Food provision vs structured meal plans in the behavioral treatment of obesity

OBJECTIVE : Providing overweight patients with the food they should eat has been shown to significantly improve weight loss in a behavioral treatment program. The objective of this study was to examine the contribution of three components of food provision to these positive effects : the specific meal plans indicating what foods should be eaten at each meal ; the food itself ; and the fact that the food was provided free. SUBJECTS : 163 overweight women. DESIGN : Randomized, controlled study with subjects assigned to one of four conditions : (1) a standard behavioral treatment program (SBT) with weekly meetings for six months ; (2) SBT plus structured meal plans and grocery lists ; (3) SBT plus meal plans plus food provision, with subjects sharing the cost ; or (4) SBT plus meal plans plus free food provision. RESULTS : Subjects in Group 1 lost significantly less weight than subjects in Groups 2-4 at the end of the six month program (-8.0 kg vs -12.0, -11.7 and -11.4 kg respectively) and at follow-up one year later (-3.3 kg vs -6.9, -7.5 and -6.6 kg respectively). No significant differences were seen in weight loss between Groups 2-4, suggesting that the component of food provision that is responsible for its success is the provision of highly structured meal plans and grocery lists. Subjects receiving meal plans were more likely to exhibit an eating pattern of three meals/day, had more definite plans regarding what to eat and reported more favorable changes in foods stored in their homes and in perceived barriers to weight loss. CONCLUSIONS : Providing structured meal plans and grocery lists improves outcome in a behavioral weight control program ; no further benefit is seen by actually giving food to patients.