Abstract

Obesity and poor long-term results of obesity treatment remain an interesting paradox in modern societies. Medical and social pressures to lose weight seem to be substantial, treatment is theoretically easy and many studies suggest that quality of life is improved among reduced-obese. Nevertheless, only few obese people lose weight permanently. The aim of my study was to explore the influence of obesity and weight loss on obese people's well-being and quality of life, to study success and failure to control weight and examine conditions associated with sustained weight loss. The study consisted of five sub-studies ranging from large population based surveys with record-based linkages to open interviews focusing on people's own descriptions of weight-related problems among obese and reduced-obese subjects. Results showed that gender-specific differences existed in weight-related problems. Excess body weight was associated with social and economic disadvantages, particularly among women. Weight loss maintenance required a constant battle against weight regain, and sustained weight loss was rare. In women, low initial well-being and health-compromising behaviour that improved after weight loss seemed to predict weight loss maintenance. In men, low level of stress, medical problems and health-related behaviour were associated with sustained weight loss. Permanent behavioural changes were required for sustainability of weight loss, and improvements in the quality of life were needed to compensate for sacrifices required by weight loss maintenance. Since adequate improvements in the well-being and quality of life were seldom experienced after weight loss, regain was understandable.

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