What distinguishes weight-loss maintainers from the treatment-seeking obese? Analysis of environmental, behavioral, and psychosocial variables in diverse populations.
BACKGROUND
Understanding the factors that influence successful weight control is critical for developing interventions.


OBJECTIVE
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 > or =10% of their maximum body weight, had kept the weight off for > or =5 years, and were now of normal weight. TSO-1 and TSO-2 had a history of dieting and body mass index > or =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.
Department of Kinesiology, California Polytechnic State University, 1 Grand Avenue, San Luis Obispo, CA 93401, USA. sphelan@calpoly.edu
Suzanne
S
Phelan
Tao
T
Liu
Amy
A
Gorin
Michael
M
Lowe
Joseph
J
Hogan
Joseph
J
Fava
Rena R
RR
Wing
D001741:Black or African American / Q000523:psychology; D000704:Analysis of Variance; D001294:Attitude to Health; D001828:Body Image; D001835:Body Weight; D003863:Depression / Q000175:diagnosis; D004032:Diet / Q000523:psychology; D015444:Exercise / Q000523:psychology*; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D005518:Food Preferences / Q000523:psychology; D015438:Health Behavior; D006801:Humans; D008297:Male; D009765:Obesity / Q000523:psychology* / Q000628:therapy; D018579:Patient Selection; D010809:Physical Fitness / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life / Q000523:psychology; D012944:Social Support; D011795:Surveys and Questionnaires; D015431:Weight Loss; D044465:White People / Q000523:psychology