期刊论文详细信息
BMC Public Health
A qualitative study of the determinants of dieting and non-dieting approaches in overweight/obese Australian adults
Xiang-Yu Hou1  Esben Strodl2  Stuart Leske2 
[1] School of Public Health and Social Work, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD, 4059, Australia;School of Psychology and Counselling, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD, 4059, Australia
关键词: Weight;    Adults;    Obesity;    Overweight;    Grounded theory;    Qualitative;    Non-dieting;    Dieting;    Diet;   
Others  :  1162722
DOI  :  10.1186/1471-2458-12-1086
 received in 2012-08-03, accepted in 2012-12-13,  发布年份 2012
PDF
【 摘 要 】

Background

Dieting has historically been the main behavioural treatment paradigm for overweight/obesity, although a non-dieting paradigm has more recently emerged based on the criticisms of the original dieting approach. There is a dearth of research contrasting why these approaches are adopted. To address this, we conducted a qualitative investigation into the determinants of dieting and non-dieting approaches based on the perspectives and experiences of overweight/obese Australian adults.

Methods

Grounded theory was used inductively to generate a model of themes contrasting the determinants of dieting and non-dieting approaches based on the perspectives of 21 overweight/obese adults. Data was collected using semi-structured interviews to elicit in-depth individual experiences and perspectives.

Results

Several categories emerged which distinguished between the adoption of a dieting or non-dieting approach. These categories included the focus of each approach (weight/image or lifestyle/health behaviours); internal or external attributions about dieting failure; attitudes towards established diets, and personal autonomy. Personal autonomy was also influenced by another category; the perceived knowledge and self-efficacy about each approach, with adults more likely to choose an approach they knew more about and were confident in implementing. The time perspective of change (short or long-term) and the perceived identity of the person (fat/dieter or healthy person) also emerged as determinants of dieting or non-dieting approaches respectively.

Conclusions

The model of determinants elicited from this study assists in understanding why dieting and non-dieting approaches are adopted, from the perspectives and experiences of overweight/obese adults. Understanding this decision-making process can assist clinicians and public health researchers to design and tailor dieting and non-dieting interventions to population subgroups that have preferences and characteristics suitable for each approach.

【 授权许可】

   
2012 Leske et al.; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20150413075235287.pdf 226KB PDF download
Figure 1. 26KB Image download
【 图 表 】

Figure 1.

【 参考文献 】
  • [1]World Health Organization: Preventing Chronic Diseases: A Vital Investment. Geneva: World Health Organization; 2005.
  • [2]Australian Institute of Health and Welfare: Australia’s Health 2010. Canberra: Australian Institute of Health and Welfare; 2010.
  • [3]Australian Bureau of Statistics: Australian Health Survey: First Results, 2011–2012. Canberra: Australian Bureau of Statistics; 2012.
  • [4]Guh DP, Zhang W, Bansback N, Amarsi Z, Laird Birmingham C, Anis AH: The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Pub Health 2009, 9:88-107. BioMed Central Full Text
  • [5]National Health and Medical Research Council: Systematic Review of the Obesity Literature. Canberra: National Health and Medical Research Council; 2011.
  • [6]Lewis S, Thomas SL, Hyde J, Castle D, Komesaroff PA, Warwick Blood R: “I don’t eat a hamburger and large chips every day!”. A qualitative study of the impact of public health messages about obesity on obese adults. BMC Pub Health 2010, 10:309. BioMed Central Full Text
  • [7]National Health and Medical Research Council: Management of Overweight and Obesity in Adults, Adolescents and Children. Clinical Practice Guidelines for Primary Care Health Professionals. Canberra: National Health and Medical Research Council; 2012.
  • [8]Baradel LA, Gillespie C, Kicklighter JR, Doucette MM, Penumetcha M, Blanck HM: Temporal changes in trying to lose weight and recommended weight-loss strategies among overweight and obese Americans, 1996–2003. Prev Med 2009, 49:159-164.
  • [9]Yaemsiri S, Slining MM, Agarwal SK: Perceived weight status, overweight diagnosis, and weight control among US adults: the NHANES 2003–2008 Study. Int J Obesity 2011, 35:1063-1070.
  • [10]Siu J, Giskes K, Turrell G: Socio-economic differences in weight-control behaviours and barriers to weight control. Public Health Nutr 2011, 14:1768-1778.
  • [11]Finkelstein EA, Brown DS, Evans D: Do obese persons comprehend their personal health risks? Am J Health Behav 2008, 32:508-516.
  • [12]Riddell LJ, Inman V: Body weight and weight loss: Are health messages reaching their target? Asia Pac J Clin Nutr 2007, 16:683-687.
  • [13]Thomas SL, Lewis S, Hyde J, Castle D, Komesaroff P: “The solution needs to be complex.” Obese adults' attitudes about the effectiveness of individual and population based interventions for obesity. BMC Pub Health 2010, 10:420. BioMed Central Full Text
  • [14]Puhl R, Peterson J, Luedicke J: Fighting obesity or obese persons? Public perceptions of obesity-related health messages. Int J Obesity 2012,  .
  • [15]Institute for Clinical Systems Improvement: Prevention and Management of Obesity (Adults and Mature Adolescents). Fifth Edition. Bloomington: Institute for Clinical Systems Improvement; 2011.
  • [16]Ministry of Health, Clinical Trials Research Unit: Clinical Guidelines for Weight Management in New Zealand Adults. Wellington: Ministry of Health, Clinical Trials Research Unit; 2009.
  • [17]National Institute for Health and Clinical Excellence: Obesity: Guidance on the Prevention, Identification, Assessment and Management of Overweight and Obesity in Adults and Children. London: National Institute for Health and Clinical Excellence; 2006.
  • [18]Scottish Intercollegiate Guidelines Network: Management of Obesity. Edinburgh: A National Clinical Guideline; 2010.
  • [19]Foster GD, McGuckin BG: Non-dieting approaches: principles, practices and evidence. In Handbook of Obesity Treatment. Edited by Wadden TA, Stunkard AJ. New York: Guilford; 2002:494-514.
  • [20]National Task Force on the Prevention and Treatment of Obesity: Dieting and the development of eating disorders in overweight and obese adults. Arch Intern Med 2000, 160:2581-2589.
  • [21]Tsai AG, Wadden TA: The evolution of very-low calorie diets: an update and meta-analysis. Obesity 2006, 14:1283-1293.
  • [22]Shaw KA, O’Rourke P, Del Mar C, Kenardy J: Psychological interventions for overweight or obesity. 2005. [Cochrane Database of Systematic Reviews] Art. No.: CD003818. doi:10.1002/14651858.CD003818.pub2
  • [23]Stroebe W: Dieting, overweight, and obesity: Self-regulation in a food-rich environment. Washington: American Psychological Association; 2008.
  • [24]Mann T, Tomiyama AJ, Westling E, Lew A-M, Samuels B, Chatman J: Medicare’s search for effective obesity treatments: diets are not the answer. Am Psychol 2007, 62:220-233.
  • [25]Caplan W, Bowman JD, Pronk NP: Weight-loss outcomes: a systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up. J Am Diet Assoc 2007, 107:1755-1767.
  • [26]Nicklas JM, Huskey KW, Davis RB, Wee CC: Successful weight loss among obese U.S. adults. Am J Prev Med 2012, 42:481-485.
  • [27]Garner DM, Wooley SC: Confronting the failure of behavioral and dietary treatments for obesity. Clin Psychol Rev 1991, 11:729-780.
  • [28]Goodrick GK, Foreyt JP: Why treatments for obesity don't last. J Am Diet Assoc 1991, 91:1243-1274.
  • [29]Bacon L: Health at Every Size: the Surprising Truth About Your Weight. Dallas: BenBella Books; 2010.
  • [30]Daníelsdóttir S, Burgard D, Oliver-Pyatt W: AED Guidelines for Childhood Obesity Prevention Programs. Academy of Eating Disorders; 2009.
  • [31]Neumark-Sztainer D: Preventing obesity and eating disorders in adolescents: what can health care providers do? J Adolescent Health 2009, 44:206-213.
  • [32]Bacon L, Aphramor L: Weight science: evaluating the evidence for a paradigm shift. Nutr J 2011, 10:9-21. BioMed Central Full Text
  • [33]Tribole E, Resch E: Intuitive Eating: a Revolutionary Program that Works. New York: St. Martin’s Griffin; 2010.
  • [34]King C: Health at Every Size approach to health management: the evidence is weighed. Top Clin Nutr 2007, 22:272-285.
  • [35]Thomas SL, Hyde J, Karunaratne A, Kausman R, Komesaroff PA: “They all work…when you stick to them”: A qualitative investigation of dieting, weight loss, and physical exercise, in obese individuals. Nutr J 2008, 7:34. BioMed Central Full Text
  • [36]Brown I, Gould J: Decisions about weight management: a synthesis of qualitative studies of obesity. Clin Obes 2011, 1:99-109.
  • [37]Giacomini MK, Cook DJ: Users’ guides to the medical literature XXIII. Qualitative research in health care. A. Are the results of the study valid? Evidence-Based Medicine Working Group. J Amer Med Assoc 2000, 284:357-362.
  • [38]Cote L, Turgeon J: Appraising qualitative research articles in medicine and medical education. Med Teach 2005, 27:71-75.
  • [39]Corbin J, Strauss A: Basics of qualitative research: Techniques and procedures for developing grounded theory. 3rd edition. Los Angeles: SAGE Publications; 2008.
  • [40]Strauss A, Corbin J: Basics of qualitative research: Techniques and procedures for developing grounded theory. 2nd edition. Thousand Oaks, CA: SAGE Publications; 1998.
  • [41]Miles MB, Huberman MA: Qualitative data analysis: an expanded sourcebook. Thousand Oaks, CA: Sage Publications; 1994.
  • [42]QSR International Pty Ltd: NVivo Qualitative Data Analysis Software. Version 8. Doncaster, Victoria: QSR International Pty Ltd; 2008.
  • [43]Kwan S: Competing motivational discourses for weight loss: Means to ends and the nexus of beauty and health. Qual Health Res 2009, 19:1223-1233.
  • [44]Dickins M, Thomas SL, King B, Lewis S, Holland K: The role of the Fatosphere in fat adults’ responses to obesity stigma: A model of empowerment without a focus on weight loss. Qual Health Res 2011, 21:1679-1691.
  • [45]Lewis S, Thomas SL, Blood RW, Castle D, Hyde J, Komesaroff PA: ‘I’m searching for solutions’: why are obese individuals turning to the Internet for help and support with ‘being fat’? Health Expect 2011, 14:339-350.
  • [46]Mycroft H: Morality and accountability in a commercial weight management group. J Health Psychol 2008, 13:1040-1050.
  • [47]Green AR, Larkin M, Sullivan V: Oh stuff it! The experience and explanation of diet failure: an exploration using interpretative phenomenological analysis. J Health Psychol 2009, 14:997-1008.
  • [48]Deci EL, Ryan RM: Intrinsic motivation and self-determination in human behaviour. New York: Plenum Press; 1985.
  • [49]Deci EL: The psychology of self-determination. Lexington, MA: Lexington Books; 1980.
  • [50]Bandura A: Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice-Hall, Inc; 1986.
  • [51]Epiphaniou E, Ogden J: Successful weight loss maintenance and a shift in identity: from restriction to a liberated self. J Health Psychol 2010, 15:887-896.
  • [52]Ogden J, Hills L: Understanding sustained behaviour change: The role of life crises and the process of reinvention. Health 2008, 12:419-437.
  • [53]Garip G, Yardley L: A synthesis of qualitative research on overweight and obese people's views and experiences of weight management. Clin Obes 2011, 1:110-126.
  文献评价指标  
  下载次数:30次 浏览次数:21次