The purpose of this study was to compare dieters' behavior patterns at critical times in the weight-loss process: beginning of treatment, end of treatment, and one year post treatment. Dieters' thoughts, feelings, and actions were assessed after lapses in "high-risk" situations.

A review of the extant literature provided insight into the interpersonal, environmental, and intrapersonal risk factors for weight-loss relapse. The Risk For Relapse Questionnaire was developed to assess dieters' probability of relapse. Data were collected by personal interviews.

The TFA Clinical Interview was contained in the interview protocol and provided qualitative and quantitative data relevant to each dieter's thoughts, feelings, and actions. A comparison of individual and group thoughts, feelings, and actions contributed to the overall conclusion that the majority of dieters make short-term changes in treatment but return to maladaptive behavior patterns during post weight loss.

The results of this study indicate that dieters before and after treatment have the highest probability of relapse, whereas dieters at the end of treatment engage in behaviors conducive to weight-loss maintenance. Dieters at the beginning of treatment were guided by negative feelings leading to impulsivity. positive thinking behavior increased and feelings decreased by the end of treatment. By one year post treatment, 87% of dieters had relapsed and returned to maladaptive behavior. The heavy emphasis on positive actions regardless of negative feelings separated the 13% of weight loss maintainers from relapsers.

TFA Systems™ provided a systematic method to evaluate specific thoughts, feelings, and actions relevant to dieters' responses after lapses in "high-risk" situations. Analysis of behavior patterns supported the need for weight-loss programs to require long-term maintenance follow-up.