OBJECTIVE: Maintaining weight loss is a major challenge in obesity treatment. Individuals often indicate that waning motivation prompts cessation of effective weight management behaviors. Therefore, a novel weight loss maintenance program that specifically targets motivational factors was evaluated. DESIGN: Overweight women (n = 338; 19% African American) with urinary incontinence were randomized to lifestyle obesity treatment or control and followed for 18 months. All participants in lifestyle (n = 226) received the same initial 6-month group behavioral obesity treatment and were then randomized to (1) a novel motivation-focused maintenance program (n = 113) or (2) a standard skill-based maintenance approach (n = 113). MAIN OUTCOME MEASURE: Weight assessed at baseline, 6 and 18 months. RESULTS: Both treatment groups (motivation-focused and skill-based) achieved comparable 18-month weight losses (-5.48% for motivation-focused versus -5.55% in skill-based, p = 0.98), and both groups lost significantly more than controls (-1.51%; p = 0.0012 in motivation-focused and p = 0.0021 in skill-based). CONCLUSIONS: A motivation-focused maintenance program offers an alternative, effective approach to weight maintenance expanding available evidence-based interventions beyond traditional skill-based programs.

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