Taking charge of one's life: A theoretical model for weight management success

Abstract

Obesity is a serious health problem that affects over 33% of Americans. It is associated with increased risk of hypertension, diabetes, and cardiovascular disease, costing our nation over {dollar}40 billion annually. Research on obesity is extensive and focuses on two major areas: identification of correlates of weight loss and refinement/comparison of weight loss treatments. However, findings have been contradictory and no single approach has been effective in maintaining long term weight control. One promising area of investigation is matching weight loss interventions to the internal belief system of each individual. In order 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 participation in weight loss treatments. Semi-structured interviews were conducted with 14 obese, postmenopausal women participating in a formal weight loss treatment. Constant comparative analysis of interview data identified the basic social psychological process of Taking Charge of One's Life: a three-phase process that entailed engaging (Phase I), internalizing, (Phase II), and keeping one's commitment (Phase III). The first phase, engaging, was composed of recognizing that one's health was declining, and/or that one was not meeting the societal expectation of thinness, and then scanning newspaper advertisements to identify potential sources of help. The second phase, internalizing, was a cognitive process whereby self efficacy and outcome beliefs were incorporated within the self through learning or socialization, and this enabled women to make the commitment to weight management success. The third phase, keeping one's commitment, involved using several strategies to incorporate major changes in one's lifestyle: acquiring knowledge, negotiating support, overcoming temptation, protecting oneself, and evaluating progress. The women achieved several outcomes: weight loss, new eating and exercise habits, improved health and well-being, and strengthened self efficacy and outcome beliefs. Findings suggest that it may be important to develop and test future interventions that are based on women's perspectives, including reasons for losing weight, subjective definitions of success, and interactions with family members.