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Interventions to prevent weight gain: a systematic review of psychological models and behaviour change methods

Abstract

OBJECTIVE: To identify and review published interventions aimed at the prevention of weight gain.

DESIGN: A systematic review of published interventions aimed at the prevention of weight gain.

METHODS: Search strategies—we searched eight databases, manually checked reference lists and contacted authors. Inclusion and exclusion criteria—studies of any design, in which participants were selected regardless of weight or age, were included. Interventions targeting a specific subgroup, multifactorial interventions, interventions aimed at weight loss, and those with an ambiguous aim were excluded. Data extraction—data were extracted on behaviours targeted for change, psychological model, behaviour change methods and modes of delivery, methodological quality, characteristics of participants, and outcomes related to body weight and self-reported diet and physical activity. Classification and validation—a taxonomy of behaviour change programmes was developed and used for classification of underlying model, behaviour change methods, and modes of delivery. The data extraction and subsequent classification were independently validated.

RESULTS: Eleven publications were included, describing five distinct interventions in schools and four in the wider community. Where diet and physical activity were described, positive effects were usually obtained, but all were measured by self-report. Effects on weight were mixed but follow-up was generally short. Smaller effects on weight gain were found among low-income participants, students and smokers. Many participants in the community-based studies were overweight or obese. Study dropout was higher among thinner and lower-income subjects.

CONCLUSION: Interventions to prevent weight gain exhibited various degrees of effectiveness. Definite statements about the elements of the interventions that were associated with increased effect size cannot be made as only one of the five studies that involved an RCT design reported a significant effect on weight. This intervention involved a correspondence programme and a mix of behaviour change methods including goal setting, self-monitoring and contingencies. Future interventions might be more effective if they were explicitly based on methods of behaviour change that have been shown to work in other contexts. Effective interventions would be more easily replicated if they were explicitly described. Effectiveness might be more precisely demonstrated if more objective measures of physical activity and diet were used, and if the follow-up was over a longer period.

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References

  1. Prentice AM, Jebb SA . Obesity in Britain: Gluttony or sloth? Br Med J 1995 311: 437–439.

    Article  CAS  Google Scholar 

  2. World Health Organisation . Obesity. Preventing and managing the global epidemic. Report of a WHO Consultation on Obesity. World Health Organisation: Geneva 1997.

  3. Obesity: The report of the British Nutrition Foundation Task Force. Blackwell Science: Oxford 1999.

  4. James WP . A public health approach to the problem of obesity Int J Obes Relat Metab Disord 1995 19 (Suppl 3): S37–S45.

    PubMed  Google Scholar 

  5. Glenny A-M, O'Meara S, Melville A, Sheldon TA, Wilson C . The treatment and prevention of obesity: A systematic review of the literature Int J Obes Relat Metab Disord 1997 21: 715–737.

    Article  CAS  Google Scholar 

  6. Knowler WC, Pettitt DJ, Savage PJ, Bennett PH . Diabetes incidence in Pima indians: Contributions of obesity and parental diabetes Am J Epidemiol 1981 113: 144–156.

    Article  CAS  Google Scholar 

  7. Lissner L, Barker DJP, Blundell JE, Dietz WH, Epstein LH, Jeffery RW et al.What are the bio-behavioural determinants of body weight regulation? In: Bouchard C, Bray GA (eds) Regulation of bodyweight. Biological and behavioural mechanisms. John Wiley & Sons: Chichester 1996 159–177.

    Google Scholar 

  8. Blundell JE, King NA . Effects of exercise on appetite control: Loose coupling between energy expenditure and energy intake Int J Obes Relat Metab Disord 1998 22 (Suppl 2): S22–S29.

    PubMed  Google Scholar 

  9. Jackson MY, Proulx JM, Pelican S . Obesity prevention Am J Clin Nutr 1991 53 (Suppl): S1625–S1630.

    Article  Google Scholar 

  10. Battle EK, Brownell KD . Confronting a rising tide of eating disorders and obesity: Treatment vs. prevention and policy Addict Behav 1996 21: 755–765.

    Article  CAS  Google Scholar 

  11. Foreyt JP, Cousins JH . Primary prevention of obesity in Mexican–American children Ann N Y Acad Sci 1993 699: 137–146.

    Article  CAS  Google Scholar 

  12. Melnyk MG, Weinstein E . Preventing obesity in black women by targeting adolescents: A literature review J Am Diet Assoc 1994 94: 536–540.

    Article  CAS  Google Scholar 

  13. National Institutes of Health . Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults, 1998.

  14. Douketis JD, Feightner JW, Attia J, Feldman WF, with the Canadian Task Force on Preventive Health Care. Periodic health examination, 1999 update: 1 . Detection, prevention and treatment of obesity Can Med Assoc J 1999 160: 513–525.

    CAS  Google Scholar 

  15. Scottish Intercollegiate Guidelines Network . Obesity in Scotland. Integrating prevention with weight management 1996 8: 1–57.

  16. Spring B, Pingitore R, Kessler K . Strategies to minimize weight gain after smoking cessation: Psychological and pharmacological intervention with specific reference to dexfenflu-ramine Int J Obes Relat Metab Disord 1992 16 (Suppl 3): S19–S23.

    PubMed  Google Scholar 

  17. Hall SM, Tunstall CD, Vila KL, Duffy J . Weight gain prevention and smoking cessation: Cautionary findings Am J Public Health 1992 82: 799–803.

    Article  CAS  Google Scholar 

  18. Spring B, Wurtman J, Gleason R, Wurtman R, Kessler K . Weight gain and withdrawal symptoms after smoking cessation: A preventive intervention using d-fenfluramine Health Psychol 1991 10: 216–223.

    Article  CAS  Google Scholar 

  19. Taylor CB, Fortmann SP, Flora J, Kayman S, Barrett DC, Jatulis D, Farquhar JW . Effect of long-term community health education on body mass index. The Stanford Five-City Project Am J Epidemiol 1991 134: 235–249.

    Article  CAS  Google Scholar 

  20. Jeffery RW . Community programs for obesity prevention: The Minnesota Heart Health Program Obes Res 1995 3 (Suppl 2): S283–S288.

    Article  Google Scholar 

  21. Jeffery RW, Gray CW, French SA, Hellerstedt WL, Murray D, Luepker RV, Blackburn H . Evaluation of weight reduction in a community intervention for cardiovascular disease risk: Changes in body mass index in the Minnesota Heart Health Program Int J Obes Relat Metab Disord 1995 19: 30–39.

    CAS  PubMed  Google Scholar 

  22. Angelico F, Del Ben M, Fabiani L, Lentini P, Pannozzo F, Urbinati GC, Ricci G . Management of childhoodobesity through a school-based programme of generalhealth and nutrition education Public Health 1991 105: 393–398.

    Article  CAS  Google Scholar 

  23. Macaulay AC, Paradis G, Potvin L, Cross EJ, Saad Haddad C, McComber A, Desrosiers S, Kirby R, Montour LT, Lamping, DL, Leduc J, Rivard M . The Kahnawake Schools Diabetes Prevention Project: Intervention, evaluation, and baseline results of a diabetes primary prevention program with a native community in Canada Prevent Med 1997 26: 779–790.

    Article  CAS  Google Scholar 

  24. Epstein LH . Family-based behavioural intervention for obese children Int J Obes Relat Metab Disord 1996 20 (Suppl 1): S14–S21.

    PubMed  Google Scholar 

  25. Wing RR, Marcus MD, Epstein LH, Jawad A . A “family-based” approach to the treatment of obese type II diabetic patients J Consult Clin Psychol 1991 59: 156–162.

    Article  CAS  Google Scholar 

  26. Mellin LM, Slinkard LA, Irwin CE Jr . Adolescent obesity intervention: Validation of the SHAPEDOWN program J Am Diet Assoc 1987 87: 333–338.

    CAS  PubMed  Google Scholar 

  27. Klem ML, Wing RR, Simkin Silverman L, Kuller LH . The psychological consequences of weight gain prevention in healthy premenopausal women Int J Eat Disord 1997 21: 167–174.

    Article  CAS  Google Scholar 

  28. Epstein LH, Coleman KJ, Myers MD . Exercise in treating obesity in children and adolescent Med Sci Sports Exerc 1996 28: 428–435.

    Article  CAS  Google Scholar 

  29. Foster GD, Wadden TA, Brownell KD . Peer-led program for the treatment and prevention of obesity in the schools J Consult Clin Psychol 1985 53: 538–540.

    Article  CAS  Google Scholar 

  30. Jeffery RW, Forster JL, French SA, Kelder SH . The Healthy Worker Project: A work-site intervention for weight control and smoking cessation Am J Public Health 1993 83: 395–401.

    Article  CAS  Google Scholar 

  31. Wadden TA, Stunkard AJ, Rich L, Rubin CJ, Sweidel G, McKinney S . Obesity in black adolescent girls: A controlled clinical trial of treatment by diet, behavior modification, and parental support Pediatrics 1990 85: 345–352.

    CAS  PubMed  Google Scholar 

  32. Sallis JF, McKenzie TL, Alcaraz JE, Kolody B, Hovell MF, Nader PR . Project SPARK. Effects of physical education on adiposity in children Ann NY Acad Sci 1993 699: 127–136.

    Article  CAS  Google Scholar 

  33. Beutler EB, Cambell EP, Frincke LA, Hannon DP, Heim S, Kenney NB, Schneider KE, Smith BS, Vaucher B . Reference Manager Version 7.00N. Carlsbad: CA, USA, 1995.

    Google Scholar 

  34. Kanfer FHE, Goldstein APE . Helping people change: A textbook of methods. Pergamon: New York 1986.

    Google Scholar 

  35. Bootzin R . Behaviour modification and therapy: An introduction. Winthrop: Cambridge, Mas 1975.

    Google Scholar 

  36. Caballero B, Davis S, Davis CE, Ethelbah B, Evans M, Lohman T, Stephenson, L, Story M, White, J . Pathways: A school-based program for the primary prevention of obesity in American Indian children J Nutr Biochem 1998 9: 535–543.

    Article  CAS  Google Scholar 

  37. Cairella G, Romagnoli F, Cantarelli P, Valentini P, Tarsitani G . School oriented intervention on dietary education: Results of phase 1 Int J Obes Relat Metab Disord 1998 22 (Suppl): S254 (abstract).

    Google Scholar 

  38. Davis S, Gomez Y, Lambert L, Skipper B . Primary prevention of obesity in American Indian children. In: Williams CL, Kimm SYS (eds) Pevention and treatment of childhood obesity. New York Academy of Sciences: New York 1993 167–180.

    Google Scholar 

  39. Donnelly JE, Jacobsen DJ, Whatley JE, Hill JO, Swift LL, Cherrington A, Polk B, Tran ZV, Reed G . Nutrition and physical activity program to attenuate obesity and promote physical and metabolic fitness in elementary school children Obes Res 1996 4: 229–243.

    Article  CAS  Google Scholar 

  40. Fitzgibbon ML, Stolley MR, Kirschenbaum DS . An obesity prevention pilot program in African-American mothers and daughters J Nutr Educ 1995 27: 93–97.

    Article  Google Scholar 

  41. Forster JL, Jeffery RW, Schmid TL, Kramer FM . Preventing weight gain in adults: A pound of prevention Health Psychol 1988 7: 515–525.

    Article  CAS  Google Scholar 

  42. Gittelsohn J, Evans M, Helitzer D, Anliker J, Story M, Metcalfe L, Davis S, Cloud PI . Formative research in a school-based obesity prevention program for Native American school children (Pathways) Health Educ Res 1998 13: 251–265.

    Article  CAS  Google Scholar 

  43. Jeffery RW, French SA . Preventing weight gain in adults: Design, methods and one year results from the Pound of Prevention study Int J Obes Relat Metab Disord 1997 21: 457–464.

    Article  CAS  Google Scholar 

  44. Sherwood NA, Morton N, Jeffery RW, French SA, Neumark-Sztainer D, Falkner NH . Consumer preferences in format and type of community-based weight control programs Am J Health Prom 1998 13: 12–18.

    Article  CAS  Google Scholar 

  45. Simonetti D-A, Tarsitani G, Cairella M, Siani V, De Filippis S, Mancinelli S, Marazzi MC, Palombi L . Prevention of obesity in elementary and nursery school children Public Health 1986 100: 166–173.

    Article  Google Scholar 

  46. Stolley MR, Fitzgibbon ML . Effects of an obesity prevention program on the eating behavior of African American mothers and daughters Health Educ Behav 1997 24: 152–164.

    Article  CAS  Google Scholar 

  47. Bandura A . Social learning theory. Prentice-Hall: Englewood Cliffs, NJ 1977.

    Google Scholar 

  48. Bandura A . Social foundations of thought and action: A social cognitive theory. Prentice Hall: Englewood Cliffs, NJ 1986.

    Google Scholar 

  49. Must A, Dallal GE, Dietz WH . Reference data for obesity: 85th and 95th percentiles of body mass index (wt/ht2) and triceps skinfold thickness Am J Clin Nutr 1991 53: 839–846.

    Article  CAS  Google Scholar 

  50. Health Promotion Effectiveness Reviews . Health promotion interventions to promote healthy eating in the general population: A review. Health Education Authority: London 1997.

    Google Scholar 

  51. Health Promotion Effectiveness Reviews . Effectiveness of physical activity promotion in primary care. Health Education Authority: London 1998.

    Google Scholar 

  52. Kalichman SC, Carey MP, Johnson BT . Prevention of sexually transmitted HIV-infection: A meta-analytic review of the behavioral outcome literature Ann Behav Med 1996 18: 6–15.

    Article  CAS  Google Scholar 

  53. Medical Research Council . Primary Health Care 1997. MRC Topic Review. Medical Research Council: London 1997.

    Google Scholar 

  54. Abraham C, Sheeran P, Johnston M . From health beliefs to self-regulation: Theoretical advances in the psychology of action control Psychol Health 1998 13: 569–592.

    Article  Google Scholar 

  55. Wareham NJ, Rennie KL . The assessment of physical activity in individuals and populations: Why try to be more precise about how physical activity is assessed? Int J Obes Relat Metab Disord 1998 22 (Suppl): S30–S38.

    PubMed  Google Scholar 

  56. US Department of Health and Human Services . Physical activity and health: A report of the Surgeon General. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion: Atlanta, GA 1996.

    Google Scholar 

  57. Quellette JA, Wood W . Habit and intention in everyday life: The multiple processes by which past behavior predicts future behavior Psychol Bull 1998 124: 54–74.

    Article  Google Scholar 

  58. Gollwitzer PM, Brandstätter V . Implementation intentions and effective goal pursuit J Pers Soc Psych 1997 73: 186–199.

    Article  Google Scholar 

  59. Rissanen A, Hellovaara M, Krekt P, Revnanen A, Aromaa A . Determinants of weight gain and overweight in adult Finns Eur J Clin Nutr 1991 45: 419–430.

    CAS  PubMed  Google Scholar 

  60. Haapanen N, Miilunpalo S, Pasanen M, Oja P, Vuori I . Association between leisure time physical activity and 10-year body mass change among working-aged men and women Int J Obes Relat Metab Disord 1997 21: 288–296.

    Article  CAS  Google Scholar 

  61. Coakley EH, Rimm EB, Colditz G, Kawachi I, Willett W . Predictors of weight change in men: Results from the Health Professionals Follow-up Study Int J Obes Relat Metab Disord 1998 22: 89–96.

    Article  CAS  Google Scholar 

  62. Williamson DF, Madans J, Anda RF, Kleinman JC, Kahn HS, Byers T . Recreational physical activity and ten-year weight change in a US national cohort Int J Obes Relat Metab Disord 1993 17: 279–286.

    CAS  PubMed  Google Scholar 

  63. Rennie KL, Wareham NJ . The validation of physical activity instruments for measuring energy expenditure: Problems and pitfalls Public Health Nut 1998 1: 265–271.

    CAS  Google Scholar 

  64. Wareham NJ, Hennings SJ, Prentice AM, Day NE . Feasibility of heart-rate monitoring to estimate total level and pattern of energy expenditure in a population-based epidemiological study: The Ely Young Cohort Feasibility Study 1994–5. Br J Nutr 1997 78: 889–900.

    Article  CAS  Google Scholar 

  65. Gossard D, Haskell WL, Taylor CB, Mueller JK, Rogers F, Chandler M, Ahn DK, Miller NH, DeBusk RF . Effects of low- and high-intensity home-based exercise training on functional capacity in healthy middle-aged men Am J Cardiol 1986 57: 446–449.

    Article  CAS  Google Scholar 

  66. Bates CJ, Thurnham DI, Bingham SA, Margetts BM, Nelson M . Biochemical markers of nutrient intake. In: Margetts BM, Nelson N (eds) Design concepts in nutritional epidemiology. Oxford University Press: Oxford 1991 192–265.

    Google Scholar 

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Hardeman, W., Griffin, S., Johnston, M. et al. Interventions to prevent weight gain: a systematic review of psychological models and behaviour change methods. Int J Obes 24, 131–143 (2000). https://doi.org/10.1038/sj.ijo.0801100

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