Professional versus self-help weight loss at the worksite: The challenge of making a public health impact

The need has been identified to treat obesity in sufficiently large numbers of individuals to achieve a public health impact. The workplace is a prime site for such interventions. Previous worksite studies have demonstrated that behavioral programs are feasible, but expensive professional programs, high attrition rates, and poor maintenance have all compromised cost effectiveness. One way to address these challenges is to train in-house volunteers to conduct self-help treament programs. The present study, a randomized trial conducted in a blue-collar industry, compared volunteer leaders to professional leaders. In the self-help condition, the volunteer leaders were elected from within the groups themselves using a social network endorsement system. Dependent measures included percent overweight, weight reduction quotient, attendance and a cost-effectiveness index. When only those who completed treatment and follow-up were considered, the professionally led groups lost and maintained the loss of significantly more weight than the self-help groups. But, when dropouts were included as treatment failures, both groups did equally well. The formidable challenges behind the development of behavioral programs that can make a public health impact are discussed.