Login to MyKarger

New to MyKarger? Click here to sign up.



Login with Facebook

Forgot your password?

Authors, Editors, Reviewers

For Manuscript Submission, Check or Review Login please go to Submission Websites List.

Submission Websites List

Institutional Login
(Shibboleth or Open Athens)

For the academic login, please select your country in the dropdown list. You will be redirected to verify your credentials.

Original Article

Open Access Gateway

Instrumentalization of Eating Improves Weight Loss Maintenance in Obesity

Christensen B.J.a · Iepsen E.W.b · Lundgren J.b · Holm L.a · Madsbad S.c · Holst J.J.b · Torekov S.S.b

Author affiliations

aInstitute of Food and Resource Economics, University of Copenhagen, Copenhagen, Denmark; bDepartment of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen and the NNF Center for Basic Metabolic Research, Copenhagen, Denmark; cDepartment of Endocrinology, Hvidovre University Hospital, Hvidovre, Denmark

Corresponding Author

Dr. Bodil Just Christensen

Institute of Food and Resource Economics

University of Copenhagen

Rolighedsvej 25, 1958 Frederiksberg C, Denmark

bjuc@ifro.ku.dk

Related Articles for ""

Obes Facts 2017;10:633-647

Do you have an account?

Login Information





Contact Information











I have read the Karger Terms and Conditions and agree.



Abstract

Aim: The purpose of this study was to identify psychosocial determinants for maintaining weight loss. Methods: 42 obese individuals who achieved a 12% weight loss before entering a 52-week weight maintenance program were interviewed qualitatively. Psychosocial factors related to weight loss maintenance were identified in two contrasting groups: weight reducers and weight regainers. Groups were defined by health-relevant weight maintenance (additional weight loss > 3% at week 52, n = 9 versus weight gain > 3%, at week 52, n = 20). Results: Weight reducers reported structured meal patterns (p = 0.008), no comfort eating (p = 0.016) and less psychosocial stress (p = 0.04) compared to weight regainers. The ability to instrumentalize eating behavior emerged as an important factor (p = 0.007). Nutritional knowledge, motivation or exercise level did not differ between groups (p > 0.05). Conclusions: Successful weight loss maintenance was associated with an interplay between behavioral, affective and contextual changes. ‘Instrumentalization of eating behavior' seems to be an important element in long-term weight maintenance.

© 2017 The Author(s) Published by S. Karger GmbH, Freiburg


References

  1. Boutayeb A, Boutayeb S, Boutayeb W: Multi-morbidity of non communicable diseases and equity in WHO Eastern Mediterranean countries. Int J Equity Health 2013;12:60.
  2. Flegal KM, Kit BK, Orpana H, Graubard BI: Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. JAMA 2013;309:71-82.
  3. Ayensa JI, Calderon MJ. Psychopathological comorbidity of obesity (in Spanish). An Sist Sanit Navar 2011;34:253-261.
    External Resources
  4. Seidell JC: Societal and personal costs of obesity. Exp Clin Endocrinol Diabetes 1998;106(suppl 2):7-9.
  5. National Task Force on the Prevention and Treatment of Obesity, National Institutes of Health: Very low-calorie diets. JAMA 1993;270:967-974.
    External Resources
  6. Wing RR, Hill JO: Successful weight loss maintenance. Annu Rev Nutr 2001;21:323-341.
  7. Wadden TA: Treatment of obesity by moderate and severe caloric restriction. Results of clinical research trials. Ann Intern Med 1993;119:688-693.
  8. Elfhag K, Rössner S: Who succeeds in maintaining weight loss? A conceptual review of factors associated with weight loss maintenance and weight regain. Obes Rev 2005;6:67-85.
  9. Klenk J, Rapp K, Ulmer H, Concin H, Nagel G: Changes of body mass index in relation to mortality: results of a cohort of 42,099 adults. PloS One 2014;9:e84817.
  10. Hemmingsson E: A new model of the role of psychological and emotional distress in promoting obesity: conceptual review with implications for treatment and prevention. Obes Rev 2014;15:769-779.
  11. Ogden J, Clementi C, Aylwin S: The impact of obesity surgery and the paradox of control: A qualitative study. Psychol Health 2006;21:273-293.
  12. Stunkard AJ, Messick S: The three-factor eating questionnaire to measure dietary restraint, disinhibition and hunger. J Psychosom Res 1985;29:71-83.
  13. Bandura A: Self-Efficacy. New York, Wiley and Sons, 1994.
  14. Wallston KA, Wallston BS, DeVellis R: Development of the Multidimensional Health Locus of Control (MHLC) Scales. Health Educ Monogr 1978;6:160-170.
    External Resources
  15. Epiphaniou E, Ogden J: Successful weight loss maintenance and a shift in identity: from restriction to a new liberated self. J Health Psychol 2010;15:887-896.
  16. Sarlio-Lähteenkorva S: The battle is not over after weight loss: stories of successful weight loss maintenance. Health 2000;4:73-88.
  17. Hillersdal L, Christensen BJ, Holm L: Patients' strategies for eating after gastric bypass surgery: a qualitative study. Eur J Clin Nutr 2016;70:523-537.
  18. Iepsen EW, Lundgren J, Dirksen C, Jensen JE, Pedersen O, Hansen T, Madsbad S, Holst JJ, Torekov SS: Treatment with a GLP-1 receptor agonist diminishes the decrease in free plasma leptin during maintenance of weight loss. Int J Obes (Lond) 2015;39:834-841.
  19. Chi MT: Quantifying qualitative analyses of verbal data: a practical guide. J Learning Sci 1997;6:271-315.
  20. Riecke BF, Christensen R, Christensen P, Leeds AR, Boesen M, Lohmander LS, Astrup A, Bliddal H: Comparing two low-energy diets for the treatment of knee osteoarthritis symptoms in obese patients: a pragmatic randomized clinical trial. Osteoarthritis Cartilage 2010;18:746-754.
  21. Britten N: Qualitative interviews in medical research. BMJ 1995;311:251-253.
    External Resources
  22. Mozaffarian D, Hao T, Rimm EB, Willett WC, Hu FB: Changes in diet and lifestyle and long-term weight gain in women and men. N Engl J Med 2011;364:2392-2404.
  23. Jeffery RW, Drewnowski A, Epstein LH, Stunkard AJ, Wilson GT, Wing RR, Hill DR: Long-term maintenance of weight loss: current status. Health Psychol 2000;19(1 suppl):5-16.
  24. Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA, Hu FB, Hubbard VS, Jakicic JM, Kushner RF, Loria CM, Millen BE, Nonas CA, Pi-Sunyer FX, Stevens J, Stevens VJ, Wadden TA, Wolfe BM, Yanovski SZ, Jordan HS, Kendall KA, Lux LJ, Mentor-Marcel R, Morgan LC, Trisolini MG, Wnek J, Anderson JL, Halperin JL, Albert NM, Bozkurt B, Brindis RG, Curtis LH, DeMets D, Hochman JS, Kovacs RJ, Ohman EM, Pressler SJ, Sellke FW, Shen WK, Smith SC Jr, Tomaselli GF: 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation 2014;129(25 suppl 2):S102-138.
  25. Bruce Lawrence Berg HL: Qualitative Research Methods for the Social sciences. Boston, Pearson, 2004.
  26. Strauss A, Corbin, J: Basics of Qualitative Research: Procedures and Techniques for Developing Grounded Theory. Los Angeles, Sage, 1998.
  27. Wilby KJ, Govaerts MJ, Austin Z, Dolmans DH: Exploring the influence of cultural orientations on assessment of communication behaviours during patient-practitioner interactions. BMC Med Educ 2017;17, 61.
  28. Guest G, Bunce A, Johnson L: How many interviews are enough? An experiment with data saturation and variability. Field Methods 2006;18:59-82.
    External Resources
  29. Green J, Thorogood N: Qualitative Methods for Health Research, 3rd ed. London, Sage, 2013.
  30. Wing RR, Phelan S: Long-term weight loss maintenance. Am J Clin Nutr 2005;82(1 suppl):222s-225s.
    External Resources
  31. Prochaska JO, Velicer WF, Rossi JS, Goldstein MG, Marcus BH, Rakowski W, Fiore C, Harlow LL, Redding CA, Rosenbloom D, et al: Stages of change and decisional balance for 12 problem behaviors. Health Psychol 1994;13:39-46.
  32. Teixeira PJ, Silva MN, Coutinho SR, Palmeira AL, Mata J, Vieira PN, Carraca EV, Santos TC, Sardinha LB: Mediators of weight loss and weight loss maintenance in middle-aged women. Obesity (Silver Spring) 2010;18:725-735.
  33. Batra P, Das SK, Salinardi T, Robinson L, Saltzman E, Scott T, Pittas AG, Roberts SB: Eating behaviors as predictors of weight loss in a 6 month weight loss intervention. Obesity (Silver Spring) 2013;21:2256-2263.
  34. Jakubowicz D, Froy O, Wainstein J, Boaz M: Meal timing and composition influence ghrelin levels, appetite scores and weight loss maintenance in overweight and obese adults. Steroids 2012;77:323-331.
  35. Marin-Guerrero AC, Gutierrez-Fisac JL, Guallar-Castillon P, Banegas JR, Rodriguez-Artalejo F: Eating behaviours and obesity in the adult population of Spain. Br J Nutr 2008;100:1142-1148.
  36. Klem ML, Wing RR, McGuire MT, Seagle HM, Hill JO: A descriptive study of individuals successful at long-term maintenance of substantial weight loss. Am J Clin Nutr 1997;66:239-246.
    External Resources
  37. Serdula MK, Mokdad AH, Williamson DF, Galuska DA, Mendlein JM, Heath GW: Prevalence of attempting weight loss and strategies for controlling weight. JAMA 1999;282:1353-1358.
  38. Byrne S, Cooper Z, Fairburn C:. Weight maintenance and relapse in obesity: a qualitative study. Int J Obes Relat Metab Disord 2003;27:955-962.
  39. Kayman S, Bruvold W, Stern JS: Maintenance and relapse after weight loss in women: behavioral aspects. Am J Clin Nutr 1990;52:800-807.
    External Resources
  40. Westenhoefer J, Stunkard AJ, Pudel V: Validation of the flexible and rigid control dimensions of dietary restraint. Int J Eat Disord 1999;26:53-64.
  41. Phelan JC, Link BG, Diez-Roux A, Kawachi I, Levin B: ‘Fundamental causes' of social inequalities in mortality: a test of the theory. J Health Soc Behav 2004;45:265-285.

Article / Publication Details

First-Page Preview
Abstract of Original Article

Received: December 15, 2016
Accepted: August 24, 2017
Published online: December 06, 2017
Issue release date: Published online first

Number of Print Pages: 15
Number of Figures: 1
Number of Tables: 3

ISSN: 1662-4025 (Print)
eISSN: 1662-4033 (Online)

For additional information: https://www.karger.com/OFA


Open Access License / Drug Dosage / Disclaimer

This article is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND). Usage and distribution for commercial purposes as well as any distribution of modified material requires written permission. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.