Nutrition for Weight Loss

Abstract

To examine how much people who live with obesity have tried to lose weight, how they feel about diets, exercise, and other weight-loss methods, why their attempts have failed, and what they believe would be most helpful for them in their battle with their weight.

Method

Open-ended interviews were used in qualitative research of 76 obese persons in Victoria, Australia in the years 2006–2007. To diversify the sample, people with a BMI of 30 or above were sought out through advertisements in regional newspapers, sampling methods, and later purposive selection methods. Hand analysis of the data was used to create and test analytical categories using a constant, relative approach. Both team meetings and opportunities for research participants to offer feedback on the study’s findings were used to analyse the data.

Results

While individuals frequently followed commercial diets to try to lose weight, few had ever used or were motivated to engage in physical activity. Most people were introduced to weight loss methods through friends or relatives. Participating in interventions with others in their social network increased the likelihood that participants felt supported and welcomed. Participants accused themselves of failing to maintain their weight loss or “commit” to diets. Although diets did not provide sustained weight loss, two-thirds of participants thought dieting was a useful strategy for losing weight.

Conclusion

Obese people receive a lot of advice on how to deal with their weight, but relatively few of them receive the right long-term assistance or supervision to carry out those recommendations. To motivate people to exercise, it is crucial to comprehend the good effects of social networks. If there is to be a pattern of social change regarding obesity, public health methods must involve and consult those who are already living with obesity.

Background

The general public, and even some medical professionals, hold the misconception that those who are obese are indolent and haven’t tried to drop weight. Now that we are beginning to comprehend it, the root reasons for the obesity epidemic exist on many levels, including personal, social, cultural, and biological. We also realise that fad diets are not the answer to weight loss and that there are both immediate and long-term measures that need to be taken into account if we are to support the social change that will allow people, families, and communities to live healthy lifestyles.

Many obese people still turn to “short-term” methods in their ongoing, and lifelong, battle with their weight, even though programmes centred around physical exercise and behavioural therapy for persons living with obesity have been demonstrated to have positive effects on well-being. Furthermore, although many popular commercial diets are ineffective, doctors still advocate them as standalone weight-loss plans. While some studies have sought to quantify the various diets that obese individuals have been on and the motivations for weight reduction attempts, very few research have qualitatively addressed the underlying driving elements of obese people’s weight loss efforts, their perceptions and expectations of diets, and the long- and short-term physical and emotional health repercussions of weight loss attempts. Few studies have also asked obese people what they believe to be the best solutions for helping them control their weight.

The findings in this publication were part of a bigger investigation into the social and health experiences of obese persons in Victoria, Australia. The purpose of this article was to examine in depth the weight loss attempts made by obese persons, their views regarding diets and weight loss methods, their theories on why these attempts failed, and suggestions for what could be able to assist them in their battle with their weight.

Methods

The study, which was conducted in Victoria, Australia, sought to create a picture of both the lived experiences of obesity and the effect that sociocultural influences have on obesity. A qualitative study design was used because there is little literature describing the stories of obese people. Qualitative research seeks to provide an in-depth understanding of people’s experiences through their own words rather than statistically accurate data. In qualitative investigations, statements and statistics are offered to illustrate the wide range of experiences of a group of people as well as the moments at which any similarities and contrasts arise. The study didn’t intend to be broadly applicable; instead, it sought to shed light on the difficulties that some obese people face in their ongoing attempts to lose weight.

Based on a thorough literature study, discussions with public health experts, and conversations with obese people, a comprehensive, open-ended interview schedule was created. The influence of dieting on participants’ physical and emotional health, wellness, and experiences with commercial diets were some of the topics covered in the study. Other topics included participants’ views toward physical activity and how they had used specific dieting tactics. To reach the widest potential audience, they employed a variety of recruitment techniques.

These included newspaper articles from the area, convenience and snowball sampling methods, and later, purposeful sampling to diversify the sample to include men, people under 25, and those living in rural and distant locations. The cost of any trip made by the individuals was compensated. Between September and October of 2006, audiotapes of the interviews were made. Participants could select whether they wanted to be interviewed in person or over the phone. The latter was crucial since it enabled us to include

• People who were uncomfortable or hesitant to interact with the researchers in person,
• Those who were unable to travel to a face-to-face interview.
• People who resided in isolated or rural areas. The duration of each interview was 60 to 120 minutes.

They tested the analytical procedures, developed analytical categories, and then gave an explanation of why categories appeared using a constant, continuous, comparative methodology. One of the authors of the study conducted the initial analysis (ST). The transcripts were read and reread. Thematic and conceptual categories that formed were noted together with their causes, points of similarity, and points of divergence. Inter-rater dependability was investigated.

Other team members chose a random sample of interviews and analyzed them to ensure that the data interpretation was accurate. Any discrepancies were thoroughly examined until a decision was made. Recruitment and interviewing came to an end after we were confident that no new topics were developing (analytical saturation). After the analysis was finished, participants received a copy of the results and were urged to get in touch with the research team with any questions or feedback.

Results

A hundred and one-people asked questions about the study. Of those, 17 persons declined to take part after learning more about the study. Eight people missed the interview because they were absent. Participants ages ranged from 16 to 72 (on average 47), were mostly female, had a mean BMI of 42.5, and primarily identified as being of “white Australian” ethnicity.

What encourages obese people to diet?

All of the participants had repeatedly tried to reduce weight throughout their lives and, on average, had started dieting in their early teens. Although all participants’ primary motivation was weight loss, they also listed several secondary motivations. These included general health and well-being, preparing for lap band surgery, increased mobility, a desire to avoid death, medical professional advice, a desire to be more actively involved in their children’s lives, a desire to engage in social activities, a desire to avoid being teased about their weight, an aspiration to be socially accepted, and a wish to begin a committed relationship.

Strategies for losing weight

Weight Watchers, prescription drugs like Orlistat and Phentermine, complementary therapies, slimming milkshakes, and “starvation” periods were the most widely used weight loss methods. Dietary trends followed an intriguing pattern of development. Participants admitted that they began with “fad” diets promoted in magazines when they were teenagers before moving on to more official commercial diets.

Some participants claimed that when these methods failed, they turned to more drastic measures such as taking prescription drugs and dietary supplements with extremely low calories. There was a lot of overlap between the programmes, and people frequently tried many different weight loss techniques at once. These participants most frequently combined prescription drugs with diets.

The majority of participants first learned about a specific diet through a person in their social network, including a family member, acquaintance, or co-worker. Many people were able to provide a personal account of a sister, mother, or friend who had lost a significant amount of weight following a fad diet. Some respondents claimed that hearing about the diet success stories of people in their networks gave them confidence that the diet would be successful for them.

Social network users were extremely important in motivating participants to try various diets. Many people viewed diet classes as a social event they attended with friends or family. This was especially true for sisters, spouses, and partners, as well as moms and daughters. Others described their diet group as a place where they had a sense of solidarity with other overweight and obese people, had some social contact, and a sense of belonging.

The “diet group” was viewed as a place of social recognition given that these individuals also spoke of a feeling of isolation, discrimination, and rejection in the larger society. However, the diet group was far from a welcoming and encouraging environment for people and instead promoted low self-esteem, unfavourable emotions, and self-blame.

We asked the participants why they had tried particular diets. The majority of participants who had signed up for Weight Watchers said they did so because a friend or member of their family was already “doing Weight Watchers.” Those who had signed up for Weight Watchers also mentioned that they had attempted the diet numerous times with a friend or relative, underscoring once more the desire of many participants to engage in a social activity with their peers.

The majority of those who had used prescription drugs were pleased with how much weight they had reduced, but they weren’t thrilled with the adverse effects. This held for the individuals’ experiences with phentermine in particular. Participants who had tried orlistat expressed dissatisfaction with the price of the medication and reported finding it challenging to afford over time. The participants’ descriptions of their interactions with Jenny Craig varied greatly. The majority of people who tried Jenny Craig did so on their own. Those who had signed up with Jenny Craig claimed to have been “seduced” by the consultants’ “spiel.”

The majority of the seven individuals who had used Optifast expressed their dissatisfaction with the lack of additional lifestyle change recommendations.

Effects of weight loss strategies over the short and long terms

The vast majority of individuals claimed that dieting had caused them to lose weight quickly. More than half of the participants claimed that dieting had been successful for them in the short term. Most people could recall the period during which they had lost the most weight, the diet that had “worked,” and the amount of weight they had lost.

Participants discussed how decreasing weight had significantly changed both their physical and mental well-being. Some participants’ emotional reactions to losing weight were described using words like “euphoric,” “extremely joyful,” “delighted,” and “ecstatic.” Some ladies went into great detail about how losing weight made them “attractive to men” and allowed them to start relationships. Other participants claimed that they could “move more,” feel “more comfortable” physically, and be able to “keep up with the kids” after losing weight.

However, the joy that comes with losing weight was fleeting for the vast majority of participants. Several participants said they felt like “failures” since they had friends or family who had succeeded on commercial diets but they had not. Others claimed that they felt “depressed,” “angry,” or “crossed” because they couldn’t keep the weight off.

Why diets fail?

Twenty participants stated that the diets themselves were “unrealistic,” “unsustainable,” “too expensive,” “didn’t address my lifestyle,” “focused on food rather than modifying my behaviour,” “boring,” or “had me continually think about my next meal,” which prevented them from sticking with it. Due to the various messages spread by various diet firms, some participants expressed their confusion about the best course of action. Many emphasised that while diets were difficult to maintain, they were effective as long as you followed them: “When you follow them, they all work. They don’t when you stop using them.” One person said she frequently abandoned her diet because “sometimes you simply want to be normal.”

A third of participants said they were to fault for failing to keep with or continue with a weight loss goal, either because of themselves or a related life event. Some claimed they had a personality type that demanded a “fast fix” and was unhappy if they did not see immediate benefits or if their weight fluctuated while participating in programmes. Other causes of diet failure include emotional issues, anxiety, physical discomfort, changing jobs, changes in financial situation, a lack of willpower, holidays, an inability to adhere to the diet “strongly enough,” or not being “dedicated enough.” The fact that participants blamed themselves rather than the diet for their inability to lose weight was once again supported by this.

Participants also discussed the pressure they experienced from friends and family after losing weight. Some participants said they became irritated when people made remarks about or called attention to how much weight they had lost because they knew they would probably gain the weight back. Participants also mentioned that if they lost a lot of weight, friends and family would say they “looked unwell” or “too thin,” and would try to persuade them to quit dieting.

Some participants said they thought their friends and family would try to “sabotage” their weight-loss efforts. Participants found it to be a double-edged sword to diet with someone from their social network. Some people admitted that they felt bad if they lost more weight than their “diet partner,” while others claimed that they felt dejected if they lost less weight or did not experience the same level of “success” on the diet.

Physical exercise

Few individuals reported using exercise as part of their weight loss plan or in conjunction with dieting. There seemed to be more obstacles in the way of the participants when we asked them if they had tried exercise. The majority of participants claimed that they had trouble exercising because of their fat, physical health issues, inability to pay for personal trainers or gym memberships, lack of free time, or feelings of discomfort or embarrassment about participating in organised fitness activities.

Participants acknowledged that it was very challenging to exercise on their own and desired an intervention where someone else would be in charge of inspiring them and assisting them in beginning to be more physically active.

Participants also mentioned feeling emotionally embarrassed, daunted or humiliated when they tried to work out by themselves. The two activities that health professionals most frequently suggested to participants were swimming and walking. Although many participants thought swimming would be the perfect form of exercise for them, the majority admitted that they felt ashamed and embarrassed about going to a place where they would have to expose so much of their bodies to strangers.

What is more beneficial?

The majority of participants were quick to point out that there isn’t a magic diet that can cure obesity. Instead, they were eager to emphasise the fact that each person was unique and that different programmes and support systems would be helpful to different people by using several instances. Many others emphasised how challenging it might be to attempt weight loss on one’s own and without assistance.

Participants complained that many diets were too expensive, making them unaffordable for people who needed to lose a lot of weight. However, over two-thirds believed that “dieting” was a successful method of weight loss. 80% of participants who were asked what obese persons needed to do to lose weight said that they needed to diet. Very few individuals listed physical activity or exercise as a crucial component of a thorough weight loss plan.

Participants wanted someone else to be in charge of assisting them in losing weight. Many believed that general practitioners (GPs), who offer primary care, were the best individuals to assist them in doing this. Despite their repeated attempts to lose weight, the majority of them now felt helpless to do so on their own. This may be the reason why some individuals unwillingly believed that obesity surgery was their only choice.

Discussion

The majority of the participants in this study used dieting as a weight loss aid rather than “lifestyle adjustments” or exercise. From this work, three intriguing explanations emerged.

People who are obese have been “socially conditioned” to blame themselves when diets don’t work and to look to diets as a remedy for their obesity

Participants had been taught to believe they could lose weight by dieting for the majority of their lives, beginning in early infancy. Diets are promoted as magical, instant fixes for extra weight. According to research, regularly hearing messages about diets and weight loss may have a significant impact on how people control their weight. This was accurate for those participants who admitted to making frequent, sometimes desperate attempts to shed weight when they were young.
Despite having many unattainable objectives and standards, most diets did, at least temporarily, resulting in some type of weight loss. Participants felt they were to blame when the diet didn’t work since they couldn’t maintain their weight loss.

Exercise and physical activity are challenging for those who have obesity

The findings made it very evident that persons who are obese are reluctant to engage in physical activity or find it highly challenging. After all, there is a substantial difference between the emotional and physical effort needed to “go on a diet” and the effort needed to increase physical activity. Exercise is not promoted as a miracle weight-loss cure. In reality, the no pain, no gain philosophy is used to convey the impression that exercising is difficult.

Many participants reported feeling emotionally uncomfortable or publicly humiliated when attempting to engage in the sorts of exercises that were advised to them by doctors, whereas others felt physically incapable of exercising due to health issues. The majority of participants’ narratives made it obvious that participating in physical activity can feel isolating. Many individuals reported feeling powerless, especially when it came to physical activity.

Social networks can have both helpful and harmful effects to live healthier lifestyles

The views and opinions of the people in the participants’ informal social networks, particularly family members, had a big impact on them. Social networks were crucial in motivating individuals to try new diets, but they were also crucial in sabotaging participants’ attempts to lose weight.

Conclusion

We are very good at identifying the immediate causes of health issues related to obesity, but we struggle to identify and address more upstream determinants like people’s lack of empowerment, the influence of social media networks, and the impact of broader messages people hear about how to lead healthy lives. This may be mostly because people who are obese are not represented in obesity research or the design of public health programmes.

While many people who are considered obese receive a lot of advice on how to deal with their weight, relatively few of them receive the proper long-term assistance or direction. If public health strategies to combat obesity are to result in patterns of societal change, then persons who are living with obesity must be included in the design, testing, and assessment of interventions.