Structure House, United States
Jennifer Pells is a clinical psychologist at Structure House, a residentially-based obesity treatment facility owned by Acadia Healthcare, located in Durham, NC. She has several research publications and numerous poster presentations involving obesity, behavioral weight management, and related issues such as persistent pain, osteoarthritis, type 2 diabetes, and binge eating disorder.
Weight regain is a significant issue in behavioral obesity treatment despite efficacy of behavioral weight loss interventions during and in the initial months following treatment. Continued treatment contact may reduce regain, however, the most effective approach to continuing care is unclear and time-limited interventions with decreasing contact remain the standard. This observational study examined a residentially-based program that offers continuing care via return visits for adults with obesity. We evaluated return visit patterns and the association between return visits and weight maintenance. Weight and return visit data were analyzed for 1031 adults who attended the Structure House weight management program for the first time between 2008-2013. All participants included in this study had at least one follow-up visit. Over 6 years analyzed, 28% of participants completed at least one return visit, which was more common than multiple return visits (66% of participants vs. 34%). Analyses revealed significant weight loss from initial visit up to and during first return visit, but significantly smaller weight loss during the period between visits. The greatest weight loss (13%) was observed for participants who returned 6-12 months after initial visit. This data suggests an important role for additional treatment beyond initial program completion to improve weight loss and maintenance. Although ongoing treatment may be necessary to sustain continued weight loss, the ‘booster visit’ model may offer an additional or alternative option when continuous treatment is not feasible. A limitation was the lack of weight comparison data for participants who did not complete a return visit.
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