A Randomized Trial Comparing Two Doses of Portion-Controlled Foods Within a Primary Care Weight Loss Program

Inclusion Criteria: * Patients from the University Medicine Denver, University Medicine Anschutz, and A.F. Williams clinics meeting the following criteria * Age 18 or older * Able to keep a food record for 3 days prior to study entry * Able to give informed consent * Willing to accept randomization to either treatment condition, to attend all sessions, and to complete study-related assessments * Body mass index (BMI) ≥ 30 kg/m2 and \< 50 kg/m2 * Elevated waist circumference (≥ 88 cm for women, ≥ 102 cm for men) + any one of the following: * Glucose intolerance (fasting glucose ≥ 100 or non-fasting glucose ≥ 140, including type 2 diabetes); individuals taking medications for diabetes qualify automatically * Elevated blood pressure (≥130/85), including hypertension (≥140/90); individuals taking anti-hypertensive medication qualify automatically * Hypertriglyceridemia (TG ≥ 150); individuals taking lipid-lowering medications qualify automatically * Decreased high-density lipoprotein (HDL) cholesterol (\< 40 for men, \< 50 for women) * Obstructive sleep apnea Exclusion Criteria: * Medical conditions in which significant weight loss is normally contraindicated (e.g. pregnancy, congestive heart failure requiring diuretics, poorly controlled diabetes, Stage 4 or 5 chronic kidney disease, clinically evident cirrhosis, other severe internal organ disease); exceptions may be made if a referring physician documents that it is safe and appropriate for the individual to lose weight * Treated for cancer within the past 5 years, except for basal cell or squamous cell skin cancer; exceptions may be made with written permission from a physician * Weight gain or loss of ≥5% of weight in the past 6 months; patients who have not been weight stable may be re-screened in 3 months * Concurrent use of corticosteroids or second-generation antipsychotic medications (exceptions may be made for individuals using these medications who have been weight stable for 6 months) * Psychiatric diagnoses likely to affect adherence to a research study protocol (e.g., poorly controlled schizophrenia, active substance abuse) * Prior or planned bariatric surgery * Participation in an organized weight loss program (e.g., Weight Watchers) at the time of enrollment