Accountability Frameworks in Medical Weight Loss Programs: A Comprehensive Literature Review

Limited adherence to weight loss regimens is a major contributor to the unsuccessful treatment of obesity in patients. Accountability approaches have been used to enhance weight loss program adherence. The purpose of our review is to characterize techniques used to improve patient accountability during weight loss programs. The PubMed database was used to search for studies, analyses, and clinical trials that improved adherence by promoting participant accountability. Articles cited by these references were analyzed, yielding 10 studies. The results were evaluated by comparing efficacy in weight loss, accountability measures used, and the value placed by participants on the program's focus on accountability measures. Interventions that required social and professional support, planning, physical activity, and an accountability advisor to follow up beyond self-motivation increased the adherence rates of patients. Tools such as online forums and team-based accountability sessions also promoted adherence to long-term weight loss goals. Treatment programs with multiple interventions are optimal when beginning a long-term treatment plan. These accountability strategies may be used in other areas of medicine.