Weight Loss in Postmenopausal Women

weight loss clinic

Self-Efficacy Targeted Treatments for Weight Loss in Postmenopausal Women

Matching behavioral treatment programs to different types of obese clients is a rarely studied strategy, thus guidelines for identifying who might benefit most from which program remain elusive. This study categorized the weight control self-efficacy beliefs of obese, postmenopausal women, and determined the effects of self-efficacy targeted versus non-targeted (control) treatment on weight loss outcomes (body habitus, physical conditioning, affect, and eating behaviors). Obese (BMI 33 ± 5), postmenopausal (60 ± 6 years old) women (n = 59) participated in a 6-month weight loss program. The 37 women categorized by Q methodology as Assured (self-confident, independent) were randomized to Assured (AT) or Non-Targeted (NT) treatment; the 22 Disbelievers (doubtful, wavering) were randomized to Disbeliever (DT) or NT treatment. At baseline, the Assured had significantly smaller body girths and reported significantly greater self-esteem, fewer symptoms of binge eating, and less negative affect overeating than the Disbelievers. Improvement in these variables with weight loss erased significant differences between the groups and was the desired outcome. Treatment delivery type may have influenced attrition rate since significantly more Assured dropped from NT than AT and significantly more Disbelievers dropped from DT than NT. Thus, the self-efficacy type may serve as a means to identify different types of treatment needs (flexible vs. rigid) to sustain women's adherence and success in the program. The significant weight loss outcomes for women in all groups argue for the incorporation of strategies to enhance self-efficacy but not the need for specific treatments that directly target self-efficacy types.

weight loss clinic

The effectiveness of obesity treatment programs has improved in the last decade largely due to multi-faceted refinements (Brownell & Wadden, 1992) and longer interventions (Goodrick & Foreyt, 1991; Perri, Nezu, Patti, & McCann, 1989; Wadden & Bell, 1990). Nevertheless, epidemiological evidence indicates increased prevalence of obesity across time (Flegal, Carroll, Kuczmarski, & Johnson, 1998; Kuczmarski, Flegal, Campbell, & Johnson, 1994) and the persistence of obesity in nearly 34% of American women (Kuczmarski et al., 1994), rising with the individual's chronological age (Williamson, Kahn, Remington, & Anda, 1990). This increased prevalence of obesity despite improved treatments remains an unsolved paradox; hence, there is a quest to develop even more effective approaches for its treatment. Matching behavioral treatment programs to different types of obese clients is a rarely studied strategy, despite its inherent appeal. Thus, guidelines for identifying which individual might benefit most from which program remain elusive.
One widely promulgated but underinvestigated strategy involves matching individuals and programs according to the degree of overweight in an attempt to limit cost, risk, and intensity of approach (Brownell & Wadden, 1991). Another promising, yet underinvestigated, approach involves the targeted enhancement of self-efficacy. Self-efficacy, the belief in one's ability to successfully accomplish particular behaviors, is a major determinant of one's choice of activities, as well as the amount of effort and length of time expended in their pursuit (B andura, 1977, 1997). Although several investigators have demonstrated positive relationships between self-efficacy and weight loss (Dennis & Goldberg, 1996; Edell, Edington, Herd, O'Brien, & Witkin, 1987; Jeffery et al., 1984), data were correlational. The theoretical underpinnings of self-efficacy have not been foundational to the design and evaluation of weight loss treatments.
Early studies of weight control that explored the role of self-efficacy tended to passively measure, rather than actively manipulate, this phenomenon. For example, positive associations between self-efficacy and weight loss have been observed during interventions (Bernier & Poser, 1984; Edell, Edington, Herd, O'Brien, & Witkin, 1987; Stotland & Zuroff, 1991; Strecher, DeVellis, Becker, &  Rosenstock, 1986)

source: Dennis, Karen E. PhD, Rn, Faan, Tomoyasu, Naomi PhD, McCrone, Susan H. PhD, Rn, Goldberg, Andrew P. Md, Bunyard, Linda Rd, Ld, Qi, Bing Bing Ms, Scholarly Inquiry for Nursing Practice

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