on Criterion 1, the match between the program and consumer. We present a number of published methods for matching in the obesity field and identify several factors that influence the decisions made by individuals. In Chapter 6, we focus on Criterion 2, the soundness and safety of the program, describing critical areas that need to be addressed by all obesity-treatment programs. Chapter 7, which addresses Criterion 3, outcomes of the program, provides a literature review on predictors of weight loss and maintenance. It also presents a new concept of weight that refocuses the goal of losing weight from weight loss alone to achieving and maintaining good health through weight management. In Chapter 8, we synthesize the information in this and the next three chapters to provide practical advice for programs and consumers to increase the probability of successful weight-management outcomes.
