Change For Weight Management Research Articles

Facilitators and barriers to behavior change in overweight and obesity management using the COM-B model.

Increasing overweight and obesity rates represent one of the global public health challenges. COM-B is a theoretical model used to identify areas to target to achieve behavior change. It identifies three factors that are needed for any behavior to occur: capability, opportunity, and motivation. We aimed to assess the potential facilitators and barriers to behavior change in weight management using the COM-B. The study included 139 people with overweight and obesity (mean age 48.81 ± 14.49 years; 64.5% female; body mass index 32.64 ± 6.51 kg/m2; waist-to-height ratio 0.62 ± 0.10) from primary care settings. All participants completed the Brief Measure of Behavior Change (COM-B), the General Self-Efficacy Scale (GSE), the Rosenberg Self-esteem Scale (RSE), and the Overall Evaluation of Health (OEH). Multiple linear regression was performed to analyse the data. The associations between sociodemographic and clinical variables and COM-B domains attenuated or were no longer significant when psychological resources were added to the regression models. Self-efficacy was identified as a stronger facilitator of health behavior change (p < 0.001) when compared to self-esteem (p < 0.05). No associations between automatic motivation and psychological resources were identified, however. Automatic motivation was found to be associated with higher age, being in a relationship, and better health. Behavioral interventions for weight management should specifically target different components of COM-B. Self-efficacy and self-esteem may play a significant role in individual capabilities, opportunities, and reflective motivation and should be included in tailored public health interventions. Health programs targeting younger and single people, and people with chronic conditions may help to promote sustainable behavior change.

Behavioral innovations in the management of obesity and overweight using the COM-B model

Abstract Background Increasing overweight and obesity rates represent one of the global health challenges in the 21st century. Obesity is a gateway to many non-communicable diseases and shorter life expectancy. Understanding individual capability, opportunity, and motivation for health behavior change (COM-B) may help to develop effective public health interventions. However, so far, only a very few studies examined interventions based on behavior change theories. Thus, we aimed to assess the potential facilitators and barriers to behavior change in weight management using the COM-B model. Methods We included 146 people with overweight and obesity (66.7% female; mean age 46.62±14.51 years; body mass index 32.46±6.51 kg/m2) from primary care settings. All participants completed the Brief Measure of Behavior Change (COM-B), the General Self-Efficacy Scale (GSE), the Rosenberg Self-esteem Scale (RSE), and the Self-Rated Heath scale (SRH). Multiple linear regression analyses were used to analyze the data. Results In univariate analyses COM-B domains were positively associated with female gender, living with a partner, lower body mass index, and higher SRH. However, the associations between sociodemographic and clinical variables and COM-B domains were no longer significant when self-esteem and general self-efficacy were added to the multivariate regression models. Self-efficacy was associated with reflective motivation (β: 0.53; p &amp;lt; 0.001), physical capability (β: 0.43; p &amp;lt; 0.001), and psychological capability (β: 0.44; p &amp;lt; 0.001) the most significantly. Self-esteem was strongly associated with physical capability (β: 0.41; p &amp;lt; 0.01). Total explained variances in the final models varied from 17.7% to 25.0%. Conclusions Personal resources may play a significant role in weight management and should be included in tailored public health interventions (Grant support: VEGA: 1/0748/22). Key messages • Interventions focused on the enhancement of personal resources may improve weight management. • Behavioral and cultural aspects should be considered when designing effective public health interventions.

Gestational weight gain and optimal wellness (GLOW): rationale and methods for a randomized controlled trial of a lifestyle intervention among pregnant women with overweight or obesity

BackgroundExcess gestational weight gain (GWG) is common among women with overweight or obesity, increasing their risks for pregnancy complications, delivering a large infant, and postpartum weight retention. To date, only intensive interventions have had success and few interventions have been designed for implementation in healthcare settings.MethodsWe describe the development, rationale, and methods of GLOW (GestationaL Weight Gain and Optimal Wellness), a randomized controlled trial evaluating the efficacy of a lifestyle intervention to prevent excess GWG among racially/ethnically diverse women with overweight or obesity in an integrated healthcare delivery system. Participants in Kaiser Permanente Northern California will be randomized, within 2 weeks of completing a study baseline clinic visit at 10 weeks’ gestation, to either usual medical care or a multi-component pregnancy lifestyle intervention adapted from the Diabetes Prevention Program (target N = 400). Informed by focus groups with patients and designed to be feasible in a clinical setting, the intervention will include 13 weekly individual sessions (11 delivered by telephone) focused on behavior change for weight management, healthy eating, physical activity, and stress management. Outcomes will be assessed in women and their infants from randomization to 12 months postpartum. The primary outcome is GWG. Secondary outcomes include changes in diet and physical activity during pregnancy and infant birthweight. Exploratory outcomes include cardiometabolic profile assessed via pregnancy blood samples and cord blood samples; and postpartum weight retention and infant anthropometrics up to 12 months of age. The trial includes systematic approaches to enhance intervention fidelity, intervention adherence, and participant retention in trial assessments.DiscussionGLOW is among few trials targeting excess GWG among diverse women with overweight or obesity in a healthcare setting, with long-term maternal and infant outcomes assessed up to 12 months after delivery. This evaluation of a multi-component intervention is designed to produce generalizable results to inform potential adoption of the intervention in clinical settings.Trial registrationClinicalTrials.gov (NCT02130232): submitted April 30, 2014; posted May 5, 2014.

MHealth Applications: A Tool for Behaviour Change in Weight Management.

Obesity has become a public concern all over the world and weight management is of interest to consumers. Heavy intake of food and lack of exercise are the foremost factors for obese condition. Self-management programs are essential for the prevention and treatment of obesity and weight management. Mobile health (m-Health) applications for weight management can be a useful tool in monitoring behaviour and self-management programs, thus engaging consumers in lifestyle changes to mitigate the risk of obesity. The aim of this review is to identify and compare the features supported in mHealth applications for weight management.

Motivation and perceived competence for healthy eating and exercise among overweight/obese adolescents in comparison to normal weight adolescents

BackgroundThe current literature on determinants of behavior change in weight management lacks sufficient studies on type of motivation among children/adolescents, on perceived competence, and in relation to healthy eating. This study aimed to investigate type of motivation and levels of perceived competence for healthy diet and exercise, as well as general self efficacy among adolescents. We hypothesized that overweight/obese adolescents would demonstrate lower autonomous motivation and perceived competence regarding diet and exercise, and lower self-efficacy in general, and that the scores would be influenced by socioeconomic factors.MethodsNormal weight (n = 40, body mass index < 85% for age and gender) and overweight or obese adolescents (n = 60, body mass index ≥ 85% for age and gender) aged 13-18 years were recruited from pediatric ambulatory clinics. Information was collected about demographics, socioeconomic factors, and lifestyle behaviors. The study subjects completed a survey including the Treatment Self-Regulation Questionnaire (TSRQ) and the Perceived Competence Scale (PCS) for healthy eating and exercise, and the General Self-Efficacy Scale (GSES). Composite scores for the three scales were compared between the two groups using the using the two-sample t-test (for normal data) or the Mann-Whitney U test (for non-parametric data). Relationships between the composite scores and patient characteristics were determined using Pearson or Spearman’s correlations.ResultsThe average age of the total cohort was 15.9 ± 1.9 years. 54% were female, and 82% identified as Latino/Hispanic. In comparison to normal weight subjects, overweight/obese adolescents exhibited higher scores for controlled motivation (mean ± standard deviation 28.3 ± 9.3 vs 18.1 ± 8.1) and higher perceived competence [median and 25-75% interquartile range 22.5 (19.0-26.0) vs 20.0 (15.5-25.0)] in relation to eating a healthy diet. These differences persisted after adjustment for age, sex, paternal education, and family income.ConclusionsOverweight/obese adolescents did not lack autonomous motivation but demonstrated higher controlled motivation and perceived competence for healthy eating in comparison to normal weight adolescents, independent of socioeconomic factors. In the clinical practice of weight management, providers should carefully assess adolescents for type of motivation and perceived competence, while accounting for potential barriers to behavior change.

Weight satisfaction, management strategies and health beliefs in knee osteoarthritis patients attending an outpatient clinic.

Although weight control is important in managing knee osteoarthritis (OA), it is difficult to achieve. Understanding beliefs regarding weight management in people with knee OA may improve weight control. To examine differences in bodyweight satisfaction, weight management strategies and weight-related health-beliefs in obese, overweight and normal weight people with knee OA. The beliefs and attitudes to weight in 102 people with symptomatic knee OA were ascertained. Participants were classified as being obese, overweight or of normal weight. Although obese and overweight participants were less satisfied with their bodyweight, they were more likely to want to lose weight and to report dieting compared with normal weight participants(P < 0.001 for all) and also more likely to report weight gain in the past 6 months (P < 0.001). While most participants rated food intake to be a main determinant of health, this belief was more common in normal weight participants (P = 0.04). When asked about their own weight gain, obese participants more frequently believed genetic and metabolic factors to be important than normal and overweight participants (P = 0.01). While 51 (53%) believed that increasing activity was more important than dietary change to avoid weight gain, this was more commonly believed by obese and overweight participants (P < 0.05). Despite desiring and attempting to lose weight, obese people with symptomatic knee OA more commonly reported weight gain. Overweight and obese participants attributed weight gain to non-modifiable factors but believed physical activity is more important than dietary change in weight management. Thus, education regarding the importance of diet as compared with non-modifiable factors and physical activity may improve weight management in obese people with knee OA.

Moderation: An alternative to restraint as a mode of weight self-regulation

This study considered two types of eating and weight self-regulation, in five groups, including four types of weight controllers and one non-dieting group. New scales were developed to measure eating moderation and restraint. Moderation was largely uncorrelated with restraint in 4 groups and had a fairly strong positive relation in 1 group. The moderation scale was unrelated to the Dutch Eating Behavior Questionnaire (DEBQ) restraint scale and the Three Factor Eating Questionnaire (TFEQ) rigid restraint subscale and weakly positively related to TFEQ flexible restraint. The restraint scale was strongly correlated to the DEBQ restraint scale, and to both flexible and rigid restraint subscales of the TFEQ. Across the five groups, moderation had exclusively positive relationships with attitude, behavior and emotion variables, while restraint had primarily negative relationships. The study supports moderation as a new dimension of weight self-regulation, independent of restraint. The new measures of moderation and restraint can be used together in research on the processes of change in weight management.

Using pictures as vignettes to assess stages of change in weight management

To evaluate the association between descriptions of the stage of change in weight management (using pictures as vignettes) and the changes in the restriction of amount of food and body weight. The goal is to develop counselling methods for helping people to change their lifestyles. A total of 74 people at high risk of type 2 diabetes participated in six months of group counselling. The data were collected through questionnaires and video-recordings at the beginning and the end of the counselling process, and were analyzed using both deductive content analysis and statistical analysis. Most of the participants were at the contemplation stage at the beginning of the study, and nearly half were at the action stage at six months. There were associations between progression in the lifestyle change process, the restriction of food amount, and weight changes. Judging from this, the descriptions of the change process of weight management using pictures were well made, because the change process progressed in parallel with the changes in weight and restriction of the amount of food eaten. Assessing the stages of change in weight management by using pictures as vignettes is easy to carry out, and feasible. The descriptions of the stages of change were parallel with the changes in restriction of food and changes in weight.