Nearly half of patients with eating disorders who denied a need for treatment on admission converted to acknowledging that they needed to be admitted within 2 weeks of hospitalization. Since treatment avoidance is associated with poor outcome, these findings suggest a need for studies assessing the long-term outcome and ethics of pressuring patients with eating disorders into treatment.

ObjectiveTo develop and validate the Weight Control Strategies Scale (WCSS), a self-report instrument to assess use of specific behaviors thought to facilitate weight loss.Design and MethodsFactor analysis was conducted on 323 overweight and obese adults (mean age=48.7±10.9 years, mean BMI=35.4±4.9 kg/m2, 74% female) enrolled in three different behavioral weight loss trials who completed the WCSS prior to starting treatment. To evaluate construct validity, additional data on dietary intake, physical activity, treatment session attendance, and weight change were obtained from a subsample of participants before and after participation in a 48-week weight loss program.ResultsPrincipal components analysis with varimax rotation revealed a four component solution for the WCSS, representing the following subscales: Dietary Choices, Self-monitoring Strategies, Physical Activity, and Psychological Coping (a’s from 0.79–0.89). Longitudinal analyses showed that WCSS subscale scores increased during treatment (p’s <0.01). In adjusted models, changes in WCSS total and subscale scores were associated with posttreatment weight loss (p’s <0.01). Additionally, changes in WCSS Dietary Choices and Physical Activity subscales were related to posttreatment changes in total daily kilocalorie consumption (p=0.019) and weekly kilocalorie expenditure through physical activity (p<0.001), respectively.ConclusionsFindings support the validity and reliability of the WCSS in a weight loss treatment seeking sample.

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