A review of psychosocial pre‐treatment predictors of weight control

Abstract

Prompted by the large heterogeneity of individual results in obesity treatment, many studies have attempted to predict weight outcomes from information collected from participants before they start the programme. Identifying significant predictors of weight loss outcomes is central to improving treatments for obesity, as it could help professionals focus efforts on those most likely to benefit, suggest supplementary or alternative treatments for those less likely to succeed, and help in matching individuals to different treatments. To date, however, research efforts have resulted in weak predictive models with limited practical usefulness. The two primary goals of this article are to review the best individual-level psychosocial pre-treatment predictors of short- and long-term (1 year or more) weight loss and to identify research needs and propose directions for further work in this area. Results from original studies published since 1995 show that few previous weight loss attempts and an autonomous, self-motivated cognitive style are the best prospective predictors of successful weight management. In the more obese samples, higher initial body mass index (BMI) may also be correlated with larger absolute weight losses. Several variables, including binge eating, eating disinhibition and restraint, and depression/mood clearly do not predict treatment outcomes, when assessed before treatment. Importantly, for a considerable number of psychosocial constructs (e.g. eating self-efficacy, body image, self-esteem, outcome expectancies, weight-specific quality of life and several variables related to exercise), evidence is suggestive but inconsistent or too scant for an informed conclusion to be drawn. Results are discussed in the context of past and present conceptual and methodological limitations, and several future research directions are described.

Expectations Are More Predictive of Behavior than Behavioral Intentions: Evidence from Two Prospective Studies

“…Consistent with research conducted in the West, greater initial weight loss was the dominant predictor of sustained weight loss (17).…”

An investigation of psychological, social and environmental correlates of obesity and weight gain in young women

“…This supports the conclusions made in a recent comprehensive review of the correlates of weight loss in treatment populations, in which an autonomous, self-motivated cognitive style was one of the strongest predictors of successful weight management. 32 On the whole, however, there were relatively few strong associations between the variables examined in this study and either BMI or 2-year weight change, as indicated by the large number of nonsignificant findings and the relatively modest effect sizes observed. This was particularly the case with correlates of weight change.…”

Application of the Theory of Planned Behaviour to weight control in an overweight cohort. Results from a pan-European dietary intervention trial (DiOGenes)

“…This disequilibrium can arise from an excess in calorie intake and/or a deficit in calorie expenditure (lack of physical activity). However, obesity is recognised as a heterogeneous condition and it is accepted that large individual differences in people's ability to control their body weight exist (Schifter & Ajzen, 1985;Teixeira, Going, Sardinha, & Lohman, 2005). Individual differences in behaviours closely related to energy balance or weight control, determine the development of overweight and obesity.…”