When weight management lasts. Lower perceived rule complexity increases adherence

Center for Adaptive Behavior and Cognition, Max Planck Institute for Human Development, Lentzeallee 94, 14195 Berlin, Germany.
Appetite (Impact Factor: 2.69). 09/2009; 54(1):37-43. DOI: 10.1016/j.appet.2009.09.004
Source: PubMed


Maintaining behavior change is one of the major challenges in weight management and long-term weight loss. We investigated the impact of the cognitive complexity of eating rules on adherence to weight management programs. We studied whether popular weight management programs can fail if participants find the rules too complicated from a cognitive perspective, meaning that individuals are not able to recall or process all required information for deciding what to eat. The impact on program adherence of participants' perceptions of eating rule complexity and other behavioral factors known to influence adherence (including previous weight management, self-efficacy, and planning) was assessed via a longitudinal online questionnaire given to 390 participants on two different popular weight management regimens. As we show, the regimens, Weight Watchers and a popular German recipe diet (Brigitte), strongly differ in objective rule complexity and thus their cognitive demands on the dieter. Perceived rule complexity was the strongest factor associated with increased risk of quitting the cognitively demanding weight management program (Weight Watchers); it was not related to adherence length for the low cognitive demand program (Brigitte). Higher self-efficacy generally helped in maintaining a program. The results emphasize the importance of considering rule complexity to promote long-term weight management.

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    • "Despite areas of the LWMP empowering patients and helping progression with increased confidence and skills, there were post-programme concerns as participants presented dependence on dietitians. Literature suggests success in weight management often depends on self-efficacy and the results show participants who are not yet ready to continue alone (Mata et al., 2010). It is appreciated that weight management is often difficult due to a lack of immediate benefits compared to the amount of sacrifices needed and the results shown are concerning (Rowberg, 2010). "
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    ABSTRACT: Purpose ‐ The increasing prevalence of obesity in the UK has been of concern for some time. This is particularly true in Liverpool and in response the Liverpool Weight Management Programme (LWMP) was devised. It offers a service involving dietitians and other expert agencies working towards facilitating dietary and lifestyle changes in obese NHS patients in Liverpool via a 12-week education programme. This qualitative study aims to investigate patients' experiences of the LWMP. Design/methodology/approach ‐ Informed volunteers participated in focus groups exploring their experiences following the programme. Focus groups were audio recorded and transcribed verbatim, then analysed following a thematic approach utilising constant comparison analysis to allow a qualitative view of the LWMP to be formed. Findings ‐ Participants described an increase in immediate self-confidence during the LWMP, as opposed to coercion and pressure experienced elsewhere. The results also show the implementation of dietary changes by participants and favourable opinions towards both the group settings and patient-centred care. Participants also positively described the LWMP regarding the programmes social approach and aspects of programme content; however, there were issues with over-dependence on healthcare professionals. Healthcare professionals also need to recognise that long-term empowerment may still be lacking and that follow-up support and the effectiveness of some areas of programme content need to be considered to ensure patients benefit from sustainable weight management. Originality/value ‐ This paper addresses an identified need for qualitative research in the area of health service weight management programmes and highlights the importance of long-term support in empowering patients by exploring their lived experience of the LWMP.
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    • "those of the German Obesity Society [45]. In this connection, the study of Mata et al. [46] inferred that longer-term care or a longer period within weight loss programmes significantly increases the likelihood of permanent (sustained) weight loss. A clear preference for support, backing and help during therapy was also shown, inter alia, in the study conducted by Kayman et al. [47]. "
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    ABSTRACT: Obesity is associated with increased risk of morbidity and mortality and also appears to have an adverse effect on health-related quality of life. Though advances in obesity therapy and rehabilitation can be observed, the long-lasting outcome is dissatisfying to most of the patients and, therefore, the whole health care system. The study aims to identify key attributes of coordinated weight loss programmes and elicit patients' preferences for overweight and obesity therapy in rehabilitation programmes. A self-administered survey measuring attitudes and preferences was conducted in Germany in 2009. Discrete-choice experiment scenarios were developed using a fractional factorial design and results analysed using a random effects logit model. N=110 patients completed the questionnaire, 51.82% of these were male, the mean age was 53.05 years and mean body mass index was 33.54 kg/m2 (SD 7.73). A total of 823 choices could be included in the final estimation. The most important aspects for the respondents' selection were care coordination (coefficient 1.473; SE 0.185) and individual therapy (coefficient 1.446; SE 0.188). The aspect 'infrastructure of care' (coefficient 0.570; SE 0.175) was less relevant. All attributes led to significant coefficients. Patients value coordination of care and individual therapy most highly. So weight reduction therapy should enable patients to receive a structured, coordinated and interpersonal therapy that is tailored to their personal needs, behaviour and circumstances. Patients are willing to forego infrastructure quality in favour of better coordination and structure in their therapy.
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    • "We contribute to this literature by conducting a randomized control experiment which explicitly compares the impact of standard accounting training with a simpli…ed, rule-of-thumb-based program. In this vein, we build on a growing literature that supports the merits of simpli…cation in settings as varied as retirement savings plan enrollment (Beshears, Choi, Laibson, and Madrian 2010, Choi, Laibson , and Madrian 2009), Medicare drug plans (Mullainathan and Sha…r 2009), weight loss (Mata, Todd, and Lippke 2010), and college student loan applications (Bettinger, Long, Oreopoulos, and Sanbonmatsu 2009). Research in cognitive psychology o¤ers additional evidence that simpler rules and less feedback "
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    ABSTRACT: Individuals and business owners engage in an increasingly complex array of financial decisions that are critical for their success and well-being. Yet a growing literature documents that in both developed and developing countries, a large fraction of the population is unprepared to make these decisions. Evidence on potential remedies is limited and mixed. Two randomized trials test the impact of financial training on firm-level and individual outcomes for microentrepreneurs in the Dominican Republic. We find no significant effect from a standard, fundamentals-based accounting training. However, a simplified, rule-of-thumb training produced significant and economically meaningful improvements in business practices and outcomes.
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