Cognitive and behavioural strategies employed to overcome “lapses” and prevent “relapse” among weight‐loss maintainers and regainers: a qualitative study

Lawlor, E. R. , Hughes, C. A., Duschinsky, R., Pountain, G. D., Hill, A. J., Griffin, S. J. and Ahern, A. L. (2020) Cognitive and behavioural strategies employed to overcome “lapses” and prevent “relapse” among weight‐loss maintainers and regainers: a qualitative study. Clinical Obesity, 10(5), e12395. (doi: 10.1111/cob.12395) (PMID:32767708) (PMCID:PMC7116423)

Abstract

While many behavioural weight management programmes are effective in the short-term, post-programme weight regain is common. Overcoming “lapses” and preventing “relapse” has been highlighted as important in weight-loss maintenance, but little is known on how this is achieved. This study aimed to compare the cognitive and behavioural strategies employed to overcome “lapses” and prevent “relapse” by people who had regained weight or maintained weight-loss after participating in a weight management programme. By investigating differences between groups, we intended to identify strategies associated with better weight-loss maintenance. Semi-structured interviews were conducted with 26 participants (58% female) recruited from the 5-year follow-up of the WRAP trial (evaluation of a commercial weight-loss programme). Participants who had lost ≥5% baseline weight during the active intervention were purposively sampled according to 5-year weight trajectories (n=16 “Regainers”, n=10 “Maintainers”). Interviews were audio-recorded, transcribed verbatim, and analysed thematically. Key differences in strategies were that Maintainers continued to pay attention to their dietary intake, anticipated and planned for potential lapses in high-risk situations, and managed impulses using distraction techniques. Regainers did not report making plans, used relaxed dietary monitoring, found distraction techniques to be ineffective and appeared to have difficulty navigating food within interpersonal relationships. This study is one of the longest qualitative follow-ups of a weight loss trial to date, offering unique insights into long-term maintenance. Future programmes should emphasise strategies focusing on self-monitoring, planning and managing interpersonal relationships to help participants successfully maintain weight-loss in the longer-term.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Lawlor, Dr Emma
• Authors: Lawlor, E. R., Hughes, C. A., Duschinsky, R., Pountain, G. D., Hill, A. J., Griffin, S. J., and Ahern, A. L.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: Clinical Obesity
• Publisher: Wiley
• ISSN: 1758-8103
• ISSN (Online): 1758-8111
• Published Online: 07 August 2020
• Copyright Holders: Copyright © 2020 The Authors
• First Published: First published in Clinical Obesity 10(5):e12395
• Publisher Policy: Reproduced under a Creative Commons licence