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Weighing the Options: Criteria for Evaluating Weight-Management Programs
with success at weight loss and maintenance of that loss. These include a habit of regular exercise, continued contact with the treatment program, reasonable and nutritious eating patterns, continued self-monitoring of diet and exercise, a positive problem-solving attitude toward life's stressors, and positive changes in physiological factors that are often adversely affected by obesity.
Given that the goal in matching consumers with programs is to maximize the chances of achieving long-term weight loss, it is unfortunate that the ability of consumers and health-care providers to make successful matches is limited at present. The complex interactions that occur between an individual and the many factors that influence program choice are beyond the current ability of biomedical science to explain, much less predict. Clearly, there is a need for future research to reduce the chances of mismatches. Nevertheless, it is possible to make some prudent qualitative recommendations to increase the likelihood of a successful match.
Program's Perspective: Who Is Appropriate for This Program?
Each program decides what types of clients are appropriate and inappropriate given its specific philosophies, protocols, and treatment approaches. Pregnant women and individuals who are underweight or anorectic are inappropriate candidates for any weight-loss program. Nonclinical programs should require (and do-it-yourself programs should advise) that lactating women, children, and adolescents, as well as those with bulimia; significant cardiovascular, renal, or psychiatric disease; diabetes; or other significant medical problems undertake weight loss only under medical supervision. Nonclinical programs should encourage clients with obesity-related comorbidities or other health problems to maintain contact with their health-care provider for the duration of the program. Both nonclinical and clinical programs should obtain some information on the state of health and weight-loss goals of potential clients to determine if they are appropriate for a specific program and what types of individualized attention they may require.
Do-it-yourself programs such as those provided in diet books, diet plans in magazines, or over-the-counter weight-loss devices or products should provide information in the text or other instructional materials on who might and who should not use the program. Since there is usually no legal obligation that this information be provided or that it be true and complete, it is the responsibility of the publisher or manufacturer of the program to provide it voluntarily. In general, the lack of such information or the suggestion that the program is for anyone who wishes to