Natural Weight Loss Recovery from Obesity
Even though many types of obesity treatment programs are ineffective, some individuals successfully resolve their weight problems without professional help (Garner & Wooley, 1991). Very little is known about the natural recovery process, including what motivates people to successfully lose weight, what deters help-seeking and what behavior change strategies are most effective. This information could be very helpful in improving obesity treatment interventions as well as reducing barriers to finding help.
For example, we know from the field of substance abuse and addictions (which are much better researched), that current treatments are often perceived as stigmatizing and ineffective (Cunningham, Sobell, Sobell, Agrawal, & Toneatto, 1993). Moreover, psychosocial variables can play a strong role in motivating or deterring one from seeking help (George & Tucker, 1996), and lasting behavior change often occurs over several years and can be supported by changing environmental conditions (Tucker, Vuchinich, & Pukish, 1995).
So, help seeking among substance users is more strongly linked to psychosocial problems than demographics or substance use patterns. Also, recovery is often associated with increased problems pre-treatment and improved functioning post-treatment, such as interpersonal relationship or physical and mental health (Tucker et al., 1995).
Weight Loss Study
The study that this blog post is referring to is a retrospective investigation of motivations for weight loss and behavior change strategies associated with natural recovery from obesity. The data was gathered from a group of previously obese but currently normal-weight individuals as well as an untreated group of obese individuals, who were serving as controls to identify what specifically helped recovery in the first group. Participants in both groups had a past or present weight problem of at least 4 years in duration. The recovered participants had maintained a normal weight (=-10% of ideal weight) for at least 1 year and a mean of 4.5 years.
Thus, recovered participants have maintained their weight loss results for a substantial amount of time. The two groups were similar in terms of the age of onset (early adulthood), problem duration, past weight loss attempts, weight-related health problems, and number of pregnancies for women. Both groups also had an original BMI of above 30, which exceeds the cutpoint for obesity; however, recovered participants had a somewhat lower BMI than controls. Participants were interviewed in person and were asked about three main topics – weight loss methods (15 weight loss methods including behavioral strategies, diets, use of drugs), motivations for and influences on weight loss (18 factors such as role of significant other and family members, changes in social activities, physical health), and treatment barriers (27 potential reasons why participants did not seek treatment). The researchers also interviewed participants’ family members and friends to verify participants’ claims.
Weight Loss Strategy Findings
Interestingly, the results on what methods successful participants used to lose weight are not surprising. Significantly greater exercise and increased intake of vegetables, fruits and fiber distinguished formed failed weight loss attempts and successful long-term ones. Furthermore, recovered participants were more likely to eat slowly and reduce snacking compared to the control group. Even though many control group participants used exercise previously as a weight-loss strategy, only successful participants continued to exercise at least at 50% of their original level after losing weight.
In terms of the motivational factors for losing weight, problems related to appearance (e.g.: problems with clothes) and negative emotional states (low self-esteem, unhappiness) scored the highest. These were followed by concerns about future health, wanting to be healthier now, and family histories of illness and obesity. Men were actually significantly more likely to report health problems or health concerns as motivation to lose weight. Also, many participants cited social problems and intimate relationships as motivating factors.
When it comes to weight loss maintenance, it seems that relationship difficulties and changes in living arrangements can hinder maintenance, although positive changes in these categories also help weight loss efforts both in the short- and long-run. Finally, the main reason why participants would not seek help is the belief that they could do just as well on their own as with treatment. Other barriers are treatment cost, negative attitudes toward treatment, embarrassment related to treatment procedures (being weighed and measured, disclosing food intake, exercising in front of others), and believing that one’s weight problem is not serious enough for treatment.
Obesity Treatment and Weight Loss Conclusions
According to current findings, weight loss can be achieved and maintained by following behavioral change strategies (Schachter, 1982). Obesity treatment programs need to understand what motivates people to want to lose weight for the long term and what contextual variables can help this, often lengthy, process. Further studies are necessary to understand what aids natural weight loss and how to incorporate those elements into treatment models.
Weight Loss References
Tinker, J.E. & Tucker, J.A. (1997). Motivations for weight loss and behavior change strategies associated with natural recovery from obesity. Psychology of Addictive Behaviors, 11, 98-106.
Garner, D. M., & Wooley, S. C. (1991). Confronting the failure of behavioral and dietary treatments for obesity. Clinical Psychology Review, 11, 729—780.
Cunningham, J. A., Sobell, L. C., Sobell, M. B., Agrawal, S., & Toneatto, T. (1993). Barriers to treatment: Why alcohol and drug abusers delay or never seek treatment. Addictive Behaviors, 18, 347-353.
Tucker, J. A., Vuchinich, R. E., & Pukish, M. M. (1995). Molar environmental contexts surrounding recovery from alcohol problems by treated and untreated problem drinkers. Experimental and Clinical Psychopharmacology, 3, 195-204.
Tucker, J. A. (1995). Predictors of help-seeking and the temporal relationship of help to recovery among treated and untreated recovered problem drinkers. Addiction, 90, 805-809.
Schachter, S. (1982). Recidivism and self-cure of smoking and obesity. American Psychologist, 37, 436-444.