International Journal of Behavioral Medicine

, Volume 23, Issue 1, pp 84–93 | Cite as

Engagement in New Dietary Habits—Obese Women’s Experiences from Participating in a 2-Year Diet Intervention

  • Christina AhlgrenEmail author
  • Anne Hammarström
  • Susanne Sandberg
  • Bernt Lindahl
  • Tommy Olsson
  • Christel Larsson
  • Anncristine Fjellman-Wiklund



Dietary weight loss interventions most often result in weight loss, but weight maintenance on a long-term basis is the main problem in obesity treatment. There is a need for an increased understanding of the behaviour patterns involved in adopting a new dietary behavior and to maintain the behaviour over time.


The purpose of this paper is to explore overweight and obese middle-aged women’s experiences of the dietary change processes when participating in a 2-year-long diet intervention.


Qualitative semi-structured interviews with 12 overweight and obese women (54–71 years) were made after their participation in a diet intervention programme. The programme was designed as a RCT study comparing a diet according to the Nordic nutrition recommendations (NNR diet) and a Palaeolithic diet (PD). Interviews were analysed according to Grounded Theory principles.


A core category “Engagement phases in the process of a diet intervention” concluded the analysis. Four categories included the informants’ experiences during different stages of the process of dietary change: “Honeymoon phase”, “Everyday life phase”, “It’s up to you phase” and “Crossroads phase”. The early part of the intervention period was called “Honeymoon phase” and was characterised by positive experiences, including perceived weight loss and extensive support. The next phases, the “Everyday life phase” and “It’s up to you phase”, contained the largest obstacles to change. The home environment appeared as a crucial factor, which could be decisive for maintenance of the new dietary habits or relapse into old habits in the last phase called “Crossroads phase”.


We identified various phases of engagement in the process of a long-term dietary intervention among middle-aged women. A clear personal goal and support from family and friends seem to be of major importance for long-term maintenance of new dietary habits. Gender relations within the household must be considered as a possible obstacle for women engaging in diet intervention.


Dietary habits Engagement Experience Intervention Obese Qualitative study 



The authors would like to thank David Ekholm for valuable help with interviewing. This study was supported by grants from the Swedish Council for Working Life and Social Research (2006–0699 and 2010–0398), the Swedish Research Council (K2011-12237-15-6), the Swedish Heart and Lung Foundation, the County Council of Västerbotten, and Umeå University, Sweden.

Ethical standards

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation the Ethical Review Board at Umeå University, Umeå, Sweden (Dnr 07-034M) and with the Helsinki declaration of 1975 as revised in 2000. Informed consent was obtained from all informants for being included in the study.

Conflict of interest

The authors declare no conflict of interest.


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Copyright information

© International Society of Behavioral Medicine 2015

Authors and Affiliations

  • Christina Ahlgren
    • 1
    • 2
    Email author
  • Anne Hammarström
    • 2
    • 3
  • Susanne Sandberg
    • 3
  • Bernt Lindahl
    • 3
  • Tommy Olsson
    • 3
  • Christel Larsson
    • 4
    • 5
  • Anncristine Fjellman-Wiklund
    • 1
    • 2
  1. 1.Department of Community Medicine and Rehabilitation, PhysiotherapyUmeå UniversityUmeåSweden
  2. 2.Umeå Centre for Gender Studies in MedicineUmeå UniversityUmeåSweden
  3. 3.Department of Public Health and Clinical MedicineUmeå UniversityUmeåSweden
  4. 4.Department of Food and NutritionUmeå UniversityUmeåSweden
  5. 5.Department of Food and Nutrition, and Sport ScienceUniversity of GothenburgGothenburgSweden

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