Barriers to Adherence to a Weight Loss Diet Using the Nominal Group Technique

Abstract

Abstract Objectives At any given time, a large percentage of the female population, especially those of childbearing age, is engaged in some form of weight loss behavior. Although numerous weight loss plans and diets have been shown to achieve weight loss in the short term, the long-term maintenance of weight loss is modest at best. The identification of factors associated with difficulty adhering to a weight loss diet and sustaining weight loss maintenance is paramount to improving the long-term success of weight loss interventions. Methods As part of a study investigating the effects of dietary protein distribution on weight loss in women (N = 33; age = 33 ± 8; BMI = 36 ± 4), we conducted a series of nominal group technique (NGT) sessions aimed at identifying perceived barriers to adherence to a weight-loss diet. NGT generates a large number of unique responses to a specific research question, in this case, factors that make it hard to stick to a weight-loss diet. Responses from all NGT sessions were then aggregated and grouped into major themes to create an overall thematic framework of highest ranking responses. Results The major themes to emerge were individual- and environmental-level barriers. Individual-level themes rated the most highly by the groups were knowledge, cravings, emotions, habits, impatience, and willpower—specifically, knowing when to stop eating, being able to control cravings and emotional eating, and sustaining dietary lifestyle changes. The highest ranking environmental-level themes included family/social, time constraints, eating out, food being present, and cost. Events that bring people together, especially those centered around food and drink, and busy schedules were particularly challenging for women's efforts to stay “on track” with their weight control goals. Conclusions Our findings provide a rich depiction of the barriers that women find most salient in adhering to a weight-loss diet. These results highlight the importance of understanding the intricate interplay between individual- and environmental-level factors that make achieving and maintaining a healthy body weight difficult. This information can be used to inform the planning and implementation of behavioral weight-loss interventions in women. Funding Sources The United States Department of Agriculture, Agricultural Research Service and the North Dakota Beef Commission.