Faculty of Medical and Health Sciences, University of Auckland, 22-30 Park Avenue, Auckland 1142, New Zealand.
Te Toka Tumai Diabetes, Te Whatu Ora Health New Zealand, 214 Greenlane West, Auckland 1051, New Zealand.
Nutrients. 2023 Mar 6;15(5):1297. doi: 10.3390/nu15051297.
Long-term weight loss maintenance is often difficult to achieve. This review analysed qualitative data on self-perceived barriers and facilitators of weight loss and weight loss maintenance among weight loss intervention participants. A literature search was conducted using electronic databases. Qualitative studies written in English and published between 2011-2021 were eligible for inclusion if they explored the perspectives and experiences of individuals who received standardised dietary and behavioural support for weight loss. Studies were excluded if weight loss was achieved through self-directed methods, only increasing physical activity, or surgical or pharmacological interventions. Fourteen studies were included, totaling 501 participants from six countries. Thematic analysis was used to identify four aggregate themes: internal factors (i.e., motivation and self-efficacy), programme-specific factors (i.e., the intervention diet), social factors (i.e., supporters and saboteurs), and environmental factors (i.e., an obesogenic environment). Our findings demonstrate that internal, social, and environmental factors all influence weight loss success, as well as the acceptability of the weight loss intervention. Future interventions may be more successful if they prioritise participant acceptability and engagement by, for example, providing tailored interventions, a structured relapse management plan, strategies to enhance autonomous motivation and emotional self-regulation, and extended contact during weight loss maintenance.
长期的体重减轻维持往往难以实现。本综述分析了减肥干预参与者对减肥和减肥维持的自我感知障碍和促进因素的定性数据。使用电子数据库进行了文献检索。如果研究探讨了接受标准化饮食和行为支持以减轻体重的个人的观点和经验,则符合纳入标准的是 2011-2021 年间以英文撰写并发表的定性研究。如果体重减轻是通过自我指导的方法、仅增加体力活动或手术或药物干预实现的,则排除在外。纳入了 14 项研究,共 501 名来自六个国家的参与者。采用主题分析方法确定了四个综合主题:内部因素(即动机和自我效能)、特定于计划的因素(即干预饮食)、社会因素(即支持者和破坏者)和环境因素(即肥胖环境)。我们的研究结果表明,内部、社会和环境因素都会影响减肥的成功以及减肥干预的可接受性。如果未来的干预措施优先考虑参与者的可接受性和参与度,例如提供量身定制的干预措施、结构化的复发管理计划、增强自主动机和情绪自我调节的策略以及在减肥维持期间延长联系,那么这些干预措施可能会更成功。