Klingemann, Harald; Bucher, Sabine; Buri, Caroline; Bolliger-Salzmann, Heinz; Laederach, Kurt (2016). Coping with obesity in Switzerland through self-change and professional help. Obesity Medicine, 4, pp. 1-11. Elsevier 10.1016/j.obmed.2016.09.001
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Background and objectives: This interdisciplinary study investigated the development of behavioral
changes in individuals who were able to achieve successful long-term behavior modification (weight loss
and maintenance) compared to individuals unable to lose substantial weight or to prevent weight regain
after weight loss. The participants were recruited through media calls and interviewed in a twostep
selection telephone interview to ensure quota requirements. This is the first time that such a
large group of individuals who have overcome their obesity problem without professional help has been
studied in Switzerland. The results provide valuable information on problem-solving strategies that
could be supported at a professional level and contribute to ensuring that offers of help with obesity are
both customizable and cost-efficient. These data fill a major gap in research because little is known about
the “natural course of obesity.” In addition, the results will be used to prepare a follow-up project to
examine the effectiveness of different interventions by applying useful everyday weight-stabilizing
strategies.
Methods: The study participants were recruited through various media calls for more than 8 months.
They were questioned using a two-step questionnaire via telephone interviews. The interviews were
conducted between November 2010 and October 2011 and were based on age-, sex- and weight lossrelated
quotas. The 240 respondents were grouped into four categories: successful self-changers (SSC),
unsuccessful self-changers (USC), successful help-seekers (SHS) and unsuccessful help-seekers (UHS).
Questions included anthropometric parameters, sociodemographic variables and educational and professional
status.
Results: The main results show that self-change is possible and potentially common for people with
obesity. Moreover, we demonstrated that the profile of coping and maintenance strategies is largely
similar for individuals who seek help and self-changers who do not seek help. Based on the sequence of
self-change processes, the motivation stage shows that both help-seekers and self-changers are influenced
by motivating factors during the change process. Concerning coping strategies, we found that
seeking outside support does not uniformly result in greater health literacy than similar methods applied
by self-changers. With regard to the maintenance of weight loss, both groups showed 5 stabilization
parameters: characteristics of the (modified) success method, a long-term awareness of discipline and
determination, constant vigilance and self-monitoring, not jeopardizing what has been achieved and the
perception of positive consequences felt by the individual and encountered at a social level. In cases of
failed stabilization efforts, problems involving comorbidity and social relationships played a major role.
Outlook: The similarities in coping methods adopted by help-seekers and self-changers indicated that
the same determinants are relevant for individual change processes. Consequently, these factors are
influenced by professionals but are also found outside of clinical therapy or advice. The coping methods
observed in both groups correspond closely to the recommendations from major meta-analyses, i.e.,
flexible management of food intake, a healthy and balanced diet, sufficient exercise and an intrinsic
motivation to control body weight. Thus, all respondents are in possession of the appropriate knowledge,
regardless of whether they take advantage of professional advice. Furthermore, future research in this
field should apply the successful non-professional ideas and strategies for weight stabilization elucidated
by this study.
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