In collaboration with Payame Noor University and Iranian Health Psychology Association

Document Type : Scientific Research

Authors

Abstract

Objective: Obesity is one of the health threatening problems and the second preventable mortality factor, the prevalence of which is increasing. The most frequent consequence of obesity treatment among adults is weight regain; so, preventing gradual weight regain should be the first goal in this case. The present study aims at determining the predictive power of biological, psychological and social factors in maintaining weight in the overweight and the obese.
Method: Therefore, 157 obese women referred to Sina Hospital Obesity Clinic were selected by purposeful sampling method. The subjects filled out the self-report questionnaires at the beginning of the study. Then, they underwent diet and sport medicine interventions. At the end of the sixth month, weight of the subjects was measured and the weight loss was studied.
Results: Results obtained from stepwise regression analysis indicated that among the studied variables of the research, subjective weight (SW), weight cycling, state and trait anxiety, body areas satisfaction (BAS) and appearance evaluation (AE) have more predictive power in explaining weight maintenance variance and could explain successful weight maintenance by 37%.
Conclusion: The findings of the study show that weight maintenance has a positive meaningful relationship with subjective weight (SW), weight cycling, state anxiety and body areas satisfaction (BAS); also, there is a meaningful negative relationship with the said variable and trait anxiety and appearance evaluation (AE). Hence, programming for cognitive and emotional interventions is assumed necessary in clinical interventions for obesity.

Keywords

خداپناه، مژده؛ مرادی، علیرضا؛ وثوق، سیمین و خداپناه، مژگان (1389). «عملکرد افراد مبتلا به چاقی در کارکردهای اجرایی (بازداری)». مجله روانشناسی بالینی. سال 2، شماره 1.
رقیبی، مهوش و میناخانی، غلامرضا (1390). «ارتباط مدیریت بدن با تصویر بدنی و خودپنداره». دانش و پژوهش در روانشناسی کاربردی. سال 12. شماره 4. 72-81.
ژاندا، لوئیس (1384). آزمون­های شخصیت: 24 تست برای شناختن مشکلات شخصیتی و راه­های مقابله با آنها. ترجمه محمدعلی بشارت و محمد حبیب­نژاد. تهران: نشر آییژ. (تاریخ انتشار به زبان اصلی 2001).
صادقی، خیرالله؛ غرایی، بنفشه؛ فتی، لادن و مظهری، سیدضیاءالدین (1389). «اثربخشی رفتار درمانی شناختی در درمان مبتلایان به چاقی». مجله روانپزشکی و روانشناسی بالینی ایران. سال 16، شماره 2، 117-107.
 
Apovian, C. M. & Lenders, C. M. (2007). A clinical guide for management of overweight and obese children and adults. CRC press. Taylor & Francis group.
Aronne, L. J. (2002). "Current pharmacological treatments for obesity". In C. G. Fairburn, & K. D. Brownell (Eds.). Eating disorders and obesity: A comprehensive handbook (2nd ed.) (pp. 551–557). NewYork: Guilford Press.
Banning, M. (2005). "Obesity: Pathophysiology and treatment". Promotion of Health. 125, 163-167.
Bell, L. & Rushforth, J. (2008). Overcoming body image disturbance: A programme for people with eating disorders. Routledge. 
Bodenlos, J. S.; Lemon, S. C.; Schneider, K. L.; August, M. A. & Pagoto, S. L. (2011). "Associations of mood and anxiety disorders with obesity: Comparisons by ethnicity". Journal of Psychosomatic Research, doi: 10. 1016/ j.jpsychores. 03.004.
Brownell, K. D. & Rodin, J. (1994). "Medical, metabolic, and psychological effects of weight cycling". Archives of Internal Medicine.154, 1325-1330.
Brownell, K. D.; Marlatt, G. A.; Lichtenstein, E. & Wilson, G. T. (1986). "Understanding prevention relapses".  American psychologist. 7, 756-782.
Byrne, S. M.; Allen, K. L.; Dove, E. R.; Watt, F. J. & Nathan, P. R. (2008). "The reliability and validity of the dichotomous thinking in eating disorders scale". Eating Behaviors. 9, 154-162.
Byrne, S. M.; Cooper, Z. & Fairburn, C. G. (2004). "Psychological predictors of weight regain in obesity". Behaviour Research and Therapy. 42, 1341–1356.
Cappelleri, J. C.; Bushmakin, A. G.; Gerber, R. A.; Leidy, N. K.; Sexton, C. C.; Lowe, M. R. & Karlsson, J. (2009). "Psychometric analysis of the Three-Factor Eating Questionnaire-R21: results from a large diverse sample of obese and non-obese participant". International Journal of Obesity. 33(6), 611-20.
Cash, T. F. & Fleming, E. C. (2002). "The impact of body image experiences: development of the body image quality of life inventory". The International Journal of Eating Disorders. 31, 455–60.
Cooper, Z. & Fairburn, C. G. (2001). "A new cognitive behavioral approach to the treatment of obesity". Behavior Research and Therapy.  39, 499-511.
de Lauzon, B.; Romon, M.; Deschamps, V.; Lafay, L.; Borys, J. M.; Karlsson, J.; Ducimetiere, P.; Charles, M. A. & Fleurbaix Laventie Ville Sante Study Group (2004). "The Three-Factor Eating Questionnaire-R18 is able to distinguish among different eating patterns in a general population". Journal of Nutrition.134(9), 2372–2380.
Dove, E. R.; Byrne, S. M. & Bruce, N. W. (2009). "Effect of dichotomous thinking on the association of depression with BMI and weight change among obese females". Behavior Research and Therapy. 47, 529-534.
Elfhag, K. & Rössner, S. (2005). "Who succeeds in maintaining weight loss? A conceptual review of factors associated with weight loss maintenance and weight regain". Obesity Reviews. 6, 67–85.
Fairburn, C. G.; Cooper, Z. & Shafran, R. (2003). "Cognitive behavior therapy for eating disorder: a “transdiagnostic” theory and treatment". Behaviour Research and Therapy. 41 (5), 509-528.
Foster, G. D.; Wadden, T. A.; Vogt, R. A. & Brewer, G. (1997). "What is a reasonable weight loss? Patients expectations and evaluations of obesity treatment outcomes". Journal of Consultingand Clinical Psychology. 65, 79-85.
Friedman, M. A.; Schwartz, M. B. & Brownell, K. D. (1998). "Differential relation of psychological functioning with the history and experience of weight cycling: Psychological correlates of weight cycling". Journal of Consulting and Clinical Psychology. 66, 646–650.
Hill, J. O.; Thompson, H. & Wyatt, H. (2005). "Weight maintenance: What’s missing?" American Dietetic Association.105, S63-S66.
Jeffery, R. W. (1996). "Does weight cycling present a health risk?" American Journal of Clinical Nutrition. 63, 452-455.
Jeffery, R. W.; Drewnowski, A.; Epstein, L. H.; Stunkard, A. J.; Wilson, G. T.; Wing, R. R. & Hill, D. R. (2000). "Long-term maintenance of weight loss: current status". Health Psychology. 19, 5-16.
Kabacoff, R. J.; Segal, D. L.; Hersen, M. & Van Hasselt, V. B. (1997). "Psychometric properties and diagnostic utility of the Beck Anxiety Inventory and the State- Trait Anxiety Inventory with older adult psychiatrics outpatients". Journal of Anxiety Disorder. 11, 33-47.
Keskitalo, A. M.; Tuorila, H.; Spector, T. D.; Cherkas, L. F.; Knaapila,  A.; Kaprio, J.; Silventoinen, K. & Perola, M. (2008). "The Three-Factor Eating Questionnaire, body mass index, and responses to sweet and salty fatty foods: a twin study of genetic and environmental associations". American Journal of Clinical Nutrition. 88(2). 263–271. 
Konttinen, H.; Haukkala, A.; Sarlio-Lähteenkorva, S.; Silventoinen, K. & Jousilahti, P. (2009). "Eating styles, self-control and obesity indicators. The moderating role of obesity status and dieting history on restrained eating". Appetite. 53(1). 131–134. 
Lattimore, P.; Fisher, N. & Malinowski, P. (2011). "A cross-sectional investigation of trait disinhibition and its association with mindfulness and impulsivity". Appetite. 5, 241-248.
Levine J. A.; Eberhardt N. L. & Jensen M.D. (1999). "Role of nonexercise activity thermogenesis in resistance to fat gain in humans". Science. 283. 212–214.
Ma, W. F.; Yen, W. J.; Chen, W. C.; Chang, H. J.; Haung, X. Y. & Lane, H. Y. (2009). "Role of state and yrait anxiety in physical activity participation for adults with anxiety disorders". Jouranl of Formosan Medical Association. 108 (6). 481-492.
Muraven, M.; Gagne, M. & Rosman, H. (2008). "Helpful self-control: Autonomy support, vitality, and depletion". Journal of Experimental Social Psychology. 44. 573-585.
Novy, D. M.; Rowzee, D. V.; Goodwin, J. & Rowzee, R. D. (1993). "Psychometric comparability of the state –trait anxiety inventory for different ethnic subpopulations". Psychological Assessment. 5 (3). 343-349.
O‘Neil, P. M. & Jarrell, M. P. (1992). "Psychological aspects of obesity and very-low-calorie diets". American Journal of Clinical Nutrition. 56. 185-189.
Oettingen, G. & Mayer, D. (2002). "The motivating function of thinking about the future: Expectations versus fantasies". Journal of Personality and Social Psychology. 83. 1198-1212.
Oettingen, G. & Wadden, T. A. (1991). "Expectation, fantasy and weight loss: is the impact of positive thinking always positive?". Cognitive Therapy Research. 15. 167-174.
Palmeira, A. L.; Branco, T. L.; Martins, S. C.; Minderico, C. S.; Silva, M. N.; Vieira, P. N.; Barata, J. T.; Serpa, S. O.; Sardinha, L. B. & Teixeira, P. J. (2010). "Change in body image and psychological well-being during behavioral obesity treatment: Associations with weight loss and maintenance". Body Image. 7. 187-193.
Pasman, W. J.; Saris, W. H. M. & Westertep- Plantenga, M. S. (1999). "Predictors of weight maintenance". Obesity Research. 7. 43- 50.
Sarlio - Lahteenkorva, S. (2007). "Determinants of long-term weight maintenance". Acta Pediatrica. 96. 26-28.
Schembre, S.; Greene, G. & Melanson, K. (2009). "Development and validation of a weight-related eating questionnaire". Eating Behaviors. 10. 119–124
Schmidt, K.; Gensichen, J.; Petersen, J. J.; Szecsenyi, J.; Walther, M.; Williams, G. & Freund, T. (2012). "Autonomy support in primary care- validation of the german version of the Health Care Climate Questionnaire". Journal of Clinical Epidemiology. 65(2). 206-211.
Schwartz, M. B. & Brownell, K. D. (2004). "Obesity and body image". Body Image. 1. 43-56.
Teixeira, P. J.; Going, S. B.; Sardinha, L. B. & Lohman, T. G. (2005). "A review of psychosocial pre-treatment predictors of weight control". ObesityReviews. 6. 43- 56.
Torres, S. J. & Nowson, C. A. (2007). "Relationship between stress, eating behavior, and obesity". Nutrition. 23. 887–894.
Vaidya, V. (2006). "Psychosocial aspects of obesity. In V. Vaidya (Eds)". Health and Treatment Strategies in Obesity. (pp. 73-85). Basel Press. 
Van Buren, D. J. & Sinton, M. M. (2009). "Psychological aspects of weight loss and weight maintenance". Journal of theAmerican Dietetic Association. 109(12). 1994–1996. 
Williams, G. C.; Grow, W. M.; Freedman, Z. R.; Ryan, R. M. & Deci, E. L. (1996). "Motivational predictors of weight loss and weight-loss maintenance". Journal of Personality and Social Psychology. 70. 115-126.
Williams, J. M. G.; Healy, H.; Eade, J.; Windle, G.; Cowen, P. J.; Green, M. W. & Durlach, P. (2002). "Mood, eating behaviour and attention". Psychological Medicine. 32. 469-481.
Williamson, D. A.; Newton, R. D. & Walden, H. M. (2006). "Obesity. In A. V. Nikcevic, A. R. Kuczmierczyk & M. Bruch, Eds". Formulation and Treatment in Clinical Health Psychology. (pp. 42-60). London: Brunner-Routledge.
Wooley, S. C. & Garner, D. M. (1991).
"Obesity treatment: the high cost of false hope". Journal of theAmerican Dietetic Association. 91. 1248-1251.
World Health Organization (1998). Obesity: Preventing and managing the global epidemic. Geneva, Switzerland: Author.
World Health Organization (2009). Obesity and overweight. Geneva, Switzerland: Author.
Zeldman, A.; Ryan, R. M. & Fiscella, K. (2004). "Motivation, autonomy support and entity beliefs: their role in methadone maintenance treatment". Journal of Social and Clinical Psychology. 23. 675-696.