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Cognitive and behavioural strategies employed to overcome "lapses" and prevent "relapse" among weight-loss maintainers and regainers: A qualitative study.

Accepted version
Peer-reviewed

Type

Article

Change log

Authors

Duschinsky, Robbie 
Pountain, Gillian D 
Hill, Andrew J 

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 Weight Loss Referrals for Adults in Primary Care (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 emphasize strategies focusing on self-monitoring, planning and managing interpersonal relationships to help participants successfully maintain weight-loss in the longer-term.

Description

Keywords

lapses, qualitative, relapse, strategies, weight-loss maintenance, weight-management programmes, Adult, Aged, Behavior Therapy, Body Weight Maintenance, Body-Weight Trajectory, Female, Humans, Male, Middle Aged, Obesity, Qualitative Research, Randomized Controlled Trials as Topic, Recurrence, Secondary Prevention, Weight Reduction Programs

Journal Title

Clin Obes

Conference Name

Journal ISSN

1758-8103
1758-8111

Volume Title

10

Publisher

Wiley

Rights

All rights reserved
Sponsorship
Medical Research Council (MC_UU_12015/4)
Department of Health (via National Institute for Health Research (NIHR)) (RP-PG-0216-20010)
MRC (unknown)
MRC (MC_UU_00006/6)
This study is funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research RP-PG-0216-20010. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. ALA and SJG are supported by the Medical Research Council (MC_UU_12015/4). SJG is an NIHR senior investigator. The University of Cambridge has received salary support in respect of SJG from the National Health Service in the East of England through the Clinical Academic Reserve.