Original Article

Annals of Behavioral Medicine

, Volume 38, Issue 2, pp 94-104

First online:

What Distinguishes Weight-Loss Maintainers from the Treatment-Seeking Obese? Analysis of Environmental, Behavioral, and Psychosocial Variables in Diverse Populations

  • Suzanne PhelanAffiliated withDepartment of Kinesiology, California Polytechnic State UniversityDepartment of Psychiatry and Human Behavior, Brown University Email author 
  • , Tao LiuAffiliated withDepartment of Community Health, Center for Statistical Sciences, Brown University
  • , Amy GorinAffiliated withDepartment of Psychology, University of Connecticut
  • , Michael LoweAffiliated withDepartment of Psychology, Drexel University
  • , Joseph HoganAffiliated withDepartment of Community Health, Center for Statistical Sciences, Brown University
  • , Joseph FavaAffiliated withThe Miriam Hospital, Weight Control and Diabetes Research Center
  • , Rena R. WingAffiliated withDepartment of Psychiatry and Human Behavior, Brown UniversityThe Miriam Hospital, Weight Control and Diabetes Research Center

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Abstract

Background

Understanding the factors that influence successful weight control is critical for developing interventions.

Purpose

The purpose of the study was to provide a comprehensive understanding of the role of psychosocial, environmental, and behavioral variables in distinguishing weight-loss maintainers (WLM) from treatment-seeking obese (TSO).

Methods

WLM (n = 167) had lost ≥10% of their maximum body weight, had kept the weight off for ≥5 years, and were now of normal weight. TSO-1 and TSO-2 had a history of dieting and body mass index ≥25. TSO-1 was predominantly Caucasian; TSO-2 was predominantly African-American. Bayesian model averaging was used to identify the variables that distinguished WLM from TSO-1 and TSO-2.

Results

The variables that most consistently discriminated WLM from TSO were more physical activity (ORs = 3.95 and 2.85), more dietary restraint (ORs = 1.63 and 1.41), and less dietary disinhibition (ORs = 0.69 and 0.83). Environmental variables, including the availability of physical activity equipment, TVs, and high-fat foods in the home, also distinguished WLM from TSO.

Conclusions

Obesity treatment should focus on increasing conscious control over eating, engaging in physical activity, and reducing disinhibition. Changes in the home environment may help facilitate these behavioral changes.

Keywords

Multiple health behaviors Weight control Successful weight losers Diverse populations