Supporting Weight Loss Maintenance: The Role of Planning, Problem Solving and Recommendations for Future Interventions

Abstract

Relapse after weight loss is a prevalent issue and maintenance outcomes require improvement. This thesis investigates the role of planning in weight loss maintenance, the context in which good planning occurs and produces recommendations for the development of future interventions. After reviewing the literature relevant to this body of work, the need for research in this area and potential gains in supporting behaviour change maintenance are discussed. The first study investigates common perceptions of planning in a sample of participants who had been attempting weight loss maintenance for a period of six months (N = 53), using a mixed method approach. Quantitative findings indicate that maintainers engaged in more planful (rational) problem solving styles, and exhibited less impulsive and less avoidant problem solving styles. Qualitatively, maintainers constructed more plans and showed more accepting and forgiving attitudes in the face of mistakes or lapses than did their counterparts. The second study investigates the capacity for an email-based mindful snacking intervention to cultivate more mindful and less habitual snacking over two weeks, among participants who self-identified as wanting to change their snacking habits (N = 78). A secondary aim examines the potential to cultivate self-compassion alongside mindful snacking. Both mindful eating and action-planning are used within the intervention. Results show that while mindful eating significantly increased, snacking habit strength also significantly increased and self-compassion significantly decreased over the two week intervention period. Likely mechanisms and implications of these changes are discussed. The third study investigates the role of plan quality, problem solving style, coping style and self-compassion in predicting engagement/disengagement intentions following different feedback conditions. Participants who completed the intervention in study 2 and additional measures for study 3 (N = 72) were provided with either positive or negative feedback regarding their intervention outcomes and subsequently asked about their intentions to either continue or discontinue their practice. Findings indicate that neither the feedback condition (positive vs negative), nor actual improvement in habit scores significantly predicted future intentions. However, self-compassion, problem-solving skill and coping style as well as the degree of perceived helpfulness of the intervention each significantly predicted future intentions in univariate models. Backwards-entry logistic regression was used to explore the strongest predictors and only disengagement coping and perceived helpfulness remained as significant predictors, controlling for the effects of feedback, habit improvement, plan quality, problem-solving skill, engagement coping and self-compassion. The thesis concludes with a critical appraisal of the presented studies, a discussion of methodological considerations and interpretations within the broader context of the behaviour change maintenance literature. Recommendations for future interventions are presented and the clinical implications of this research are highlighted.