The relationship between stress and weight loss in a diet-exercise programme for obese women.

Forty-two obese women participated in two successive 3-month diet-exercise programmes. A stress questionnaire was answered on commencement, after 1 1/2 and 3 months (38 subjects), and after 6 months (30 subjects). A discussion group, informal counselling and in-depth interviews (12 subjects) provided reliable additional data. The hypothesis that subjects with juvenile-onset obesity experience greater stress on the programme and are less successful, was unsupported. The semistructured interviews indicated: that stress is inherent in dieting; that the compensatory effect of exercise mediates the loss of eating as a stress-coping mechanism; and that as goal weight is approached, a serious emotional crisis is experienced, due to the loss of the obese state as a defence. Negative findings from the stress questionnaire, and the patterns which emerged from the interviews, are conceptualised in terms of a general model of reactions to weight loss, which is based on a postulated homeostatic mechanism to maintain acceptable stress levels.