Personal motivation, self-regulation barriers and strategies for weight loss in people with overweight and obesity: a thematic framework analysis

Abstract

Objective: To explore motivations, self-regulation barriers, and strategies in a multi-ethnic Southeast Asian population with overweight and obesity. Design: Qualitative design using semi-structured face-to-face and videoconferencing interviews. Data was analyzed using thematic framework analysis and constant comparison method. Setting: Specialist weight management clinic. Participants: 22 participants were purposively sampled from 13 April to 30 April 2021. Median age and BMI of the participants was 37.5 (interquartile range [IQR] = 13.3) and 39.2 kg/m2 (IQR = 6.1) respectively. 31.8% were men, majority had a high intention to adopt healthy eating behaviors (median = 6.5; IQR = 4.8-6.3) and 59% of the participants had a medium level of self-regulation. Results: Six themes and fifteen subthemes were derived. Participants were motivated to lose weight by (1) the sense of responsibility as the family’s pillar of support and (2) to feel “normal” again. We coupled self-regulation barriers with corresponding strategies to come up with four broad themes – (3) habitual overconsumption – mindful self-discipline; (4) proximity and convenience of food available – mental tenacity; (5) momentary lack of motivation and sense of control – motivational boosters; (6) overeating triggers – removing triggers. We highlighted six unique overeating triggers namely trigger activities (e.g. using social media); eating with family, friends, and colleagues; provision of food by someone; emotions (e.g. feeling bored at home, sad and stressed); physiological condition (e.g. premenstrual syndrome); and the time of the day. Conclusions: Future weight management interventions should consider encompassing participant-led weight loss planning, motivation boosters, and self-regulation skills to cope with momentary overeating triggers.

Sustainability of Weight Loss Through Smartphone Apps: Systematic Review and Meta-analysis on Anthropometric, Metabolic, and Dietary Outcomes

“…As weight management is an integral aspect of population health, we should not be typecasting or identifying people with overweight and obesity for weight management but empowering people with the skills and resources to manage their weight independently. This is especially because of the global weight gain observed during the COVID-19 pandemic [ 47 ], which could be associated with varying levels of personal motivation [ 5 ], peer influence [ 48 ], and self-regulation [ 49 ]. Although many purchased home gym equipment during this period, the sustained use of such equipment without peer influence or health coaching may not have been high.…”

“…A weight reduction of 5%-10% has been shown to lower the risk of cardiometabolic diseases by improving cardiometabolic measures such as high waist circumference, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), high blood glucose level, and high blood pressure [ 4 ]. However, weight loss through behavioral modification remains challenging because of the lack of self-regulation and motivation [ 5 ].…”

Weight‐loss interventions for improving emotional eating among adults with high body mass index: A systematic review with meta‐analysis and meta‐regression

“…While typical weight management programs behaviour have been effective in promoting weight loss through caloric restrictions and increased physical activity (Gudzune et al., 2015), participants of such programs were shown to regain more than 80% of the weight lost within 5 years (Anderson et al., 2001). Such weight cycling has been associated with covert behavioural factors such as emotional eating (Braden et al., 2016; Chew et al., 2022), a behaviour that is commonly unaddressed in conventional weight‐loss programmes.…”

Effectiveness of Combined Health Coaching and Self-Monitoring Apps on Weight-Related Outcomes in People With Overweight and Obesity: Systematic Review and Meta-analysis

“…Although one study reported improved outcomes when health coaching was used in addition to a smartphone app, the sample in each group was small, undermining the study’s reliability [ 46 , 47 ]. Interventional effects may also be influenced by personal intention, motivation [ 48 ], socioenvironmental resources, and interventional engagement for weight loss [ 49 ]. We also found intraprogram variations in health-coaching programs.…”