What distinguishes weight-loss maintainers from the treatment-seeking obese? Analysis of environmental, behavioral, and psychosocial variables in diverse populations

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. © 2009 The Society of Behavioral Medicine.