The Psychology of Eating: From Healthy to Disordered Behavior

202 Obesity Treatment

large majority eventually return to their baseline weight. Within each trial,
however, a minority not only lose weight initially but also successfully
maintain this loss. Klem et al. (1998) examined the psychological states of
784 men and women who had both lost weight and maintained their weight
loss and concluded that weight suppression was not associated with psy-
chological distress. In contrast, Wooley and Wooley (1984) suggested that
the minority of “success stories” are “in fact condemned to a life of weight
obsession, semi starvation and all the symptoms produced by chronic hunger

... and seem precariously close to developing a frank eating disorder”
(p. 187).
What factors distinguish between those who regain any weight they lose
and those who manage to show weight loss maintenance in the longer term?
To date some studies have specifically examined these success stories. This
research, together with data from the trials of obesity treatment, provides
some preliminary insights into the factors which predict and/or correlate
with successful weight loss and maintenance. In particular, the literature
highlights a role for a range of variables which can be conceptualized as
profile characteristics, historical factors, help-seeking behaviors, and
psychological factors.

Profile characteristics

Research suggests that baseline BMI predicts weight loss and maintenance;
however, while some studies indicate that lower baseline weight is predictive
of greater success (Stuart and Guire, 1978; Neumark-Sztainer, Kaufmann,
and Berry, 1995; Ogden, 2000a), other studies show the reverse effect
(Wadden et al., 1992). Research also suggests that employment outside of
the home, higher income, and being older are predictive of weight loss and
maintenance (Neumark-Sztainer, Kaufmann, and Berry, 1995; Wong et al.,
1997; Ogden, 2000a). Some research has also looked at gender, although
the data remain contradictory (e.g., Colvin and Olson, 1983).

Historical factors

Some research points to an individual’s previous dieting attempts and their
weight history as important for successful weight loss and maintenance.
In particular, studies indicate that a longer history of dieting and a higher
number of dieting attempts predict success (Hoiberg et al., 1994; Ogden,
2000a). In contrast, Kiernan et al. (1998) concluded from their study that