The challenges of implementing behaviour changes that lead to sustained weight management

Abstract

Summary Weight loss is a difficult journey often characterised by repeated faltering attempts. There are numerous approaches to weight management but they all involve changes in self‐management, eating or activity behaviour. Weight loss induces changes in physiological and emotional systems, which tend to pull people back to where they came from. At the present time, it is not clear how the rate, extent or type of weight loss impact on signalling systems that oppose weight loss. Dietary changes in behaviour appear to be more achievable for weight loss earlier in the weight loss journey, while physical activity becomes a critical adjunct to initial dietary changes for weight loss maintenance. A range of weight control behaviours characterises weight loss and weight loss maintenance. People successfully maintaining significant weight loss tend to control their appetite, do more physical activity and remain vigilant, to catch slips in behaviour that may lead to weight regain. There may be differing clusters of behaviours, which characterise weight loss compared with weight loss maintenance, and there appear to be different clusters of behaviours that characterise weight loss maintainers. To navigate from the journey of weight loss to one of habitual weight loss maintenance requires long‐term self‐management. Environments and programmes that support, nurture and facilitate long‐term behaviour change give people the capability, the opportunity and the motivation to navigate to a healthy weight.

Unconscious Agendas in the Etiology of Refractory Obesity and the Role of Hypnosis in Their Identification and Resolution:A New Paradigm for Weight-Management Programs or a Paradigm Revisited?

“…Secondly there is the growing problem of obesity, evidenced by Nguyen and El-Serag (2010), Hurt et al (2011), Zimmerman (2011 and many others, amongst all ages and all social levels of the population, many of whom have experienced the rigours of other, more conventional, diet and exercise based programmes, and who are aware of the low success for these in achieving long term sustainable weight loss benefits (Stubbs & Lavin, 2013;Barte et al, 2010). Many of these weight-troubled individuals may turn to hypnosis either as an "easy" option to their problems, or in a last, desperate attempt to find a weight loss method that will work for them.…”

“…Only scant attention may be directed towards emotional support and behavioural modification, and as a result perhaps, such programmes rarely achieve the long-term success that the organisers of such weight reduction programmes would wish (Lehnert et al, 2012: Chambers & Swanson, 2012Stubbs & Lavin, 2013). Increasingly therefore, such programmes are incorporating behavioural techniques such as motivational interviewing, relaxation and meditation, CBT and mindfulness into the structure of such programmes as a means of enhancing motivation, and Wing et al (2008) and Spahn et al (2010) have explored some of the behavioural factors which appear to mediate long-term maintenance of weight loss.…”

Undergraduate UK nutrition education might not adequately address weight management

“…Dietary restraint, locus of control and self-efficacy are all factors that have been identified in the literature (32,33,42,43) and were discussed repeatedly by participants. Self-monitoring, goal setting and coping have also been identified elsewhere (33,44) and were described by participants too.…”

“…While it is possible that the competency framework is purposefully brief, the weighting of the document appears to be shifted towards the sciences of food and nutrition rather than the socialscience concepts of nutrition and health-related behaviour. Nutrition encompasses many conditions that require sound knowledge of science (43) and weight management is only one small aspect of nutritional knowledge. The lack of detail about psychological and behavioural concepts contrasts markedly from core competency 1 (Science) and core competency 3 (Health and Wellbeing), which specified multiple and specific knowledge and skills to be embedded into curricula.…”

“…A holistic understanding of diet-related issues is perhaps essential to the effective treatment and prevention of many modern dietary challenges (8) . Overweight and obesity are important societal issues that are impacted by food choice and behaviour (43,46) ; food and eating are intertwined with behavioural and social factors that affect the antecedents and outcomes of consumption (8,34,42,43) . It should be recognised that the responsibility to embed and evidence the core competencies rests with the education providers and that the goal of the present research was to provide a constructive evaluation of the existing AfN criteria.…”