The Skinny Book: The 6-Step Methodology for Weight Management
by Ayaz Virji
Category: Health & Fitness

Obesity is a multi-factorial disease and its treatment requires more than just advice to diet and exercise. The purpose of this study was to determine the success rate of a comprehensive, evidence-based 6-step program for weight management when applied to an obese sample population. This retrospective, observational study takes place in an outpatient private clinic. The participants include 16 obese patients chosen based on prior enrollment in the 6-step program and having a BMI of 30 or greater. The 6 steps include: medical screening, patient education, diet selection/exercise, cognitive restructuring, behavioral therapy, and a plan for weight maintenance. Patient visits occurred about every three weeks and lasted about 30 minutes. The major outcome measured was weight lost over a minimum 3-month period. Patients initially underwent a medical screening to ensure no medical or psychological barriers for weight loss were present. Patients were educated about basic elements on the physiology of weight loss and weight maintenance. A structured diet was individualized for each patient based on prior success/failure with a particular diet and also patient preference of qualitative vs quantitative diet. Most chose a diet based on low glycemic index foods. Cognitive and behavioral therapy were given during patient sessions focusing on goal setting, understanding obesity as a disease with medical consequences, activity modification, and identifying environmental eating cues. A plan for weight maintenance was employed based on a 5-10% weight loss over 3 months followed by a 3-month weight maintenance cycle. All enrolled patients lost weight. Weight loss ranged from 6 to 42 lbs with an average loss of 16.4 lbs (p