General Self-Efficacy and Body Weight: The Role of Race and Gender

Overweight and obesity have become a prominent concern for policymakers, the Surgeon General, scholars, and for work organizations. The estimated annual cost of obesity in terms of lost productivity is in the tens of billions of dollars, and the estimated annual medical cost of obesity is in the hundreds of millions of dollars. Psychologists have become increasingly interested in issues related to body weight, such as ways to help people reduce body weight. The aims of our study are twofold. First, based on social cognitive theory, we offer the first study of the relationship between general self-efficacy (GSE) and body weight based on a large, representative sample. Second, we also offer an understanding of the role of race and gender as potential boundary conditions of this relationship. Findings indicate that race moderates the relationship between GSE and body weight (both BMI and perceived weight) such that this relationship is positive for Blacks but negative for Whites. Gender did not moderate the relationship between GSE and body weight. These results suggest that body weight is unrelated to general self-efficacy in the population writ large and that body weight is differentially related to self-efficacy based on race but not gender.

Experiences of weight stigma in everyday life: An ecological momentary assessment study

Weight stigma and discrimination have been linked to negative health outcomes. Most research on this topic is retrospective, which may not accurately capture day-to-day experiences. The current used ecological momentary assessment to examine weight stigma and discrimination in everyday life. Participants answered ecological momentary assessments about the nature, frequency, and contextual details of weight stigma and discrimination. Over the course of the study, only eight episodes of weight stigma and discrimination were reported. Given that prior ecological momentary assessment studies reported substantially more frequent weight stigma and discrimination, possible explanations for the findings and implications for future research are discussed.

Narratives for Obesity: Effects of Weight Loss and Attribution on Empathy and Policy Support

Despite an urgent need to address the issue of obesity, little research has examined the psychological factors that influence support for obesity-related policy initiatives, which represent an important tool for addressing this complex health issue. In the present study, we measured the degree to which people supported obesity-related policy interventions and empathized with a person struggling with obesity after reading a personal account of his or her situation. The narrative described an obese individual who was portrayed as either successfully losing weight or not, and as attributing his or her weight-loss outcome to personal or environmental factors. We found that protagonists who successfully lost weight and/or took personal responsibility for their situation elicited more empathy from participants, which was associated with support for societal policy interventions for obesity. These findings suggest that specific features of personal narratives influence support for obesity-related policies and highlight empathy as a mechanism through which such narratives affect obesity-related attitudes.

Fat as Productive: Enactments of Fat in an Australian Suburb

By foregrounding positive and productive capacities of fat, we explore experiences of expanding, maintaining, or diminishing body sizes to accommodate the different meanings and enactments of fat. Drawing on fieldwork conducted in a South Australian community that has experienced significant socioeconomic disadvantage, we detail how the "problem" of fat in public health discourse is countered in the lived experience of people targeted for obesity intervention. In so doing, we attend to the multiple meanings and practices of fat that differ to the focus within public health interventions on the negative health consequences of overweight and obesity.

How Formerly Overweight and Obese Individuals Negotiate Disclosure of Their Weight Loss

Overweight and obese individuals frequently experience weight-based stigma, and reducing stigma is one reason people want to lose weight. However, research suggests even after individuals become a normal weight, knowledge of their old body size can result in stigma. Through interviews of 30 formerly overweight or obese individuals and the framework of Communication Privacy Management theory, this study found the vast majority of participants perceived more benefits from disclosing their larger identity than risks, regardless of weight-loss method. Participants revealed their weight loss in order to inspire others, build relationships, or hold themselves accountable. Conversely, a few participants concealed to protect their thinner identity (i.e., they feared stigma) or to avoid coming across as boastful. In contrast to previous studies, this investigation suggests most participants were not dissuaded from revealing their former body size due to a threat of residual stigma. Participants' disclosure was overwhelmingly met with encouraging and supportive responses.

Elementary School Students' Perceptions of Overweight Peers

Obesity is a growing epidemic in the United States. Children who are overweight tend to participate in fewer activities, to withdraw from social situations, and to be less physically active than their normal-weight peers. Additionally, they have lower self-image and often suffer from depression. Research on children's perceptions of overweight peers has been sparse, with the few completed studies tending to focus on adolescents. In the current study, participants were asked to listen to four stories, two involving females and two involving males. Following each story, the children were presented with obese and nonobese target pictures and asked to match the two gender-specific pictures of children with the “nice” and “mean” characters from the story. Results show an overall main effect, indicating that the number of “nice” responses given to nonobese target figures was significantly greater than the number given to obese target figures. No gender effects were observed.

Compensating for Stigma: Obese and Nonobese Women's Reactions to Being Visible

The hypothesis that obese women compensate for the prejudice of others was tested by having obese and nonobese women converse by telephone with someone who they believed, correctly or incorrectly, could or could not see them. Partners rated obese women's social skills negatively when the women were visible (thus activating the partners' prejudice) but thought they were not. Obese women rated themselves as more likable and socially skilled than nonobese women did when the women thought they were visible to female partners. Judges' ratings of the women's contribution to the conversation indicated that there were no obvious differences in the impressions created by their verbal or nonverbal behaviors. Results support the hypothesis that obese women who were aware of the need to compensate for their partners' reactions to their appearance were able to do so.

Body Image and Sociocultural Norms

Internalization of sociocultural norms about the body has been theorized to be an important factor in fostering body dissatisfaction in women. Some theorists have suggested that a lesbian identity may buffer or immunize lesbians from the damaging effects of society's pressure to be thin by reducing this internalization. This study was designed to test this claim empirically. Questionnaires were completed by 108 lesbians and 115 heterosexual women recruited through snowball sampling. Lesbians felt more fit, reported less negative attitudes toward their lower bodies, and internalized sociocultural norms less than heterosexual women. For all women, internalization of sociocultural norms significantly predicted body attitudes. Lesbians and heterosexual women appear to be similarly exposed to and aware of society's messages, and as such their body attitudes substantially overlap. However, lesbians are buffered from these views in some specific areas. These differences appear to be primarily the result of differential internalization of sociocultural norms.

Self-Objectification and Its Psychological Outcomes for College Women

The objectification of women by our society can become internalized by women, resulting in negative psychological outcomes. Using Fredrickson and Roberts' (1997) objectification theory, we tested a model of the relationships between self-objectification and disordered eating and depressive symptoms in a sample of undergraduate women ( n = 384). One postulate of self-objectification theory is that self-objectification can lead to a lack of internal awareness, which may mediate the relationship between self-objectification and restrictive eating, bulimic, and depressive symptoms. Results of structural equation modeling suggest that self-objectification has a direct relationship to restrictive eating, bulimic, and depressive symptoms. The mediational role of internal awareness was relevant for depressive symptoms but not for restrictive eating or bulimic symptoms. Depressive symptoms did, however, mediate the relationship between self-objectification and bulimic symptoms. The relevance of our findings to the understanding of objectification theory are discussed and future areas of research recommended.

Transforming Lesbian Sexuality

Women are objectified and sexualized by the media and the economy, so that they live in a culture of sex. Lesbians are excluded from the mainstream sexual and appearance norms for women, yet are affected by these norms, including the association of sex and violence against women. The word sexuality has been used to connote both sexual orientation and sexual activity, and it is argued that this dual meaning illustrates the dominance of patriarchal definitions of women's sexuality. This article discusses methodologic issues in understanding who is a lesbian and presents various models or dimensions for understanding who is included in research about lesbians. It asks the question “What is sex?” and reviews the implications of this question for lesbian sexual activity. This question has implications for a collorary question: “What is a lesbian relationship?”, and the article discusses the implications of this question on various forms of sexual and nonsexual relationships among lesbians.

Gender Differences in Internal Beliefs About Weight and Negative Attitudes Towards Self and Others

Previous research has found that people with an internal weight locus of control (beliefs in self-control over weight) are more likely to join and stay in weight-loss programs and have higher self-esteem than those who have an external locus of control (e.g., belief that weight is due to luck, genes). There has been no research on how weight locus of control affects the self-esteem of people who are not average weight or not satisfied with their weight. The present study predicted that for people who are overweight, weight locus of control would be negatively related to self-esteem. The results confirmed this interaction between weight locus of control and weight on self-esteem for women, but not for men. The second prediction was that internal weight locus of control would have negative social consequences in terms of greater negative stereotyping of obese people, and this was also confirmed for women. Because weight loss is rarely permanent, it would seem important to change people's attitudes about the lack of control that they (and others) have over body weight.

Inequalities in body mass index and smoking behavior in 70 countries: evidence for a social transition in chronic disease risk

Despite the growing burden of chronic disease globally, few studies have examined the socioeconomic patterning of risk across countries. The authors examined differences in the social patterning of body mass index (BMI) and current smoking by urbanicity among 70 countries from the 2002-2003 World Health Surveys. Age-adjusted, gender-stratified ordinary least squares and logistic regression analyses were conducted in each country to assess the relation between education and BMI or smoking. Meta-analytic techniques were used to assess heterogeneity between countries in the education-risk factor relations. Meta-regression was used to determine whether the heterogeneity could be explained by country-level urbanicity. In the least urban countries, persons with higher education had a higher BMI, while the opposite pattern was seen in the most urban countries, with this pattern being especially pronounced among women. In contrast, smoking was consistently concentrated among persons of lower education among all men and among women in the least urban countries. For women in the most urban countries, higher education was associated with higher odds of smoking, although there was substantial variability in this relation. These results highlight a global trend toward an increasing burden of chronic disease risk among persons of lower socioeconomic position as countries become more urban.

The impact of weight stigma on caloric consumption

The present study assessed the influence of exposure to weight stigma on energy intake in both overweight and normal-weight adult women. Seventy-three women (mean age: 31.71 ± 12.72 years), both overweight (n = 34) and normal weight (n = 39), were randomly assigned to view one of two videos depicting either weight stigmatizing material or neutral material, after which they consumed snacks ad libitum. Pre- and post-video measures included blood pressure, attitudes toward overweight individuals, and positive and negative affect. Participants' body weight was measured, as was the number of kilocalories consumed following video exposure. Overweight women who watched the stigmatizing video ate more than three times as many kilocalories as overweight women who watched the neutral video (302.82 vs. 89.00 kcal), and significantly more calories than the normal-weight individuals who watched either the stigmatizing or the neutral video. A two-by-two analysis of covariance revealed that even after adjusting for relevant covariates, there was a significant interaction between video type and weight status in that when overweight, individuals consumed significantly more calories if they were in the stigmatizing condition vs. the neutral condition (F(1,65) = 4.37, P = 0.04, η(2) = 0.03). These findings suggest that among overweight women, exposure to weight stigmatizing material may lead to increased caloric consumption. This directly challenges the notion that pressure to lose weight in the form of weight stigma will have a positive, motivating effect on overweight individuals.

Leaks, Lumps, and Lines

Women’s bodies have often been positioned in art and popular culture as monstrous or defiled and women’s bodily products (e.g., menstrual fluid, breast milk) as disgusting. This framing has led to the stigmatization of aspects of women’s bodies (e.g., leaking fluids, lumps of fat, and lines in the skin that indicate aging), especially those aspects that are perceived as threats to culture and society. In this article, the author draws on feminist theory, stigma theory, and terror management theory to explain the positioning of menstruating, fat, and old women as threatening and stigmatized. Evidence for the stigma is discussed, as are the effects of stigma on the stigmatized and the stigmatizers. Ways of resisting, reframing, and coping with stigma are suggested.

Competing motivational discourses for weight loss: means to ends and the nexus of beauty and health

Western cultural discourses generally deem fat unhealthy and unattractive, providing strong motivation for body nonconformists to lose weight. Semistructured interviews with 42 overweight and obese participants illuminate how individuals understand health and beauty weight-loss motivations and the relationship between the two. Interviews indicate that health and beauty motivate because they are seen as means to various ends. Specifically, participants aspire to health to fulfill various social roles and to live long, meaningful lives. Moreover, they aspire to conventional beauty ideals hoping that aesthetic conformity will elicit benefits, both psychological and social. Interviews also illustrate an intertwining of discourses in which participants conflate beauty and health in three ways: indicating that depictions of the beauty ideal are depictions of the health ideal; using beauty indicators as health indicators; and employing beauty as a motivator for health goals. This article concludes with a discussion of the health, social, and policy implications of these findings.

Bodies, mothers and identities: rethinking obesity and the BMI

Despite the intense level of attention directed towards obesity, there has been limited success in addressing the rising rates of this public health phenomenon. This paper argues that current approaches to obesity fail to consider concepts of embodiment, and in particular, that gendered and class-based experiences of embodiment are ignored in health promotion practices and policies. Drawing on Bourdieu's concept of habitus, this ethnographic study sought to locate obesity within the biographies and everyday experiences of two groups of women from differing socio-economic settings. Rather than identify with the clinical category of obesity, these women constructed identities that were refracted through a gendered and classed habitus, and in particular, through their role as mothers. Food provision and practices were central to constructs of mothering, and these relational identities were at odds with the promotion of individual behavioural changes. Moreover, these women's daily lives were shaped by different class-based aspects of habitus, such as employment. In demonstrating the ways in which obesity is enmeshed in participants' taken-for-granted, everyday practices, we problematise the universality of health-promotion messages and highlight the integral role that the critical theory of habitus has in understanding the embodiment of obesity.

Lesbian body image perceptions: the context of body silence

As are all women, lesbians are influenced by Western society's expectations of what a woman should look like. However, they are also influenced by the lesbian subculture. One of the author's aims was to explore how the sociocultural contexts in which lesbians belong influence their perceptions of body image. She purposively selected 20 lesbians and used constant comparative analysis to guide data collection and analyze the resulting transcribed interviews. The internalization of the dominant culture's beauty expectations coupled with the adoption of a lesbian identity caused the participants to contend with a multitude of oppressive mandates from both sociocultural contexts. The author interpreted the outcomes of these oppressions through the lens of stigma theory. The results of the stigma assisted in the development of the context of Body Silence. The study results might serve to provide a better understanding of lesbian body image as an important component of lesbians' mental health.

Expectations of obese trainees: How stigmatized trainee characteristics influence training effectiveness

This study identifies stigma as a potential precursor to self-fulfilling prophecies in training interactions. Expectations held by leaders often result in actions that elicit expectancy-confirming behaviors from their subordinates. The results of the present study suggest that trainee weight (manipulated with a photograph depicting the trainee as either obese or average weight for height) influenced female trainer expectations and evaluations of the training and trainee. Furthermore, the results suggest that negative expectations held by trainers were related to trainee evaluations of the training and the trainer and, for less flexible trainers, to decrements in trainee performance on the trained task. Overall, the results suggest that trainer expectations can be influenced by stereotypes held about trainee characteristics, thus undermining training effectiveness.

The stigma of obesity in customer service: a mechanism for remediation and bottom-line consequences of interpersonal discrimination

Using a customer service paradigm, the authors extended the justification-suppression model (JSM) of prejudice (C. S. Crandall & A. Eshleman, 2003) to include contemporary, covert forms of discrimination and to identify a discrimination remediation mechanism. Overall, the results of 3 studies revealed that actual and confederate obese shoppers in high-prejudice justification conditions faced more interpersonal discrimination than average-weight shoppers. Furthermore, Studies 1 and 2 demonstrate that adopting strategies that remove perceivers' justifications for discriminating against obese individuals (i.e., the controllability of weight) decreases the incidence of interpersonal discrimination. Additionally, Study 3 demonstrates negative bottom-line consequences of interpersonal discrimination for organizations (e.g., customer loyalty, purchasing behavior). Together, these studies confirm that the JSM applies to covert forms of discrimination, show the importance of examining subtle discrimination, and offer a mechanism for theory-driven strategies for the reduction of covert forms of discrimination.

Health selection in a 14-year follow-up study--a question of gendered discrimination?

Health selection, as one of the several possible explanations for social inequities in health, has been receiving more attention recently but few researchers turn the issue into a question of discrimination. The aim of the study was to analyse the impact of health in young age for social position in adult age and to discuss health selection in terms of discrimination from a gender-theoretical perspective. A prospective cohort study was conducted, in which all pupils (N = 1083) in the last year of compulsory school in a middle-sized municipality in northern Sweden were followed for 14 years. The response rate was high, with 96.6% still participating after 14 years. The data were collected through repeated comprehensive self-administered questionnaires as well as through teacher interviews and register data. Health selection was analysed in a multiple logistic regression model, with working-class position at age 30 as a dependent variable and different measures of health/health behaviour at age 16 and 21 as independent variables. Overall, the impact of early health/health behaviour on future socioeconomic position was small or non-existent. However, even after correction for possible mediating and moderating mechanisms, being overweight at age 16 and at age 21 was related to future working-class position among women only. Possible mediating mechanisms were feeling looked down upon, not being active in associations and not reading cultural/political events in daily newspapers. Early menarche together with early motherhood and low education could not explain the correlations. Our results indicate that overweight girls and young women are exposed to gendered discrimination which probably occurs in many arenas, based on the societal norms for female bodies in our society. There is a need to redirect research on health selection into gender research in order to further explore the subject as well as the possible mechanisms of gendered discrimination.

Prevalence, characteristics, and correlates of teasing experiences among overweight children vs. non-overweight peers

OBJECTIVE

Information regarding the prevalence, nature, sources, and psychosocial correlates of teasing was obtained for overweight (OV) children (10 to 14 years of age) vs. non-overweight (non-OV) peers. It was hypothesized that weight-related teasing would be negatively correlated with self-esteem in specific domains and with enjoyment of physical/social activities and positively correlated with loneliness, bulimic behaviors, body dissatisfaction, and enjoyment of sedentary/isolative activities.

RESEARCH METHODS AND PROCEDURES

Teasing experiences and psychosocial correlates were assessed among OV children from a fitness camp and a demographically similar school sample of non-OV children.

RESULTS

Among the OV children, appearance-related teasing was more prevalent, frequent, and upsetting, involved disparaging nicknames focusing more on weight rather than less stigmatized aspects of appearance, and more often perpetrated by peers in general rather than a specific peer. Degree of teasing within the full sample was significantly associated with higher weight concerns, more loneliness, poorer self-perception of one's physical appearance, higher preference for sedentary/isolative activities, and lower preference for active/social activities, all but the latter association holding up above and beyond actual weight status and demographics. Among OV children, teasing was associated with bulimic behaviors. Associations with type of teasing showed specificity, with weight-related teasing predicting weight and appearance variables and competency-related teasing related to social domain factors.

DISCUSSION

When frequency, intensity, emotional impact, and stigmatized content are examined, findings indicate that teasing is more severe for OV children. Effective interventions are needed to help victims cope with and prevent further weight-related teasing, which may improve peer functioning, enhance weight control efforts, and reduce risk for future eating disturbance.

Weight stigmatization and ideological beliefs: relation to psychological functioning in obese adults

OBJECTIVE

This study evaluated the relation among weight-based stigmatization, ideological beliefs about weight, and psychological functioning in an obese, treatment-seeking sample.

RESEARCH METHODS AND PROCEDURE

Ninety-three obese, treatment-seeking adults (24 men and 69 women) completed a battery of self-report questionnaires measuring psychological adjustment, attitudes about weight, belief in the controllability of weight, and the frequency of weight-based stigmatization.

RESULTS

Weight-based stigmatization was a common experience for participants. Frequency of stigmatizing experiences was positively associated with depression, general psychiatric symptoms, and body image disturbance, and negatively associated with self-esteem. Further, participants' own negative attitudes about weight problems were associated with their psychological distress and moderated the relation between the experience of stigmatization and body image.

DISCUSSION

Weight-based stigmatization is a common experience for obese individuals seeking weight loss treatment and appears to contribute to poor mental health adjustment. The negative effects of these experiences are particularly damaging for those who hold strong antifat beliefs.

Bias, discrimination, and obesity

This article reviews information on discriminatory attitudes and behaviors against obese individuals, integrates this to show whether systematic discrimination occurs and why, and discusses needed work in the field. Clear and consistent stigmatization, and in some cases discrimination, can be documented in three important areas of living: employment, education, and health care. Among the findings are that 28% of teachers in one study said that becoming obese is the worst thing that can happen to a person; 24% of nurses said that they are "repulsed" by obese persons; and, controlling for income and grades, parents provide less college support for their overweight than for their thin children. There are also suggestions but not yet documentation of discrimination occurring in adoption proceedings, jury selection, housing, and other areas. Given the vast numbers of people potentially affected, it is important to consider the research-related, educational, and social policy implications of these findings.

Weighing the care: physicians' reactions to the size of a patient

OBJECTIVE

To examine how the weight of a patient affects both the attitudes that physicians hold as well as the treatments that they intend to prescribe.

DESIGN

In a six-cell randomized design, physicians evaluated a medical chart of a male or female patient, depicted as either average weight, overweight or obese, who presented with a migraine headache.

SUBJECTS

A total of 122 physicians affiliated with one of three hospitals located in the Texas Medical Center of Houston completed the experiment.

MEASUREMENTS

Using a standard medical procedure form, physicians indicated how long they would spend with the patient and which of 41 medical tests and procedures they would conduct. They also indicated their affective and behavioral reactions to the patient.

RESULTS

The weight of a patient significantly affected how physicians viewed and treated them. Although physicians prescribed more tests for heavier patients, F(2, 107)=3.65, P<0.03, they simultaneously indicated that they would spend less time with them, F(2, 107)=8.38, P<0.001, and viewed them significantly more negatively on 12 of the 13 indices.

CONCLUSION

This study reveals that physicians continue to play an influential role in lowering the quality of healthcare that overweight and obese patients receive. As the girth of America continues to increase, continued research and improvements in the quality of such healthcare deserve attention.

Outcomes of a traditional weight control program and a nondiet alternative: a one-year comparison

The purpose of this study was to evaluate the effectiveness of a traditional weight control program and nondiet alternative in improving behavioral (e.g., restrained, emotional, and external eating), psychological (e.g., body preoccupation, physical self-esteem), and biomedical (e.g., body weight, blood pressure, cholesterol) outcomes. There were 2 intervention groups--traditional weight control (TWC) and Diet Free Forever (DFF); a nonvolunteer comparison group; and a control group, all made up of employees of 3M (N = 357). The 2 intervention groups participated in 10-week eating programs. Outcome variables were assessed at baseline, at 10 weeks for the intervention groups only, and again at 1 year. At baseline, the 2 intervention groups had higher restrained, external, and emotional eating scores, greater body preoccupation, and lower physical self-esteem than the comparison and control groups. They also weighed more. At 1 year, both intervention groups had decreased their body preoccupation and increased their physical self-esteem. Participants in the DFF program reduced their restrained eating, whereas those in the TWC program increased their restrained eating. Neither eating program had an impact on the biomedical outcomes.

Poly-friendships

SUMMARY In contrast to the monogamous model for sexual relationships (including those of lesbians) in western society, friendships are permitted to be polyamorous. However, friendships do not receive the level of salience and priority that sexual relationships do. This article focuses on three issues that keep lesbians from prioritizing friendships: (1) the culture of sex in the U.S. and western nations; (2) the way we define "sex"; and (3) the way we define friendships.

Body image change in pregnancy: a comparison of normal weight and overweight primigravidas

BACKGROUND

Body image in pregnancy has been linked to maternal and neonatal health. This study examined the relationship between prepregnancy body weight and body image change in primigravid women.

METHODS

Through a self-administered, free-response questionnaire, 76 primigravidas of at least 30 weeks' gestation described their feelings about current appearance and body shape and compared these to prepregnancy feelings. Respondents also completed the Body Shape Questionnaire to measure current concern with body shape.

RESULTS

Women who were overweight before pregnancy were more likely to have had a positive change in body image when they were at more than 30 weeks' gestation. Women who were normal weight before pregnancy were more likely to have had a negative change. Despite overweight women's positive changes, their body shape concerns were more negative than those of normal weight women.

CONCLUSIONS

Our study highlights the relationship between social values, prepregnancy body weight, and body image change during pregnancy. Some women may benefit from discussing their experiences in a patient-centered context.

Obesity Treatment: Examining the Premises

Five basic premises underlie the recommendation that obese persons should lose weight: (1) obesity is physically unhealthy; (2) in obese persons, weight loss improves physical health; (3) long-term weight loss is possible; (4) the benefits of weight loss exceed the costs; and (5) weight loss is superior to or can add incrementally to the effects of alternative methods of improving the health and happiness of obese persons. Although the data are occasionally ambiguous, they generally support these premises. Obesity apparently causes increased morbidity and decreased longevity, even after controlling for many plausible confounding factors. Clinical studies consistently show that weight loss reduces morbidity. No adequate data exist on which to evaluate the effects of weight loss on mortality among obese persons. Additional data are needed, but long-term weight loss seems possible, although such losses remain difficult to maintain. A crude estimate is that about 20% of obese persons who attempt to lose weight can achieve and maintain a clinically meaningful weight loss. The short-term health and psychologic costs of gradual weight loss are minor, manageable, and easily surpassed by the short-term health and psychologic benefits. Long-term effects of weight loss on mortality are difficult to judge, and further research is needed. Weight loss can add incrementally to the effects of alternative methods to improve health and happiness among obese persons. Thus, these "alternatives" are better termed "complementary approaches," and their use need not preclude attempts at weight loss. Finally, we provide several guidelines to help practitioners assist obese persons in making reasonable informed decisions about weight loss.

Rethinking traditional weight management programs: a 3-year follow-up evaluation of a new approach

We evaluated the effectiveness of a nondiet approach designed to reduce restrained eating behaviors and improve self-acceptance and self-esteem. This approach also encourages participants to address eating and exercise behavior separately. Subjects were Conoco employees who participated in the Wellness Department's Eat For L.I.F.E. (Long-term change; Image of self; Fun; Enjoyment of eating) program and completed pre-participation and 3-year follow-up questionnaires (N = 79). Pre- and postsurvey data were used to assess participants eating behavior, dieting behavior, self-acceptance, self-esteem, level of physical activity, and demographic information. Mastery of the internally directed eating style was assessed during the program at 3 months, at the conclusion of the 6-month program, and at the 3-year follow-up. Analysis of variance indicated that Eat For L.I.F.E. participants were able to significantly decrease their restrained eating behavior and increase self-acceptance, self-esteem, and level of physical activity. Participants also were able to adopt many aspects of the nonrestrained, internally directed eating style and decrease their frequency of weighing-in behavior. These results indicate that strategies fostering internally directed eating behaviors may be more centrally related to an individual's well-being than programs supporting externally directed eating behaviors.

The relationship of internally directed behavior to self-reinforcement, self-esteem, and expectancy values for exercise

PURPOSE

This study investigated two opposing orientations toward exercise and wellness behavior as related to selected personal characteristics. A "self-trusting" orientation focuses on process measures, and exercise and wellness behavior is internally directed. A "self-controlling" orientation focuses on outcome measures, and exercise and wellness behavior is externally directed.

DESIGN

Relationships among variables were assessed using Pearson correlation and step-wise multiple regression.

SETTING

One questionnaire was administered to all subjects under quiet classroom conditions.

SUBJECTS

Subjects were enrolled in university physical education activity classes (N = 154), a health promotion and fitness undergraduate class (N = 52), and a commercial aerobic dance program (N = 68).

MEASURES

The questionnaire, containing 157 items, assessed exercise orientation, wellness orientation, general self-esteem, physical self-esteem, self-reinforcement, expectancy values for exercise, and level of physical activity.

RESULTS

Individuals who reported exercising to improve physical appearance and/or physical performance had higher control scores on the exercise scale; exercising for pleasure or social reasons served as suppressor variables. High control scores on wellness and exercise orientation were indicative of individuals less likely to positively self-reinforce their behavior. A high control score on the wellness scale was significantly related to lower general and physical self-esteem scores. Finally, higher physical self-esteem was significantly related to exercising for pleasure and athletic reasons; exercising to improve physical appearance served as a suppressor variable.

CONCLUSIONS

These data strengthen the recommendation that health promotion professionals consider alternative approaches to promoting exercise and enhancing wellness.(ABSTRACT TRUNCATED AT 250 WORDS)