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Addressing adult obesity: a psychological framework

Kseib, K. (2018). Addressing adult obesity: a psychological framework. (Unpublished Doctoral thesis, City, University of London)

Abstract

Background: Obesity remains a significant public health priority despite ongoing efforts, with few notable advances made in recent years. Individual behaviour change mechanisms, or ‘active ingredients’, can only partially explain and predict successful weight loss. In addition, maintenance following a period of initial weight loss is rare and relies upon unique combinations of interrelated and overlapping factors. Whilst the outcome of weight loss and its maintenance has been the focus of much research, the individual weight loss journey as a process has been largely overlooked. By looking through the lens of the lived experience, there lies an opportunity to sequence the temporal and contextual dimensions of the weight journey and gain greater insight into this process.

Aims: The current study aimed to examine the temporal and contextual dynamics of the weight loss journey by listening to the personal narratives of people who had attended a psychologically-led weight loss intervention, in this way revealing the barriers and enablers to their initial weight loss and maintenance over time.

Methods: The study adopted a qualitative approach, using a combination of focus groups and 1-1 interviews with participants who had previously attended a psychologically-based weight management intervention.

Results: The study recruited a total of 46 individuals who took part in either a focus group (n=40) or 1-1 interview (n=6). A conceptual linear framework was devised which highlighted three core superordinate themes; Alienation, Connectedness and The Future (Abandonment or Autonomy), representing distinct stages of the weight journey. In exploring the conditions under which individuals migrate across stages results indicated a role for the development of a self-identity which assumes personal responsibility for meeting psychological and emotional needs beyond the physical realm of weight loss. Although most personal narratives reflected a sense of abandonment post intervention and associated weight relapse, a small minority engendered a sense of autonomy and a focus upon psychological and emotional capacities as a metric for their weight loss journey.

Conclusions: Bringing into view temporal and contextual dimensions involved in managing weight over time, the findings have implications for addressing the issue of weight as a symptom rather than as a cause and centralise the importance of meeting psychological and emotional needs over and above a unilateral focus on weight loss.

Publication Type: Thesis (Doctoral)
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Departments: Doctoral Theses
Doctoral Theses > School of Health Sciences Doctoral Theses
School of Health Sciences
URI: https://openaccess.city.ac.uk/id/eprint/21659
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