Use of personal trainers and financial incentives to increase exercise in a behavioral weight-loss program.

Exercise is the best predictor of long-term weight loss. This study evaluated two strategies for improving exercise adherence and long-term weight loss in obese outpatients. Obese men and women (N?=?193) were randomized to 1 of 5 treatment groups for 18 months: standard behavior therapy (SBT); SBT with supervised walks (SW) 3 times per week; SBT?+?SW with personal trainers (PT), who walked with participants, made phone reminders, and did make-up SW; SBT?+?SW with monetary incentives (I) for completing SW; and SBT?+?SW?+?PT?+?I. Both PT and I enhanced attendance at SWs, the combination producing the best adherence. Increased walk attendance did not result in higher overall energy expenditure, however, and long-term weight loss was also not improved. Post hoc analyses suggest that the level of exercise needed for successful long-term weight loss is much higher than that usually recommended in behavioral treatment programs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)