Academic journal article The Qualitative Report

"Taking Charge of One's Life": A Model for Weight Management Success

Academic journal article The Qualitative Report

"Taking Charge of One's Life": A Model for Weight Management Success

Article excerpt

Obesity is a serious, prevalent, and refractory disorder that increases with age particularly in women who enroll in formal weight loss treatments. This study examined the processes used by obese postmenopausal women as they participated in a formal weight loss program. Using grounded theory, interviews were conducted with 14 women engaged in a formal weight loss study examining success with specific, targeted weight loss treatments based on one's weight control self-efficacy typology. "Taking Charge of One's Life" emerged as a model for weight management success, comprised of three phases: engaging, internalizing, and keeping one's commitment. This study supports the unique, complex, and individualized nature of making a decision to lose weight and then maintaining one's commitment to weight loss. Key Words: Obesity, Women, Postmenopausal, Weight Management, and Grounded Theory

Introduction

Being overweight or obese is a serious health problem that affects over 66% of American adults (Centers for Disease Control and Prevention, 2006). The prevalence of obesity-related medical conditions continues to rise. Several medical conditions associated with obesity include hypertension, diabetes mellitus, dyslipidemia, certain forms of cancer, sleep apnea, and osteoarthritis (The Obesity Society, 2008). Nationally, related health costs may exceed $78 billion annually (Finkelstein, Fiebelkorn, & Wang, 2003). Research on obesity is extensive, and two major focal areas have been identification of correlates of weight loss and refinement/comparison of treatments. However, findings have been contradictory, and no single approach has been effective in maintaining long-term weight control. To better understand weight loss from the perspective of those actually trying to lose weight, a grounded theory approach was used to examine the process women experienced during their participation in a formal weight loss study.

The larger study examined success with specific, targeted weight loss treatments based on one's weight control self-efficacy (WCSE) type; assured or disbeliever. Women with assured WCSE were confident they could control their body weight, and women with disbeliever WCSE had a wavering faith in their ability to successfully accomplish this. All women received 10 weeks of heart healthy classes, followed by 24 weeks of active weight loss treatment aimed at their specific WCSE type, totaling 34 weeks of intervention. The goal of assured treatment was to support and further strengthen the confident efficacy beliefs of women with assured WCSE. The goal of disbeliever treatment was to build and instill confidence in women with disbeliever WCSE that they could successfully accomplish the behaviors needed for weight control (Dennis et al., 2001). Women from the larger study were interviewed for the present grounded theory study following the 34 weeks of interventions, which offered them a wealth of experience that enhanced the potential value of the interview data.

Background

Obesity is a serious, prevalent, and refractory disorder that increases with age in African-American women, and increases through age 59 in Caucasian women (National Center for Health Statistics, 2007). Although obesity is easily diagnosed and its treatment could not seem more straightforward (eat less and exercise more), behavioral modification approaches to weight loss treatment have had little impact on long-term weight loss success (Wadden, Brownell, & Foster, 2002). The inadequacy of behavioral modification approaches for long-term weight control has led to an exponential increase in research on obesity treatments in recent decades. One focal area of obesity treatment research has been the identification of factors that are correlated with weight loss. Factors that have been examined include exercise, self-efficacy, weight management processes, stress, binge eating, social support, and client treatment matching (Allan, 1991; Dennis et al. …

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