Abstract
Accurate prediction of weight loss success and failure has eluded researchers for many years. Thus, we administered a comprehensive psychometric battery before a 4-month lifestyle behavioral weight reduction program and analyzed weight changes during that period to identify baseline characteristics of successful and unsuccessful participants, among 112 overweight and obese middle-aged women (age, 47.8 ± 4.4 years; BMI, 31.4 ± 3.9 kg/m2). Mean weight and percentage fat losses among the 89 completers were −5.4 kg and −3.4%, respectively ( p < .001). A higher number of recent dieting attempts and recent weight loss, more stringent weight outcome evaluations, a higher perceived negative impact of weight on quality of life, lower self-motivation, higher body size dissatisfaction, and lower self-esteem were associated with less weight loss and significantly distinguished responders from nonresponders among all participants. These findings are discussed as to their usefulness (i) to screen individuals before treatment, (ii) to provide a better match interventions to participants, and (iii) to build a weight loss readiness questionnaire.
Similar content being viewed by others
REFERENCES
Aickin, M., and Gensler, H. (1996). Adjusting for multiple testing when reporting research results: The Bonferroni vs Holm methods. Am. J. Public Health 86: 726–728.
Ainsworth, B. E., Haskell, W. L., Whitt, M. C., Irwin, M. L., Swartz, A. M., Strath, S. J., O'Brien, W. L., Bassett, D. R., Jr., Schmitz, K. H., Emplaincourt, P. O., Jacobs, D. R., Jr., and Leon, A. S. (2000). Compendium of physical activities: An update of activity codes and MET intensities. Med. Sci. Sports Exerc. 32: S498–S504.
Allison, D. B., and Engel, C. N. (1995). Predicting treatment outcome: Why have we been so unsuccessful. In Allison D.B., and Pi-Sunyer, F.X. (eds.), ObesityTreatment, Plenum Press, New York.
Andersen, R. E., Wadden, T. A., Bartlett, S. J., Zemel, B., Verde, T. J., and Franckowiak, S.C. (1999). Effects of lifestyle activity vs structured aerobic exercise in obese women: A randomized trial. JAMA 281: 335–340.
Astrup, A., and Rossner, S. (2000). Lessons from obesity management programmes: Greater initial weight loss improves long-term maintenance. Obes. Rev. 1: 17–19.
Beck, A. T., and Steer, R. A. (1987).Manual for the Beck Depression Inventory, Psychological Corporation, New York.
Bjorvell, H., Aly, A., Langius, A., and Nordstrom, G. (1994). Indicators of changes in weight and eating behaviour in severely obese patients treated in a nursing behavioural program. Int. J. Obes. Relat. Metab. Disord. 18: 521–525.
Brownell, K.D. (1984). Behavioral, psychological, and environmental predictors of obesity and success at weight reduction. Int. J. Obes. 8: 543–550.
Brownell, K. D. (1997). The LEARN Program for Weight Control, American Health, Dallas,TX.
Brownell, K. D., and Kramer, F. M. (1994). Behavioral management of obesity. In Blackburn, G. L., and Kanders, B. S. (eds.), Obesity: Pathophysiology, Psychology, and Treatment, Chapman and Hall, New York.
Brownell, K. D., and Rodin, J. (1994). The dieting maelstrom. Is it possible and advisable to lose weight? Am. Psychol. 49: 781–791.
Brownell, K. D., and Wadden, T. A. (1991). The heterogeneity of obesity: fitting treatments to individuals. Behav. Ther. 22: 153–177.
Clark, M. M., Abrams, D. B., Niaura, R. S., Eaton, C. A., and Rossi, J. S. (1991). Self-efficacy in weight management. J. Consult. Clin. Psychol. 59: 739–744.
Clifford, P. A., Tan, S.Y., and Gorsuch, R. L. (1991). Efficacy of a self-directed behavioral health change program:Weight, body composition, cardiovascular fitness, blood pressure, health risk, and psychosocial mediating variables. J. Behav. Med. 14: 303–323.
Cooper, P. J., Taylor, M. J., Cooper, Z., and Fairburn, C. G. (1987). The development and validation of a body shape questionnaire. Int. J. Eat. Disord. 6: 485–494.
Dennis, K. E., and Goldberg, A. P. (1996). Weight control self-efficacy types and transitions affect weight-loss outcomes in obese women. Addict. Behav. 21: 103–116.
Dishman, R. K., and Ickes, W. (1981). Self-motivation and adherence to therapeutic exercise. J. Behav. Med. 4: 421–438.
Edell, B. H., Edington, S., Herd, B., O'Brien, R. M., and Witkin, G. (1987). Self-efficacy and self-motivation as predictors of weight loss. Addict. Behav. 12: 63–66.
Faith, M. S., and Allison, D. B. (1996). Assessment of psychological status among obese persons. In Thompson, J. K. (eds.), Body Image, Eating Disorders, and Obesity.An Integrative Guide for Assessment and Treatment, American Psychological Association, Washington, DC.
Faith, M. S., Allison, D. B., and Geliebter, A. (1997). Emotional eating and obesity: Theoretical considerations and practical recommendations. In Dalton, S. (eds.), Overweight and Weight Management: The Health Professional's Guide to Understanding and Practice, Aspen, Gaithersburg, MD.
Feuerstein, M., Papciak, A., Shapiro, S., and Tannenbaum, S. (1989). The weight loss profile: A biopsychosocial approach to weight loss. Int. J. Psychiatry. Med. 19: 181–192.
Fontaine, K. R., Cheskin, L. J., and Allison, D. B. (1997). Predicting treatment attendance and weight loss: Assessing the psychometric properties and predictive validity of the Dieting Readiness Test. J. Pers. Assess. 68: 173–183.
Foster, G. D., Wadden, T. A., Vogt, R. A., and Brewer, G. (1997). What is a reasonable weight loss? Patients’ expectations and evaluations of obesity treatment outcomes. J. Consult. Clin. Psychol. 65: 79–85.
Foster, G. D., Wadden, T. A., Swain, R. M., Stunkard, A. J., Platte, P., and Vogt, R. A. (1998). The Eating Inventory in obese women: Clinical correlates and relationship to weight loss. Int. J. Obes. Relat. Metab. Disord. 22: 778–785.
Glynn, S. M., and Ruderman, A. J. (1986). The development and validation of an eating self-efficacy scale. Cognit. Ther. Res. 10: 403–420.
Gormally, J., Black, S., Daston, S., and Rardin D. (1982). The assessment of binge eating severity among obese persons. Addict. Behav. 7: 47–55.
Jeffery, R.W., Drewnowski, A., Epstein, L. H., Stunkard, A. J., Wilson, G. T., Wing, R. R., and Hill, D. R. (2000). Long-term maintenance of weight loss: Current status. Health Psychol. 19: 5–16.
Kiernan, M., King, A. C., Kraemer, H. C., Stefanick, M. L., and Killen, J.D. (1998). Characteristics of successful and unsuccessful dieters: An application of signal detection methodology. Ann. Behav. Med. 20: 1–6.
Kolotkin, R. L., Head, S., Hamilton, M., and Tse, C. K. (1995). Assessing Impact of Weight on Quality of Life. Obes. Res. 3: 49–56.
Kolotkin, R. L., Head, S., and Brookhart, A. (1997). Construct validity of the Impact of Weight on Quality of Life Questionnaire. Obes. Res. 5: 434–441.
Kolotkin, R. L., Crosby, R. D., Kosloski, K. D., and Williams, G. R. (2001). Development of a brief measure to assess quality of life in obesity. Obes. Res. 9: 102–111.
Latner, J. D., Stunkard, A. J., Wilson, G. T., Jackson, M. L., Zelitch, D. S., and Labouvie, E. (2000). Effective long-term treatment of obesity: A continuing care model. Int. J. Obes. Relat. Metab. Disord. 24: 893–898.
Lohman, T., Roche, A., and Martorell, R. (1988). Anthropometric Standardization Manual, Human Kinetics, Champaign, IL.
Mazumdar, S., Liu, K. S., Houck, P. R., and Reynolds, C. F., 3rd. (1999). Intent-to-treat analysis for longitudinal clinical trials: Coping with the challenge of missing values. J. Psychiatr. Res. 33: 87–95.
Medicine, I. O. (1995). Weighing the Options: Criteria for EvaluatingWeight-Management Programs, National Academy Press, Washington, DC.
Miller, W. C., Koceja, D. M., and Hamilton, E. J. (1997). A meta-analysis of the past 25 years of weight loss research using diet, exercise or diet plus exercise intervention. Int. J. Obes. Relat. Metab. Disord. 21: 941–947.
Perri, M. G., Neza, A. M., and Viegener, B. J. (1992). Improving the Long-Term Management of Obesity: Theory, Research, and Clinical Guidelines, Wiley, New York.
Perri, M. G., Martin, D., Leermarkers, E. A., and Notelovitz, M. (1997). Effects of groupversus home-based exercise in the treatment of obesity. J. Consult. Clin. Psychol. 65: 278–285.
Prochaska, J.O., Norcross, J.C., Fowler, J. L., Follick, M.J., and Abrams, D.B. (1992). Attendance and outcome in a work site weight control program: Processes and stages of change as process and predictor variables. Addict. Behav. 17: 35–45.
Renjilian, D. A., Perri, M. G., Nezu, A. M., McKelvey, W. F., Shermer, R. L., and Anton, S. D. (2001). Individual versus group therapy for obesity: Effects of matching participants to their treatment preferences. J. Consult. Clin Psychol. 69: 717–721.
Rosenberg, M. (1965). Society and the Adolescent Self-Image, Princeton University Press, Princeton, NJ.
Rossi, J. S., Rossi, S. R., Velicer, W. F., and Prochaska, J. O. (1995). Motivational readiness to control weight. In Allison, D. B. (eds.), Handbook of Assessment Methods for Eating Behaviors andWeight-Related Problems: Measures, Theory, and Research, Sage, Thousand Oaks, CA.
Rossner, S. (1992). Factors determining the long-term outcome of obesity treatment. In Bjorntorp, P., and Brodoff, B. N. (eds.), Obesity, Lippincott, Philadelphia, PA.
Sallis, J. F., Haskell, W. L., Wood, P.D., Fortmann, S. P., Rogers, T., Blair, S.N., and Paffenbarger, R. S., Jr. (1985). Physical activity assessment methodology in the Five-City Project. Am. J. Epidemiol. 121: 91–106.
Sallis, J. F., Grossman, R. M., Pinski, R. B., Patterson, T. L., and Nader, P. R. (1987). The development of scales to measure social support for diet and exercise behaviors. Prev. Med. 16: 825–836.
Sallis, J. F., Pinski, M. A., Grossman, R. B., Patterson, T. L., and Nader, P. R. (1988). The development of self-efficacy scales for health-related diet and exercise behaviors. Health Educ. Res. 3: 283–292.
Schlundt, D. G., Taylor, D., Hill, J. O., Sbrocco, T., Pope-Cordle, J., Kasser, T., and Arnold, D. (1991). A behavioral taxonomy of obese female participants in a weight-loss program. Am. J. Clin. Nutr. 53: 1151–1158.
Secord, S., and Jourard, P. (1953). The appraisal of body cathexis: Body cathexis and the self. J. Consult. Psychol. 17: 343–347.
Serdula, M. K., Mokdad, A. H., Williamson, D. F., Galuska, D. A., Mendlein, J. M., and Heath, G. W. (1999). Prevalence of attempting weight loss and strategies for controlling weight. JAMA 282: 1353–1358.
Sherbourne, C. D., and Stewart, A. L. (1991). The MOS social support survey. Soc. Sci. Med. 32: 705–714.
St. Jeor, S. T. (ed.) (1997). Obesity Assessment: Tools, Methods, Interpretations, Chapman and Hall. New York.
Steinhardt, M. A., and Dishman, R. K. (1989). Reliability and validity of expected outcomes and barriers for habitual physical activity. J. Occup. Med. 31: 536–546.
Stunkard, A. J., and Messick, S. (1988). Eating Inventory Manual, Psychological Corporation, San Antonio, TX.
USDHHS (1996). Physical Activity and Health: A Report of the Surgeon General, USDHHS, Centers for Disease Control and Prevention, Atlanta, GA.
USDHHS (1998). Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults, NIH, National Heart, Lung, and Blood Institute, Bethesda, MD.
USDHHS (2000). The Practical Guide to the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults, NIH, National Heart, Lung, and Blood Institute, Bethesda, MD.
Wadden, T. A., and Foster, G. D. (2000). Behavioral treatment of obesity. Med. Clin. No. Am. 84: 441–461.
Wadden, T. A., and Letizia, K. A. (1992). Predictors of attrition and weight loss in patients treated by moderate to severe caloric restriction. In Wadden, T. A., and VanItallie, T. B. (eds.), Treatment of the Seriously Obese Patient, Guilford Press, New York.
Wadden, T. A., and Sarwer, D. B. (1999). Behavioral treatment of obesity: New approaches to an old disorder. In Goldstein, D. J. (ed.), The Management of Eating Disorders and Obesity, Humana Press, Totowa, NJ.
Wadden, T. A., Foster, G. D., Wang, J., Pierson, R. N., Yang, M. U., Moreland, K., Stunkard, A.J., and VanItallie, T. B. (1992). Clinical correlates of short-and long-term weight loss. Am. J. Clin. Nutr. 56: 271S–274S.
Ware, J., Snow, K., Kosinski, M., and Gandek, B. (1993). SF-36 Health Survey Manual and Interpretation Guide, New England Medical Center, Health Institute, Boston, MA.
Ware, J. E., Jr., and Kosinski, M. (2001). SF-36 Physical and Mental Health Summary Scales: A Manual for Users of Version 1, 2nd ed., Qualitymetric, Lincoln, RI.
Williamson, D. A., Davis, C. J., Bennett, S. M., Goreczny, A. J., and Gleaves, D. H. (1989).Development of a simple procedure for assessing body image disturbances. Behav. Assess. 15: 57–68.
Williamson, D. A., Gleaves, D. H., Watkins, P. C., and Schlundt, D. G. (1993). Validation of a self-ideal body size discrepancy as a measure of body size dissatisfaction. J. Psychol. Behav. Assess. 15(Suppl. 1): 57–68.
Williamson, D. A., and O'Neil, P. H. (1998). Behavioral and psychological correlates of obesity. In Bray, G. A., Bouchard, C., and James, W. P. T. (eds.), Handbook of Obesity, MarcelDekker, New York.
Wing, R. R. (1998). Beahavioral approaches to the treatment of obesity. In Bray, G. A., Bouchard, C., and James, W. P. T. (eds.), Handbook of Obesity, Marcel Dekker, New York.
Yass-Reed, E. M., Barry, N. J., and Dacey, C.M. (1993). Examination of pretreatment predictors of attrition in a VLCD and behavior therapy weight-loss program. Addict. Behav. 18: 431–435.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Teixeira, P.J., Going, S.B., Houtkooper, L.B. et al. Weight Loss Readiness in Middle-Aged Women: Psychosocial Predictors of Success for Behavioral Weight Reduction. J Behav Med 25, 499–523 (2002). https://doi.org/10.1023/A:1020687832448
Issue Date:
DOI: https://doi.org/10.1023/A:1020687832448