Using Positive Deviance for Determining Successful Weight- Control Practices

Based on positive deviance (examining the practices of successful individuals), we identified five primary themes from 36 strategies that help to maintain long-term weight loss (weight control) in 61 people. We conducted in-depth interviews to determine what successful individuals did and/or thought about regularly to control their weight. The themes included weight-control practices related to (a) nutrition: increase water, fruit, and vegetable intake, and consistent meal timing and content; (b) physical activity: follow and track an exercise routine at least 3×/week; (c) restraint: practice restraint by limiting and/or avoiding unhealthy foods; (d) self-monitor: plan meals, and track calories/weight progress; and (e) motivation: participate in motivational programs and cognitive processes that affect weight-control behavior. Using the extensive data involving both the practices and practice implementation, we used positive deviance to create a comprehensive list of practices to develop interventions for individuals to control their weight

Practices Associated with Weight Loss Versus Weight-Loss Maintenance Results of a National Survey

Background: Few studies have examined the weight-control practices that promote weight loss and weight-loss maintenance in the same sample. Purpose: To examine whether the weight control practices associated with weight loss differ from those associated with weight-loss maintenance. Methods: Cross-sectional survey of a random sample of 1165 U.S. adults. The adjusted associations of the use of 36 weight-control practices in the past week with success in weight loss (Ն10% lost in the past year) and success in weight-loss maintenance (Ն10% lost and maintained for Ն1 year) were examined. Results: Of the 36 practices, only 8 (22%) were associated with both weight loss and weight-loss maintenance. Overall, there was poor agreement (kappaϭ0.22) between the practices associated with weight loss and/or weight-loss maintenance. For example, those who reported more often following a consistent exercise routine or eating plenty of low-fat sources of protein were 1.97 (95% CIϭ1.33, 2.94) and 1.76 (95% CIϭ1.25, 2.50) times more likely, respectively, to report weight-loss maintenance but not weight loss. Alternatively, those who reported more often doing different kinds of exercises or planning meals ahead of time were 2.56 (95% CIϭ1.44, 4.55) and 1.68 (95% CIϭ1.03, 2.74) times more likely, respectively, to report weight loss but not weight-loss maintenance. Conclusions: Successful weight loss and weight-loss maintenance may require two different sets of practices. Designing interventions with this premise may inform the design of more effective weight-loss maintenance interventions. (Am J Prev Med 2011;41(2):159 -166