A Grounded Theory Approach to the Process of Successful and Advanced Weight Maintenance

By Joanne Haeffele, Eric P. Trunnell and Anita Kinney.

Published by The International Journal of Health, Wellness and Society

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Cognitive factors involved in successful weight maintenance include thoughts and thinking processes, both directly influence action and behavior. This grounded theory study explored cognitive factors (thoughts) involved in successful weight loss maintenance. The data revealed that weight maintenance is a dynamic process involving three phases: initiation to action, action to maintenance, (successful maintenance); and finally maintenance itself, which is based on the ability to sustain a target weight, within a few pounds, over an extended period of time (advanced maintenance).

Within the last two phases of weight maintenance (successful and advanced), different “activating thoughts” and “sustaining thoughts” are described that are specific to the phase. The properties of “epiphany,” “goal,” and “self-regulation” were integrated to the category of activating thoughts, whereas “mindset,” “self-efficacy,” “motivation,” “love-hate relationship with food,” and “always thinking about maintenance” were related to the category of sustaining thoughts.

The data revealed a difference among the group of successful weight maintainers, indicating that some were able to maintain their weight although they struggled with the process, while the rest were advanced weight maintainers, akin to transcendent individuals. Two different theories for successful and advanced maintainers emerged from the data. Sustaining thoughts for advanced maintainers uncovered the following different properties: “mental issue,” “self-efficacy,” “intrinsic motivation,” “positive relationship with food,” and “maintenance is programmed.”

Results find weight maintenance as a dynamic process with individuals moving back and forth across the processes of sustaining thoughts. The dichotomy of a “love-hate relationship with food” appears to be the most problematic and could drive an individual into becoming an unsuccessful maintainer while “always thinking about maintenance” appears to be the next challenge among successful maintainers. Advanced maintainers reported a positive relationship with food and no longer thought about maintenance.

Keywords: Cognitive, Weight Maintenance

The International Journal of Health, Wellness and Society, Volume 1, Issue 3, pp.43-54. Article: Print (Spiral Bound). Article: Electronic (PDF File; 778.926KB).

Dr. Joanne Haeffele

Assistant Professor of Nursing, School of Nursing, Northern Illinois University, Dekalb, IL, USA

Joanne Haeffele, PhD, FNP-BC is an Assistant Professor of Nursing, at Northern Illinois University and a board certified Family Nurse Practitioner. She received a bachelor’s degree in Nursing from Barat College/University of Health Sciences, the Chicago Medical School, a master’s degree in Nursing from the University of Illinois at Chicago and a PhD in Health Promotion and Education from the University of Utah. Dr. Haeffele has had many years of teaching experience in a graduate level Nurse Practitioner program. Additionally, as a Nurse Practitioner she is a primary care provider in a family medical practice. Dr. Haeffele is interested in health promotion behaviors and activities that will encourage her patients to make life style changes to treat their chronic medical conditions.

Dr. Eric P. Trunnell

Associate Professor, Department of Health Promotion and Education, College of Health, University of Utah, Utah, USA

Dr. Eric Trunnell, PhD, is an associate professor in the Department of Health Promotion and Education at the University of Utah, College of Health. He is a Member of the AAHE Research Coordinating Board. His area of research interest includes self-efficacy, mindfulness and Tai Chi in special populations.

Dr. Anita Kinney

Associate Professor, Cancer Control and Population Science Program, Division of Clinical Epidemiology, Department of Internal Medicine, School of Medicine, University of Utah, Utah, USA

Dr. Anita Kinney, PhD, RN, is co-leader of the Cancer Control and Population Science Program at Huntsman Cancer Institute and an associate professor in the Division of Clinical Epidemiology, Department of Internal Medicine at the University of Utah, School of Medicine. She is an epidemiologist with a clinical background as a nurse practitioner. In her research, she applies a combination of epidemiology, behavioral science, and clinical perspectives to study cancer-related issues. Her overarching research focus is to understand variation in health outcomes and attitudes, and to use this information to develop effective interventions that facilitate informed decision making and positive changes in health behaviors. Dr. Kinney is particularly interested in studying these issues in socially and geographically underserved populations.