Obesity, life style and society : psychological and psychosocial factors in relation to body weight and body weight changes

Abstract

This dissertation consists of two cross-sectional population studies (studies I and IV), and two prospective studies (studies II and III). In study I the relative importance of obesity for self-rated health with focus on age and gender differences were examined among 5,080 (2,366 males) participants in a national survey. Data were gathered through questionnaires. An inverse association was found between BMI and self-rated health. The relation was most pronounced among middle-aged men and women. An association between obesity and functional impairment, chronic disease and an impaired mental well-being was found for both men and women. For women there was also an association between obesity and chronic pain.

In study II a qualitative method was used to examine which factors 15 participants in a one-year behaviour modification weight reduction programme considered important for eating habits and weight change. The participants were interviewed three times during the programme and once one year after the programme had ended. The interviews were analysed with a qualitative method, grounded theory. External stimuli, stress and emotional reasons affected eating habits before the programme started and one year after the programme had ended. Non-sufficient support was another reason mentioned as reason for regain of lost weight.

In study III an association between locus of control orientation and weight loss was examined in a one-year follow up of 41 participants in a weight reduction programme. A questionnaire with 40 questions was used to assess the locus of control orientation before the programme started and one year later. There was no change in locus of control orientation after one year. The weight loss after one year was positively associated with an initial internal locus of control orientation.

In study IV a representative sample of 2,810 subjects from a population study was interviewed on sexual satisfaction, sexual abuse and life satisfaction. Age and gender were controlled for in the analyses. The older group of obese men reported a decrease in sexual desire compared with five ears earlier and the older group of overweight men reported involuntary participation in sexual activities more often than the normal weight group. Though the older group of obese women more often than the other BMI-groups were diagnosed with a lingering disease, there was no difference in satisfaction with physical health between the BMI-groups.

An inverse association between BMI and self-rated health as well as an association between obesity and impaired physical and mental well-being implies a dialogue between care taker and care giver on which treatment would match the caretaker's current needs for an improved well being. The results indicate that unless the factors behind an excessive eating are addressed in obesity treatment, they will obstruct the weight reduction and maintenance of lost weight. An internal locus of control orientation could be supported in weight reduction treatment. Untreated experiences of sexual trauma could be an important pre-treatment variable to consider in weight reduction programmes.