Human Nutrition, School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK.
Department of Clinical Nutrition, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
J Hum Nutr Diet. 2021 Feb;34(1):199-214. doi: 10.1111/jhn.12826. Epub 2020 Oct 21.
Qualitative studies investigating weight management experiences are usually cross-sectional or of short duration, which limits understanding of the long-term challenges.
Eleven women [mean (SD) age 44.9 (9.8) years; body mass index 40.3 (4.0) kg m ] participated in this longitudinal qualitative study, which included up to 20 weeks of total diet replacement (825-853 kcal day ) and ongoing support for weight loss maintenance (WLM), to 2 years. Semi-structured interviews were conducted at baseline and programme end, as well as at key intervals during the intervention. Questions examined five theoretical themes: motivation, self-regulation, habits, psychological resources and social/environmental influences. Data were coded and analysed in nvivo (https://qsrinternational.com/nvivo) using the framework method.
In total, 64 interviews were completed (median, n = 6 per participant). Mean (SD) weight loss was 15.7 (9.6) kg (14.6% body weight) at 6 months and 9.6 (9.9) kg (8.8% body weight) at 2 years. The prespecified theoretical model offered a useful framework to capture the variability of experiences. Negative aspects of obesity were strong motivations for weight loss and maintenance. Perceiving new routines as sustainable and developing a 'maintenance mindset' was characteristic of 'Maintainers', whereas meeting emotional needs at the expense of WLM goals during periods of stress and negative mood states was reported more often by 'Regainers'. Optimistic beliefs about maintaining weight losses appeared to interfere with barrier identification and coping planning for most participants.
People tended to be very optimistic about WLM without acknowledging barriers and this may undermine longer-term outcomes. The potential for regain remained over time, mainly as a result of emotion-triggered eating to alleviate stress and negative feelings. More active self-regulation during these circumstances may improve WLM, and these situations represent important targets for intervention.
调查体重管理经验的定性研究通常是横断面研究或持续时间较短，这限制了对长期挑战的理解。
本纵向定性研究纳入了 11 名女性（平均[标准差]年龄 44.9[9.8]岁；体重指数 40.3[4.0]kg/m ），参与者接受了长达 20 周的全饮食替代（825-853 千卡/天）和持续的减肥维持（WLM）支持，最长达 2 年。在基线和项目结束时以及干预期间的关键时间点进行了半结构化访谈。问题探讨了五个理论主题：动机、自我调节、习惯、心理资源和社会/环境影响。使用框架方法在 nvivo（https://qsrinternational.com/nvivo）中对数据进行编码和分析。
共完成了 64 次访谈（中位数，n=每个参与者 6 次）。6 个月时的平均（标准差）体重减轻为 15.7[9.6]kg（14.6%的体重），2 年时为 9.6[9.9]kg（8.8%的体重）。预先指定的理论模型提供了一个有用的框架来捕捉经验的可变性。肥胖的负面因素是减肥和维持的强烈动机。参与者认为新的日常活动可持续，并形成“维持心态”，这是“维持者”的特征；而在压力和负面情绪状态下，为了满足情绪需求而牺牲 WLM 目标的情况，在“复胖者”中更为常见。大多数参与者对维持体重减轻的乐观信念似乎干扰了对障碍的识别和应对计划。
人们对 WLM 非常乐观，而没有认识到障碍，这可能会影响长期结果。随着时间的推移，复胖的可能性仍然存在，主要是由于情绪触发的进食来缓解压力和负面情绪。在这些情况下更积极的自我调节可能会改善 WLM，而这些情况是干预的重要目标。
