Relevant Psychological Variables

The ability to cope with stress has been associated with weight maintenance. Individuals who were described as having poor coping skills, or a poor ability to manage internal or external demands that are appraised as stressful, have been show to regain weight when confronted with stressful life events (S. Byrne, Cooper, & Fairburn, 2003; Gormally & Rardin, 1981; Gormally, Rardin, & Black, 1980; Grilo, Shiffman, & Wing, 1989). People who regain lost weight tend to eat in response to the presence of negative emotional states or use food to regulate their mood; a phenomenon often referred to as emotional eating (S. Byrne et al., 2003; Ganley, 1989). Obese people who have difficulty losing or keeping off weight have been shown to use food as a source of comfort and satisfaction (Castelnuovo-Tedesco & Schiebel, 1975), eat after difficult interpersonal situations (Hockley, 1979), and eat in response to hopelessness, helplessness, anger, anxiety, or boredom (Hudson & Williams, 1981; Rotmann & Becker, 1970). Motivational factors have also been associated with weight maintenance. Successful weight maintainers have been found to be motivated to lose weight for more personal reasons as opposed to pressures from family, friends, or medical professionals (Ogden, 2000). It appears that when a person is intrinsically motivated, and weight loss is tied to meaningful outcomes other than just losing weight, patients tend to be more successful in keeping weight off. Self-efficacy has been also been associated with weight maintenance. Self-efficacy can be described as a belief in one’s capability to produce desired outcomes in one’s life. Related, individuals who respond to overeating episodes passively tend to regain weight more than those who respond actively (Jeffery et al., 1984). The key difference seems to be that active responders somehow do not get stuck when confronted with adversity. Rigid versus flexible control of eating behavior has been associated with weight regain. Rigid control is characterized by dichotomous ‘all or nothing’ thinking and alternating periods of severe restriction and no weight control efforts. Flexible control is characterized by a ‘more or less’ approach, a long-term outlook, and the inclusion of desired foods at moderate amounts (Westenhoefer, 2001). Despite the literature findings, potentially important psychological variables are rarely targeted in clinical trials of comprehensive weight loss programs or program components. Many interventions lack a psychological component altogether (for a review, see Avenell et al., 2004).