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Objective:Maintaining weight loss is a major challenge in obesity treatment. Individuals often indicate that waning motivation prompts cessation of effective weight management behaviors. Therefore, a novel weight loss maintenance program that specifically targets motivational factors was evaluated.Design:Overweight women (N=338; 19% African American) with urinary incontinence were randomized to lifestyle obesity treatment or control and followed for 18 months. All participants in lifestyle (N=226) received the same initial 6-month group behavioral obesity treatment and were then randomized to (1) a novel motivation-focused maintenance program (N=113) or (2) a standard skill-based maintenance approach (N=113).Main Outcome Measure:Weight assessed at baseline, 6 and 18 months.Results:Both treatment groups (motivation-focused and skill-based) achieved comparable 18-month weight losses (−5.48% for motivation-focused vs −5.55% in skill-based, P=0.98), and both groups lost significantly more than controls (−1.51%; P=0.0012 in motivation-focused and P=0.0021 in skill-based).Conclusions:A motivation-focused maintenance program offers an alternative, effective approach to weight maintenance expanding available evidence-based interventions beyond traditional skill-based programs.Trial Registration:clinicaltrials.gov identifier: NCT00091988. [ABSTRACT FROM AUTHOR]