204 Obesity Treatment
on attractiveness may also be important. Ogden (2000a) examined differ-
ences in psychological factors between weight loss regainers, stable obese,
and weight loss maintainers, who were classified as those individuals who
had been obese (BMI >29.9), lost sufficient weight to be considered
nonobese (BMI <29.9), and maintained this weight loss for a minimum
of 3 years. The results showed that the weight loss maintainers were more
likely to endorse a psychological model of obesity in terms of its conse-
quences such as depression and low self-esteem, and to have been motivated
to lose weight for psychological reasons such as wanting to increase their
self-esteem and feel better about themselves. Further, they showed less
endorsement of a medical model of causality including genetics and hormone
imbalance. These results suggested that it is not only what an individual
does which is predictive of success, but also what they believe. Accordingly,
for an obese person to lose weight and keep this weight off it would seem
that they need both to change their behavior and believe that their own
behavior is important. Further, they need to perceive the consequences of
their behavior change as valuable. This supports the research exploring the
psychological effects of taking obesity medication (Ogden and Sidhu, 2006).
A minority of individuals, therefore, show successful weight loss and
maintenance which relates to their profile characteristics, dieting history,
help-seeking behaviors, and beliefs about obesity.
The role of life eventsMost research exploring successful weight loss maintenance emphasizes the
impact of structured interventions or focuses on gradual changes in the
individual’s psychological state. Both such approaches see change as the result
of a “drip drip” effect that occurs slowly over time. Some changes in
behavior, and subsequent body weight, may occur in a more dichotomous
fashion following a specific event which has been explored using a number
of different terms including teachable moments, life events, life crises, epi-
phanies, and medical triggers. This approach is in line with life events
theory, which was a central part of psychological theory and research towards
the end of the twentieth century (e.g., Brown and Harris, 1978). In a recent
qualitative study, Ogden and Hills (2008) carried out a series of interviews
with those who had shown sustained behavior change in terms of either
smoking cessation (n= 10) or weight loss maintenance (n=24) and high-
lighted the role for a number of different life events. In particular, many
participants described how their behavior change had been triggered by