Research
Qualitative Research
Similarities and Differences between Weight Loss Maintainers and Regainers: A Qualitative Analysis

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Abstract

Obesity is remarkably refractory to treatment. Despite a plethora of quantitative studies, little qualitative research has been conducted on the topic of weight loss maintenance. This study used six focus groups to explore which factors promoted or prevented maintaining weight loss among a diverse, urban population. Eligible participants were those who had intentionally lost ≥10% of their body weight in the past 2 years and were categorized as either “regainers” or “maintainers” using self-reported length of weight maintenance and amount (%) regained. Regainers had regained ≥33% of their weight loss and maintainers had regained ≤15%. Participants (n=29) were predominantly African-American (58.6%) females (65.6%) with a mean age of 46.9±11.2 years. Four themes reflected similarities between regainers and maintainers, and four reflected differences between the groups. Both groups experienced lapses, used clothing fit for feedback on weight status, desired greater support during maintenance, and decreased self-monitoring of food intake over time. When compared with regainers, maintainers more often continued strategies used during weight loss, weighed themselves regularly, and used productive problem-solving skills and positive self-talk. Regainers experienced greater difficulty independently continuing food and exercise behaviors during maintenance, identifying decreased accountability and waning motivation as barriers. These findings suggest that weight loss maintenance efforts can be improved by addressing challenges such as long-term self-monitoring and problem-solving skills, and that maintenance success might depend on how people think as much as what they do.

Section snippets

Study Design

Six focus groups were conducted. The guided but flexible small group discussion was chosen to encourage participants to interact with each other (20). There were four groups of regainers (n=4, 6, 2, and 7) and two of maintainers (n=4 and 6). Characteristics for the participants (n=29), by group, are described in Table 1. In this sample, the maintainers were more likely to be women and African American, weighed less at the time of the focus group, and achieved more weight loss, although the

Identifying Themes

Collectively, the reviewers identified a total of 1,490 weight loss maintenance-related comments from the transcripts, which were grouped into 420 codes. The master code list included 72 codes, which were collapsed into 8 themes and 24 quotes were selected to represent these themes. Four themes highlighted similarities between regainers and maintainers, and four highlighted differences between the groups (Table 2 and Figure).

Similarities

There were several reported similarities between the maintainers and

Discussion

This study revealed that people share similar experiences during weight loss maintenance, regardless of whether or not they maintain their weight loss, and are comparable with other qualitative findings, where a desire for support and setbacks or weight regain were common among both maintainers and regainers (17, 18, 19). The diminished lack of support over time is unfortunate but predictable. Losing weight and maintaining weight loss are two different processes (25). One process is time

Conclusions

These data provide insights into the characteristics of those who are successful and unsuccessful at maintaining weight loss. Additional research, using both qualitative and quantitative methods, should focus on both the “what” and “how” of weight loss maintenance. Without such information, weight loss followed by weight regain is likely to remain the norm.

N.R. Reyes is a senior health services coordinator, Center for Obesity Research and Education, Temple University, Philadelphia, PA.

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  • Cited by (0)

    N.R. Reyes is a senior health services coordinator, Center for Obesity Research and Education, Temple University, Philadelphia, PA.

    A. A. Klotz is a research analyst, Center for Obesity Research and Education, Temple University, Philadelphia, PA.

    S. S. Vander Veur is program director for Clinical Research, Center for Obesity Research and Education, Temple University, Philadelphia, PA.

    T. L. Oliver is director of the Didactic Program in Dietetics and an assistant professor, Immaculata University, Immaculata, PA. At the time of the study, T. L. Oliver was senior health services coordinators, Center for Obesity Research and Education, Temple University, Philadelphia, PA.

    A. Virus is a manager, Administration and Support Services Division of Food Services, School District of Philadelphia, Philadelphia, PA. At the time of the study, A. Virus was senior health services coordinators, Center for Obesity Research and Education, Temple University, Philadelphia, PA.

    C. A. LaGrotte is a doctoral student in clinical psychology, LaSalle University, Philadelphia, PA; at the time of the study, she was a clinical research coordinator, Center for Obesity Research and Education, Temple University, Philadelphia, PA.

    B. A. Bailer is a postdoctoral research fellow, Center for Weight and Eating Disorders, University of Pennsylvania, Philadelphia; at the time of the study, she was a psychology intern, Center for Obesity Research and Education, Temple University, Philadelphia, PA.

    G. D. Foster is director, Center for Obesity Research and Education, and a professor, Departments of Medicine and Public Health, Temple University, Philadelphia, PA.

    STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.

    FUNDING/SUPPORT This research project was funded by a private and anonymous donor, without influence over the acquisition, analysis, or interpretation of data, and without commercial interest in the outcome of the project.

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