Elsevier

Behavior Therapy

Volume 45, Issue 5, September 2014, Pages 700-707
Behavior Therapy

Evidence That a Very Brief Psychological Intervention Boosts Weight Loss in a Weight Loss Program

https://doi.org/10.1016/j.beth.2014.04.001Get rights and content

Highlights

  • Greater initial weight loss is predictive of greater long-term weight loss

  • Boosting initial weight loss could have beneficial effects on maintenance

  • This research tests a brief novel theory-based psychological intervention to promote weight loss in a sample already receiving treatment

  • Results show that the intervention significantly reduced weight over and above the effects of the weight loss program

  • This brief psychological intervention could serve as an adjunct to standard weight loss programs

Abstract

Reducing morbidity and mortality associated with being overweight is a crucial public health goal. The aim of the present research was to test the efficacy of a very brief psychological intervention (a volitional help sheet) that could be used as an adjunct to standard weight loss programs to support increased weight loss in an overweight sample. Seventy-two overweight participants currently participating in a weight loss program were randomly allocated to either an intervention (volitional help sheet) condition or a control (distracter task) condition. The main outcome measure was weight at 1-month follow-up. Participants in both conditions lost significant amounts of weight, but those in the intervention condition lost significantly more than those in the control condition (d = 0.66). The findings support the efficacy of the volitional help sheet to promote additional weight loss in an overweight sample engaged in a weight loss program. The volitional help sheet therefore represents a very brief, low-cost intervention that could be used to supplement ongoing weight-loss programs.

Section snippets

Implementation Intentions

Implementation intentions (Gollwitzer, 1993) are “if-then” plans that promote health behavior change by encouraging people to link in memory a critical situation (“if”) with an appropriate response (“then”). Laboratory studies show that specifying the “if” component of an implementation intention enhances the accessibility of critical situations and that linking “if” with “then” automates the response specified in the “then” component (see Gollwitzer & Sheeran, 2006). For example, one possible

Participants

In order to maximize the ecological validity of the study, the sample was recruited from people who were already enrolled on a commercial weight loss program in the north of England. A trained consultant delivered the commercial weight loss program. Participants stay in the program for as long as they wish and meet on a weekly basis at a cost of approximately $8 per week. People receive one-to-one advice as well as group sessions organized by the consultant. The sessions were oriented around

Randomization Check

Examining whether there were prerandomization differences in age, gender, BMI, height, weight, number of serious weight loss attempts, duration of program membership, and behavioral intention between the intervention and control groups served as a randomization check. All the tests were nonsignificant, meaning randomization was achieved (Table 1).

Effects of the Volitional Help Sheet

There was no significant main effect of condition, F(1, 70) = 0.40, p = .531, but there was a main effect of time, F(1, 62) = 177.03, p < .001, with

Summary

This is the first study to have tested a volitional help sheet in overweight people seeking to reduce their weight. The key finding was that the volitional help sheet—a very brief psychological intervention—was effective in significantly increasing weight loss, over and above the effects of ongoing weight management program. The results also extend the literature on the volitional help sheet by investigating weight loss and using an objective outcome measure in a clinical sample. The following

Conclusion

The present study reports a test of the efficacy of a very brief psychological intervention to enhance ongoing weight reduction efforts. The volitional help sheet was successful in increasing weight loss, with a medium-large effect size despite the brevity of the intervention. The volitional help sheet represents a very brief, low-cost intervention that could be used to supplement ongoing weight-loss programs.

Conflict of Interest Statement

The authors declare that there are no conflicts of interest.

References (22)

  • P.M. Gollwitzer et al.

    Implementation intentions and goal achievement: A meta-analysis of effects and processes

    Advances in Experimental Social Psychology

    (2006)
  • A. Andrés et al.

    The transtheoretical model in weight management: Validation of the process of change questionnaire

    Obesity Facts

    (2011)
  • M.A. Arden et al.

    A volitional help sheet to reduce binge drinking in students: A randomized exploratory trial

    Alcohol and Alcoholism

    (2012)
  • C.J. Armitage

    Can the theory of planned behavior predict the maintenance of physical activity?

    Health Psychology

    (2005)
  • C.J. Armitage

    A volitional help sheet to encourage smoking cessation: A randomized exploratory trial

    Health Psychology

    (2008)
  • C.J. Armitage

    Effectiveness of experimenter-provided and self-generated implementation intentions to reduce alcohol consumption in a sample of the general population: A randomized exploratory trial

    Health Psychology

    (2009)
  • C.J. Armitage et al.

    A volitional help sheet to increase physical activity in people with low socioeconomic status: A randomized exploratory trial

    Psychology and Health

    (2010)
  • C.J. Armitage et al.

    A volitional help sheet to reduce alcohol consumption in the general population: A field experiment

    Prevention Science

    (2012)
  • Cancer Prevention Center

    Weight control: Processes of change

  • J. Chapman et al.

    Evidence that boosters augment the long-term impact of implementation intentions on fruit and vegetable intake

    Psychology and Health

    (2010)
  • J. Chapman et al.

    Comparing implementation intention interventions in relation to young adults’ intake of fruit and vegetables

    Psychology and Health

    (2009)
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