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Introduction: Obesity is epidemic among adults with serious mental illness (SMI) (e.g., schizophrenia, bipolar disorder) and evidenced-based weight loss programs are needed for this group. We examined the association between attendance to program sessions and weight change among adults with SMI who were enrolled in a lifestyle-based weight loss trial. Methods: Overweight and obese adults with SMI were randomized to either a control group (n=147) or an active intervention group (n=144) that received weight loss classes (3/month), individual weight management sessions (monthly), and group exercise classes (3/week) during the first 6 months. These classes tapered off during months 7-18. Study staff maintained attendance records. Standardized weight was assessed at baseline, 6 and 18 months. Regression analyses included weight change as the dependent variable and controlled for sex, age, and site. Results: The active intervention group was 51% female with an average age of 47 years. Main results have reported significant weight loss at 6 (M=-1.7kg, SD=4.6) and 18 months (M=-3.4kg, SD=7.4). Attendance at 6 and 18 months are reported in the figure below. Attendance was not associated with weight change at 6 months. Overall percent attendance was not associated with 18 month weight change (B=-0.02, p=-.59). A second regression model included percent attendance individually for each of type of session and group weight loss attendance (B=-0.10, p=.04) was associated with weight loss; however, individual weight loss sessions (B=0.002, p=.95), and group exercise (B=0.08, p=.08) were not associated with weight loss. Conclusion: Although overall attendance was not associated with weight loss, attendance to the group weight loss session was associated with weight loss at 18 months. It is not clear if the content of the weight loss groups was particularly effective or if adherence to these sessions was the strongest indicator of adherence to the behavioral recommendations. [ABSTRACT FROM AUTHOR]