Weight Control  Interactive Voice Response Study

This was a Pilot Study designed to explore IVR technology as a tool for weight loss and maintenance for patients who   are or were obese. The research project used the telephone to administer a daily questionnaire to participants who completed the UVM Weight   Control Program directed by Dr. Elena Ramirez, Ph.D. at the Behavior Therapy and Psychotherapy Center at UVM.

Patients would be required to call an automated telephone system (IVR) to report weight, caloric intake totals, nutritional values and length of time spent exercising. Additionally, participants could review and rehearse specific skills learned during the 18 weeks of Group Therapy. Participants also received confidential and personalized monthly messages that had been recorded by their therapist to the TIVR.

Previous weight loss research suggests that continued assistance post-therapy can prolong and amplify therapeutic impact. Our own research suggests that TIVR is a cost-effective means of prolonging therapeutic effect. Therefore, we have adapted Therapeutic   Interactive Voice Response (TIVR) as an adjunct for patients with obesity. The study may help us determine whether a TIVR system will enhance the benefits of an 18-week weight loss program for obesity.

Cognitive Behavioral Skills

The following are Cognitive Behavioral Skills that weight control patients are taught during therapy, and are encouraged with the IVR system:

Relaxation Response: Methods of relaxing other than overating.

Diaphragmatic Breathing: Breathing from your abdomen promotes calmness and can help you make better eating choices.

Realistic Self-talk: Make sure that what you are telling yourself is based in reality.

Disputing Irrational Thoughts: What to do when an irrational thought takes hold.

Goal Setting: The first step in reaching a goal is setting one.

Exposure Practice: A method of dealing with repeated food exposure.

Recognizing and Targeting Eating Cues: If you can identify the cues that trigger eating episodes then you can control them.

Managing Tempting Situations: Various strategies for dealing with tempting food situations.

Meal and Exercise Planning: Planning ahead means that your healthy eating and exercise goals are more likely to be met.

Self-monitoring Food and Exercise: Tools for accurately recording your food and excercise for future use.

Phone Script

Weight control tip of the day: A "tip of the day” will be played in random order to encourage weight control.

Weekly Questions:

  1. CURRENT WEIGHT: What is your current weight in pounds?

Daily Questions:

  1. AEROBIC: How many minutes were you engaged in aerobic exercise today? a.INTENSITY: How many of those minutes were moderate or high intensity aerobic exercise?

  2. EATING EPISODES: How many eating episodes did you have today? a.HOME PREPARED: How many of those eating episodes were home prepared foods:

  3. CALORIES: What was your total caloric intake today?

  4. SERVINGS: How many servings of the following foods did you consume today:
    1. FRUITS/VEGETABLES: Cooked or raw fruits/ vegetables, not including fruit juices

    2. SWEETS: Regular fat ice cream, cookies, cakes or baked goods, and candy

    3. CALORIC DRINKS: Alcoholic beverages, fruit juices, full sugar sodas, smoothies and shakes, meal supplement drinks and specialty coffee drinks.

      IF ANY, ASK: ALCOHOL: How many of those caloric drinks contained alcohol?
  5. SLEEP: In total, how many hours did you sleep in the past 24 hours? a.QUALITY NIGHT: Rate your quality of sleep last night to 0 the worst sleep ever to 9 the best night’s sleep?

  6. POSITIVE MOODS: At your best, how happy or content did you feel today from 0 not at all to 9 the happiest or most content you’ve ever been?
    1. CUE: Did positive moods trigger you to eat today? Press 1 for yes or 0 for no.

  7. NEGATIVE MOODS: At your worst, how sad or angry did you feel today from 0 not at all to 9 the most sad or angry you’ve ever been?
    1. CUE: Did negative moods trigger you to eat today? Press 1 for yes or 0 for no

  8. RELATIONSHIPS: How well did you get along with others today from 0 the worst to 9 the best you’ve ever gotten along with others.
    1. CUE: Did relationships trigger you to eat today? Press 1 for yes or 0 for no.

  9. STRESS: Rate your highest level of stress today from 0 no stress to 9 the highest stress you’ve ever experienced.
    1. CUE: Did stress trigger you to eat today? Press 1 for yes or 0 for no.

  10. FATIGUE: Rate your highest level of fatigue today from 0 no fatigue to 9 the highest fatigue you’ve ever experienced.
    1. CUE: Did fatigue trigger you to eat today? Press 1 for yes or 0 for no.

  11. BOREDOM: Rate your highest level of boredom today from 0 no boredom to 9 the most boredom you’ve ever experienced.
    1. CUE: Did boredom trigger you to eat today? Press 1 for yes or 0 for no.

  12. SOCIAL PRESSURES CUE: Did social pressures trigger you to eat today? Press 1 for yes or 0 for no.

  13. PRESENCE OF FOOD CUE: Did presence of food trigger you to eat today? Press 1 for yes or 0 for no.

  14. SATISFACTION: Rate your overall satisfaction with your weight control today from 0 not at all to 9 the most satisfied you’ve ever been.

  15. COPING STRATEGIES: For each of the following coping skills, press 1 if you used that coping skill for weight or stress control today and 0 if you did not:


    2. EXERCISE:

    3. SELF-TALK:








  16. COPING: How well did you cope with trigger situations today with 0 not at all able to cope to 9 being very able to cope.

  17. Would you like to practice your relaxation techniques now? (press 1 if yes, press 0 if no)

IF NO: Do you want to practice any other Weight Control skills now? (press 1 if yes, press 0 if no)

That concludes this survey. You may hang up to end this call. Thank you and goodbye.


This study was supported by a New Research Initiative (NRI) funded by the University of Vermont.