MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
Fakenham Medical Practice, Norfolk, UK.
Clin Obes. 2020 Oct;10(5):e12395. doi: 10.1111/cob.12395. Epub 2020 Aug 7.
While many behavioural weight management programmes are effective in the short-term, post-programme weight regain is common. Overcoming "lapses" and preventing "relapse" has been highlighted as important in weight-loss maintenance, but little is known on how this is achieved. This study aimed to compare the cognitive and behavioural strategies employed to overcome "lapses" and prevent "relapse" by people who had regained weight or maintained weight-loss after participating in a weight management programme. By investigating differences between groups, we intended to identify strategies associated with better weight-loss maintenance. Semi-structured interviews were conducted with 26 participants (58% female) recruited from the 5-year follow-up of the Weight Loss Referrals for Adults in Primary Care (WRAP) trial (evaluation of a commercial weight-loss programme). Participants who had lost ≥5% baseline weight during the active intervention were purposively sampled according to 5-year weight trajectories (n = 16 'Regainers', n = 10 'Maintainers'). Interviews were audio-recorded, transcribed verbatim, and analysed thematically. Key differences in strategies were that Maintainers continued to pay attention to their dietary intake, anticipated and planned for potential lapses in high-risk situations, and managed impulses using distraction techniques. Regainers did not report making plans, used relaxed dietary monitoring, found distraction techniques to be ineffective and appeared to have difficulty navigating food within interpersonal relationships. This study is one of the longest qualitative follow-ups of a weight loss trial to date, offering unique insights into long-term maintenance. Future programmes should emphasize strategies focusing on self-monitoring, planning and managing interpersonal relationships to help participants successfully maintain weight-loss in the longer-term.
虽然许多行为体重管理方案在短期内有效，但方案后体重反弹很常见。在体重维持中，克服“失误”和预防“复胖”已被强调为重要的，但对于如何实现这一点知之甚少。本研究旨在比较参与体重管理方案后体重反弹或维持体重减轻的人在克服“失误”和预防“复胖”时所采用的认知和行为策略。通过比较组间差异，我们旨在确定与更好的体重维持相关的策略。从体重减轻参考成年人初级保健（WRAP）试验的 5 年随访中（对商业体重减轻方案的评估）招募了 26 名参与者（58%为女性）进行半结构式访谈。根据 5 年体重轨迹（n = 16“复胖者”，n = 10“维持者”），按照参与者在积极干预期间体重减轻≥5%的基线体重有目的地抽取参与者。访谈进行了录音、逐字转录，并进行了主题分析。策略方面的主要差异在于维持者继续关注自己的饮食摄入，预计并计划在高风险情况下出现失误，并使用分散注意力的技巧来控制冲动。复胖者没有报告制定计划，饮食监测较为放松，发现分散注意力的技巧无效，并且在处理人际关系中的食物时似乎有困难。本研究是迄今为止对减肥试验进行的最长的定性随访之一，为长期维持提供了独特的见解。未来的方案应强调侧重于自我监测、计划和管理人际关系的策略，以帮助参与者在更长时间内成功维持体重减轻。
