Weight Management in Post-Menopausal Women: A Mixed-Methods Approach

Abstract

The percentage of obese adults in the U.S. has more than doubled since the late 1970.s. A large percentage of adults, especially women, are trying to lose weight at any given time. Although recommended weight-loss strategies combine reduced caloric intake with physical activity, the actual strategies used can vary. This dissertation uses a mixed-methods approach to investigate weight, weight loss, and body image in post-menopausal women ages 50 to 64. Quantitative data were analyzed from the National Health and Nutrition Examination Survey (NHANES) and semi-structured interviews with 81 women in Kentucky. Qualitative data was gathered from in-depth interviews with eight Kentucky women focusing on life-course factors that affect weight and perception of weight. Over 70% of the Kentucky subjects had attempted weight loss in the last year; 47% of the NHANES women had done so. The most common weight-loss strategies of the Kentucky sample were .ate less food. and .exercised.; in the NHANES samples, the most common choices were .ate less food. and .ate less fat.. In the Kentucky sample, feeling that one is in control of one.s own weight was associated with having joined a weight loss program. Exercise and restaurant frequency and were the most significant predictors of the weight outcomes investigated. Increased exercise was associated with an increased likelihood of being normal weight, gaining less than 10 pounds in the last 10 years, and gaining less than 30 pounds since age 25; decreased restaurant frequency was associated with all of these outcomes in the Kentucky sample. The in-depth interviews revealed that making good food choices, having others as role models, and the desire to be attractive were seen as positive influences on weight. The consumption of .bad. foods, stress, health problems that prevent exercise, menopause, and age were seen as negative influences. The qualitative data also strongly suggested that childhood weight, and past reactions of others to one.s weight, influence perception of current weight. It is the responsibility of women and the public health sector to make the most of these acknowledged motivators and minimize the perceived barriers to reverse the increasing obesity levels in the U.S.