Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-18T12:26:07.910Z Has data issue: false hasContentIssue false
  • English
  • Français

Helping individuals to help themselves*

Published online by Cambridge University Press:  07 March 2007

Lyndel Costain  and
Helen Croker
Lyndel Costain*
Affiliation:
Vervale House, 30 Rotton Park Road, Birmingham B16 9JL, UK
Helen Croker
Affiliation:
Health Behaviour Unit, Department of Epidemiology and Public Health, University College London, 2–16 Torrington Place, London WC1E 6BT, UK
*
† Corresponding author: Lyndel Costain, fax +44 20 7813 2848, email [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Obesity is a serious and increasing health issue. Approximately two-thirds of adults in the UK are now overweight or obese. Recent public health reports firmly reinforce the importance of engaging individuals to look after their health, including their weight. They also spell out the need for individuals to be supported more actively, on many levels, to enable this ‘engagement’. Meanwhile, national surveys indicate that approximately two-thirds of adults are concerned about weight control, with one-third actively trying to lose weight. This finding is hardly surprising considering current weight statistics, plus the plethora of popular diets on offer. Weight-loss methods include diet clubs, diet books, exercise, meal replacements, advice from healthcare professionals and following a self-styled diet. Obesity is a multi-factorial problem, and losing weight and, in particular, maintaining weight loss is difficult and often elusive. It is argued that the modern obesogenic or ‘toxic’ environment has essentially taken body-weight control from an instinctive ‘survival’ process to one that needs sustained cognitive and skill-based control. The evidence suggests that health professionals can help individuals achieve longer-term weight control by supporting them in making sustainable lifestyle changes using a range of behavioural techniques. These techniques include: assessing readiness to change; self-monitoring; realistic goal setting; dietary change; increased physical activity; stimulus control; cognitive restructuring; relapse management; establishing ongoing support. Consistently working in a client-centred way is also being increasingly advocated and incorporated into practice to help motivate and encourage, rather than hinder, the individual's progress.

Keywords

Behaviour changeObesityWeight management
Type
Symposium on ‘Biology of obesity’
Information
Proceedings of the Nutrition Society , Volume 64 , Issue 1 , February 2005 , pp. 89 - 96
Copyright
Copyright © The Nutrition Society 2005

Footnotes

*

The presentation was given at the meeting by Dympna Pearson.

References

Bravata, DM, Sanders, L, Huang, J, Krumholtz, HM, Olkin, I & Gardner, DM (2003) Efficacy and safety of low-carbohydrate diets: a systematic review. Journal of the American Medical Association 289, 1837–1850.CrossRefGoogle ScholarPubMed
Brownell, KD (1997) The Learn Programme for Weight Control Dallas, TX American Health Publishing Company.Google Scholar
Costain, L (2003) Diet Trials: How to Succeed at Dieting. London: BBC Consumer Publishing.Google Scholar
Department of Health(2003) Health Survey for England, 2002. London: The Stationery Office.Google Scholar
Department of Health(2004) At Least Five a Week: Evidence on the Impact of Physical Activity and its Relationship to Health. A Report from the Chief Medical Officer London: Department of Health.Google Scholar
Diabetes Prevention Program Research Group (2002) Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England Journal of Medicine 346, 393–403.CrossRefGoogle Scholar
Food Standards Agency(2004) National Diet and Nutrition Survey. Adults aged 19 to 64 Years, Vol. 4, London: The Stationery Office.Google Scholar
Foster, GD, Wadden, TA, Vogt, RA & Brewer, G (1997) What is a reasonable weight loss? Patients' expectations and evaluations of obesity treatment outcomes. Journal of Consulting and Clinical Psychology 65, 79–85.CrossRefGoogle ScholarPubMed
Foster, GD, Wyatt, HR, Hill, JO, McGuckin, BG, Brill, C, Mohammed, BS, Szapary, PO, Rader, DJ, Edman, JS & Klein, S (2003) A randomized trial of a low-carbohydrate diet for obesity. New England Journal of Medicine 348, 2082–2090.CrossRefGoogle ScholarPubMed
Freedman, MR & Kenndy, E (2001) Popular diets: a scientific review. Obesity Research 9, 1S–40S.Google Scholar
Green, SM, McCoubrie, M & Cullingham, C (2000) Practice nurses‘ and health visitors’ knowledge of obesity assessment and management. Journal of Human Nutrition and Dietetics 13, 413–423.CrossRefGoogle Scholar
Harper, A & Astrup, A (2004) Can we advise our obese patients to follow the Atkins diet. Obesity Reviews 5, 93–94.CrossRefGoogle ScholarPubMed
House of Commons Health Committee (2004) Obesity. Third Report of Session 2003–04, Vol. 1, London: The Stationery Office.Google Scholar
Hunt, P & Hillsdon, M (1996) Changing Eating and Exercise Behaviour. A Handbook for Professionals. Oxford: Blackwell Science.Google Scholar
Jebb, SA, Lang, R & Penrose, A (2003) Improving communications to tackle obesity in the UK. Proceedings of the Nutrition Society 62, 577–581.CrossRefGoogle ScholarPubMed
Jeffery, RW, Wing, RR & Mayer, RR (1998) Are smaller weight losses or more achievable weight loss goals better in the long term for obese patients. Journal of Consulting and Clinical Psychology 66, 641–645.CrossRefGoogle ScholarPubMed
Kayman, S, Bruvold, W & Stern, JS (1990) Maintenance and relapse after weight loss in women: behavioral aspects. American Journal of Clinical Nutrition 52, 800–807.CrossRefGoogle ScholarPubMed
Klem, ML, Wing, RR, Lang, W, Mcguire, T & Hill, JO (2000) Does weight loss maintenance become easier over time. Obesity Research 8, 438–444.CrossRefGoogle ScholarPubMed
Klem, ML, Wing, RR, McGuire, MT, Seagle, HM & Hill, JO (1997) A descriptive study of individuals successful at long-term maintenance of substantial weight loss. American Journal of Clinical Nutrition 66, 239–246.CrossRefGoogle ScholarPubMed
Kopelman, PG & Grace, C (2004) New thoughts on managing obesity. Gut 53, 1044–1053.CrossRefGoogle ScholarPubMed
Lean, ME (2000) Is long-term weight loss possible. British Journal of Nutrition 83, S103–S111.CrossRefGoogle ScholarPubMed
Lewin, SA, Skea, ZC, Entwistle, V, Zwarenstein, M & Dick, J (2003) Interventions for providers to promote a patient-centred approach in clinical consultations (Cochrane Review) The Cochrane Library Issue 1 Oxford Update Software.Google Scholar
McTigue, KM, Harris, R, Hemphill, B, Lux, L, Sutton, S, Bunton, A & Lohr, K (2003) Screening and interventions for obesity in adults: summary of the evidence for the U.S. Preventive Services Task Force. Annals of Internal Medicine 139, 933–949.CrossRefGoogle ScholarPubMed
Mintel, Group (2004) Dieting-UK. London: Mintel International Group Ltd.Google Scholar
Mulvihill, C & Quigley, R (2003) The Management of Obesity and Overweight: An Analysis of Reviews of Diet, Physical Activity and Behavioural Approaches. London: Health Development Agency.Google Scholar
National Audit Office(2001) Tackling Obesity in England. London: National Audit Office.Google Scholar
National Institutes of Health and National Heart, Lung, and Institute (1998) Clinical guidelines on the identification, evaluation and treatment of overweight and obesity in adults: The evidence report. http://www.nhlbi.nih.gov/guidelines/obesity/ob_home.htm.Google Scholar
National Task Force on the Prevention and Treatment of Obesity (2000) Dieting and the development of eating disorders in overweight and obese adults. Archives of Internal Medicine 160, 2581–2589.CrossRefGoogle Scholar
O'Neill, PM (2001) Assessing dietary intake in the management of obesity. Obesity Research 5, 361S–366S.Google Scholar
Peters, JC, Wyatt, HR, Donahoo, WT & Hill, JO (2002) From instinct to intellect: the challenge of maintaining healthy weight in the modern world. Obesity Reviews 3, 69–74.CrossRefGoogle ScholarPubMed
Phelan, S & Wadden, TA (2002) Combining behavioral and pharmacological treatments for obesity. Obesity Research 10, 560–574.CrossRefGoogle ScholarPubMed
Prochaska, JO & DiClemente, CC (1992) Stages of change in the modification of problem behaviors. Progress in Behavior Modification 28, 183–218.Google ScholarPubMed
Rapoport, L & Wardle, J (2000) Cognitive behaviour therapy in obesity treatment. Obesity in Practice 2, 13–15.Google Scholar
Rollnick, S, Mason, P & Butler, C (1999) Health Behaviour Change: A Guide for Practitioners. London: Churchill Livingstone.Google Scholar
Royal College of Physicians(2004) Storing up Problems: The Medical Case for a Slimmer Nation. London: Royal College of Physicians.Google Scholar
Scottish Intercollegiate Guidelines Network(1996) Obesity in Scotland. Integrating Prevention with Weight Management. Edinburgh Royal: College of Physicians.Google Scholar
Smith, CF, Williamson, DA, Bray, GA & Ryan, DH (1999) Flexible vs rigid dieting strategies: relationships with adverse behavioural outcomes. Appetite 32, 295–305.CrossRefGoogle Scholar
Stern, L, Iqbal, N, Seshadri, P, Chicano, KL, Daily, DA, McGrory, J, Williams, M, Graceley, EJ & Samaha, FF (2004) The effects of low-carbohydrate versus conventional weight loss diets in severely obese adults: one-year follow-up of a randomized trial. Annals of Internal Medicine 140, 778–785.CrossRefGoogle ScholarPubMed
Thorogood, M, Hillsdon, M & Summerbell, C (2002) Cardiovascular disorders, changing behaviour. Clinical Evidence 8, 37–59.Google Scholar
Truby, H, Millward, D, Morgan, L, Fox, K, Livingstone, MB, DeLooy, A & MacDonald, I (2004) A randomised controlled trial of four different commercial weight loss programmes in the UK in obese adults: body composition changes over six months. Asia Pacific Journal of Clinical Nutrition 13, S146.Google Scholar
Tuomilehto, J, Lindstrom, J, Eriksson, JG, Valle, TT, Hamalainen, H, Ilanne-Parikka, P, Keinanen-Kiukaanniemi, S, Laakso, M, Louheranta, A, Rastas, M, Salminen, V & Uusitupa, M (2001) Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. New England Journal of Medicine 344, 1343–1350.CrossRefGoogle ScholarPubMed
Wadden, TA, Brownell, KD & Foster, GD (2002) Obesity: responding to the global epidemic. Journal of Consulting and Clinical Psychology 70, 510–525.CrossRefGoogle Scholar
Wanless, D (2004) Securing Good Health for the Whole Population. Final Report. London: Department of Health; available at http://www.hm-treasury.gov./consultations_and_legislation/wanless/consult_ _wanless04_final.cfm.Google Scholar
Wardle, J, Griffith, J, Johnson, F & Rapoport, L (2000) Intentional weight control and food choice habits in a national representative sample of adults in the UK. International Journal of Obesity and Related Metabolic Disorders 24, 534–540.CrossRefGoogle Scholar
Wardle, J & Johnson, F (2002) Weight and dieting: examining levels of weight concern in British adults. International Journal of Obesity and Related Metabolic Disorders 26, 1144–1149.CrossRefGoogle Scholar
Wardle, J & Rapoport, L (1998) Cognitive-behavioural treatment of obesity. In Clinical Obesity. pp. 409–428 [Kopelman, P and Stock, M, editors]. Oxford: Blackwell Science.Google Scholar
(2001) Shape-Up: A Lifestyle Programme to Manage your Weight. London: Weight Concern. www.weightconcern.com.Google Scholar
Westenhoefer, J, Stunkard, AJ & Pudel, V (1999) Validation of the flexible and rigid control dimensions of dietary restraint. International Journal of Eating Disorders 26, 53–64.3.0.CO;2-N>CrossRefGoogle ScholarPubMed
Westenhoefer, J, von Falck, B, Stellfeldt, A & Fintelmann, S (2004) Behavioural correlates of successful weight reduction over 3 y. Results from the Lean Habits Study. International Journal of Obesity and Related Metabolic Disorders 28, 334–335.CrossRefGoogle ScholarPubMed
Wing, RR & Hill, JO (2001) Successful weight loss maintenance. Annual Review of Nutrition 21, 323–341.CrossRefGoogle ScholarPubMed
World Health Organization(2000) Obesity: Preventing and Managing the Global Epidemic Geneva:WHO.Google Scholar