School of Psychology and Counselling, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD 4059, Australia.
BMC Public Health. 2012 Dec 18;12:1086. doi: 10.1186/1471-2458-12-1086.
Dieting has historically been the main behavioural treatment paradigm for overweight/obesity, although a non-dieting paradigm has more recently emerged based on the criticisms of the original dieting approach. There is a dearth of research contrasting why these approaches are adopted. To address this, we conducted a qualitative investigation into the determinants of dieting and non-dieting approaches based on the perspectives and experiences of overweight/obese Australian adults.
Grounded theory was used inductively to generate a model of themes contrasting the determinants of dieting and non-dieting approaches based on the perspectives of 21 overweight/obese adults. Data was collected using semi-structured interviews to elicit in-depth individual experiences and perspectives.
Several categories emerged which distinguished between the adoption of a dieting or non-dieting approach. These categories included the focus of each approach (weight/image or lifestyle/health behaviours); internal or external attributions about dieting failure; attitudes towards established diets, and personal autonomy. Personal autonomy was also influenced by another category; the perceived knowledge and self-efficacy about each approach, with adults more likely to choose an approach they knew more about and were confident in implementing. The time perspective of change (short or long-term) and the perceived identity of the person (fat/dieter or healthy person) also emerged as determinants of dieting or non-dieting approaches respectively.
The model of determinants elicited from this study assists in understanding why dieting and non-dieting approaches are adopted, from the perspectives and experiences of overweight/obese adults. Understanding this decision-making process can assist clinicians and public health researchers to design and tailor dieting and non-dieting interventions to population subgroups that have preferences and characteristics suitable for each approach.
节食一直是超重/肥胖的主要行为治疗模式，尽管最近基于对原始节食方法的批评，出现了一种非节食模式。缺乏研究对比这些方法被采用的原因。为了解决这个问题，我们根据超重/肥胖的澳大利亚成年人的观点和经验，对节食和非节食方法的决定因素进行了定性调查。
采用扎根理论，根据 21 名超重/肥胖成年人的观点，对节食和非节食方法的决定因素进行对比，生成一个主题模型。使用半结构化访谈收集数据，以引出个人的深入经验和观点。
出现了几个类别，这些类别区分了节食和非节食方法的采用。这些类别包括每种方法的重点（体重/形象或生活方式/健康行为）；对节食失败的内部或外部归因；对既定饮食的态度，以及个人自主权。个人自主权也受到另一个类别的影响；对每种方法的知识和自我效能的感知，成年人更有可能选择他们了解更多并对实施有信心的方法。改变的时间视角（短期或长期）和被感知的人的身份（胖/节食者或健康人）也分别成为节食或非节食方法的决定因素。
从超重/肥胖成年人的观点和经验中，本研究得出的决定因素模型有助于理解为什么会采用节食和非节食方法。了解这一决策过程可以帮助临床医生和公共卫生研究人员为有偏好和适合每种方法特点的人群设计和定制节食和非节食干预措施。
