Abstract
Purpose
Successful weight maintenance after weight loss is exceedingly rare. The present study aimed to identify psychological predictors of lapses and weight maintenance.
Methods
Self-efficacy, coping, and perceptions of lapses were examined as potential predictors of lapse frequency and weight maintenance (percentage weight loss maintained). Participants included 67 adults (85.3 % women) who had intentionally lost a mean of 16 % of their body weight and had stopped losing weight at least 6 months prior to data collection. Participants completed a 7-day lapse diary tracking the frequency and perceived severity of their dietary and activity lapses, along with questionnaires on self-efficacy, coping, and characteristics of their weight loss.
Results
Participants had lost a mean of 13.9 kg, 20.4 months prior to data collection. More frequent lapsing was correlated with lower self-efficacy and greater perceived lapse severity. Lower percentage of weight loss maintained was correlated with lower self-efficacy, poorer coping, greater perceived lapse severity, and longer time since weight loss ended. “Regainers,” who maintained <90 % of their weight loss, had poorer self-efficacy, poorer coping, greater lapse frequency, and greater perceived lapse severity, than “maintainers,” who maintained at least 90 % of their weight loss.
Conclusions
The results suggest that self-efficacy, coping, and perceived lapse severity are significant predictors of weight maintenance, consistent with the relapse prevention model. The goals of improving self-efficacy and coping skills might be important additions to weight maintenance programs.
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References
Flegal KM, Carroll MD, Kit BK, Ogden CL (2012) Prevalence of obesity and trends in the distribution of body mass index among U.S. adults, 1999–2010. JAMA 307:491–497
Guh DP, Zhang W, Bansback N, Amarsi Z et al (2009) The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Pub Health 9:1–20
Puhl RM, Heuer CA (2009) The stigma of obesity: a review and update. Obesity 17:941–964
Dansinger ML, Tatsioni A, Wong JB et al (2007) Meta-analysis: the effect of dietary counseling for weight loss. Ann Int Med 147:41–50
Brownell KD, Horgen KB (2004) Food fight: the inside story of the food industry, America’s obesity crisis, and what we can do about it. McGraw Hill, New York
Jeffery RW, Kelly KM, Rothman AJ et al (2004) The weight loss experience: a descriptive analysis. Ann Behav Med 27:100–106
Wadden TA, Butryn ML, Bryne KJ (2004) Efficacy of lifestyle modification for long-term weight control. Obes Res 12(suppl):151S–162S
Befort CA, Stewart EE, Smith BK et al (2008) Weight maintenance, behaviors and barriers among previous participants of a university-based weight control program. Int J Obes 32:519–526
Klem ML, Wing RR, Lang W et al (2000) Does weight loss maintenance become easier over time? Obes Res 8:438–444
McGuire MT, Wing RR, Klem ML et al (1999) Behavioral strategies of individuals who have maintained long-term weight losses. Obes Res 7:334–341
Wing RR, Hill JO (2001) Successful weight lost maintenance. Ann Rev Nut 21:323–341
Byrne SM (2002) Psychological aspects of weight maintenance and relapse in obesity. J Psychom Res 53:1029–1036
Jeffery RW, Epstein LH, Wilson GT et al (2000) Long-term maintenance of weight loss: current status. Health Psychol 19(Suppl):5–16
Brownell KD, Marlatt GA, Lichtenstein E et al (1986) Understanding and preventing relapse. Am Psychol 41:765–782
Marlatt GA, Gordon JR (1985) Relapse prevention. Guilford Press, New York
Beutler LE, Moos RH, Lane G (2003) Coping, treatment planning, and treatment outcome: discussion. J Clin Psychol 59:1151–1167
Bandura A (1977) Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev 84:191–215
Weary G, Stanley MA, Harvey JH (1989) Attribution. Springer, New York
Elfhag K, Rossner S (2005) Who succeeds in maintaining weight loss? A conceptual review of factors associated with weight loss maintenance and weight regain. Obes Rev 6:67–85
Jeffery RW, Bjornson-Benson WM, Rosenthal BS et al (1984) Correlates of weight loss and its maintenance over two years of follow-up among middle-aged men. Prev Med 13:155–168
Kitsantas A (2000) The role of self-regulation strategies and self-efficacy perceptions in successful weight loss maintenance. Psychol Health 15:811–820
Bernier M, Avard J (1986) Self-efficacy, outcome and attrition in a weight-reduction program. Cog Ther Res 10:319–338
Linde JA, Rothman AJ, Baldwin AS et al (2006) The impact of self-efficacy on behavior change and weight change among overweight participants in a weight loss trial. Health Psychol 25:282–291
Mata J, Lippke S (2010) When weight management lasts. Lower perceived rule complexity increases adherence. Appetite 54:37–43
DePue JD, Clark MM, Ruggieros L et al (1995) Maintenance of weight loss: a needs assessment. Obes Res 3:241–248
Dohm F, Beattie JA, Aibel C et al (2001) Factors differentiating women and men who successfully maintain weight-loss from women and men who do not. J Clin Psychol 57:105–117
Head S, Brookhart A (1997) Lifestyle modification and relapse-prevention training during treatment for weight loss. Behav Ther 28:307–321
Teixeira PJ, Going SB, Sardinha LB et al (2004) A review of psychosocial pre-treatment predictors of weight control. Obes Rev 6:43–65
Larimer ME, Palmer RS, Marlatt GA (1999) Relapse prevention: an overview of Marlatt’s cognitive-behavioural model. Alcohol Res Health 23:151–159
Perri MG, Nezu AM, McKelvey WF et al (2001) Relapse prevention training and problem-solving therapy in the long-term management of obesity. J Consult Clin Psychol 69:722–726
Turner LW, Wang MQ, Westerfield RC (1995) Preventing relapse in weight control: a discussion of cognitive and behavioral strategies. Psychol Rep 77:651–656
Carels RA, Hoffman J, Collins A et al (2001) Ecological momentary assessment of temptation and lapse in dieting. Eat Behav 2:307–321
Carels RA, Douglass OM, Cacciapaglia HM et al (2004) An ecological momentary assessment of relapse crises in dieting. J Consult Clinl Psych 72:341–348
Clark MM, Abrams DB, Niaura RS et al (1991) Self-efficacy in weight management. J Consult Clin Psych 59:739–744
Drapkin RG, Wing RR, Shiffman S (1995) Responses to hypothetical high risk situations: do they predict weight loss in a behavioral treatment program or the context of dietary lapses? Health Psychol 14:427–434
Shiffman S, Stone AA, Hufford MR (2008) Ecological momentary assessment. Ann Rev Clin Psychol 4:1–21
Anderson JW, Konz EC, Frederich RC et al (2001) Long-term weight-loss maintenance: a meta-analysis of US studies. Am J Clin Nutr 74:579–584
Brownell KD, Kersh R, Ludwig DS et al (2010) Personal responsibility and obesity: a constructive approach to a controversial issue. Health Affair 29:379–387
Lowe MR, Butryn ML, Didie ER et al (2009) The power of food scale: a new measure of the psychological influence of the food environment. Appetite 53:114–118
Hetherington MM, Anderson AS, Norton GNM et al (2006) Situational effects on meal intake: a comparison of eating alone and eating with others. Physiol Behav 88:498–505
Salvy SJ, Howard M, Read M et al (2009) The presence of friends increases food intake in youth. Am J Clin Nutr 90:282–287
Mattes RD (2002) Feeding behaviors and weight loss outcomes over 64 months. Eat Behav 3:191–204
Grilo CM, Shiffman S, Wing RR (1989) Relapse crises and coping among dieters. J Consult Clin Psych 57:488–495
Fairburn CG, Cooper Z, O’Connor M (2008) Eating disorder examination. In: Fairburn CG (ed) Cognitive behavior therapy and eating disorders. Guilford Press, New York, pp 265–308
Wing RR, Shiffman S, Drapkin RG (1995) Moderate versus restrictive diets: implications for relapse. Behav Ther 26:5–24
Latner JD, Wilson GT (2002) Self-monitoring and the assessment of binge eating. Behav Ther 33:465–477
Haynes SN, O’Brien WH (1999) Principles and practice of behavioral assessment. Kluwer Academic/Plenum, New York
Nieto-Garcia FJ, Bush TL, Keyl PM (1990) Body mass definitions of obesity: sensitivity and specificity using self-reported weight and height. Epidemiology 1:146–152
Wilson GT (2010) Eating disorders, obesity and addiction. Eur Eat Disord Rev 18:341–351
Ziauddeen H, Farooqi IS, Fletcher PC (2012) Obesity and the brain: how convincing is the addiction model? Nature Rev Neurosci 13:279–286
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Latner, J.D., McLeod, G., O’Brien, K.S. et al. The role of self-efficacy, coping, and lapses in weight maintenance. Eat Weight Disord 18, 359–366 (2013). https://doi.org/10.1007/s40519-013-0068-1
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DOI: https://doi.org/10.1007/s40519-013-0068-1