Motivational predictors of weight loss and weight-loss maintenance.

Self-determination theory proposes that behavior change will occur and persist if it is autonomously motivated. Autonomous motivation for a behavior is theorized to be a function both of individual differences in the autonomy orientation from the General Causality Orientations Scale and of the degree of autonomy supportiveness of relevant social contexts. We tested the theory with 128 patients in a 6-month, very-low-calorie weight-loss program with a 23-month follow-up. Analyses confirmed the predictions that (a) participants whose motivation for weight loss was more autonomous would attend the program more regularly, lose more weight during the program, and evidence greater maintained weight loss at follow-up, and (b) participants' autonomous motivation for weight loss would be predicted both by their autonomy orientation and by the perceived autonomy supportiveness of the interpersonal climate created by the health-care staff.

[1]  T. M. Amabile.  The social psychology of creativity , 1984 .

[2]  Ralph L. Rosnow,et al.  Essentials of Behavioral Research: Methods and Data Analysis , 1984 .

[3]  I. Rosenstock.  The Health Belief Model and Preventive Health Behavior , 1974 .

[4]  R. Washburn,et al.  Physical activity assessment for epidemiologic research: the utility of two simplified approaches. , 1987, Preventive medicine.

[5]  J. Kral,et al.  The dilemma of Morbid Obesity. , 1981, JAMA.

[6]  Kenneth A. Bollen,et al.  Structural Equations with Latent Variables , 1989 .

[7]  J. Rotter.  Generalized expectancies for internal versus external control of reinforcement. , 1966, Psychological monographs.

[8]  Kenneth O. McGraw,et al.  Evidence of a detrimental effect of extrinsic incentives on breaking a mental set. , 1979 .

[9]  R. Atkinson,et al.  Low and very low calorie diets. , 1989, The Medical clinics of North America.

[10]  R. Ryan,et al.  A dark side of the American dream: correlates of financial success as a central life aspiration. , 1993, Journal of personality and social psychology.

[11]  R. Ryan,et al.  PERSONALITY PROCESSES AND INDIVIDUAL DIFFERENCES Origins and Pawns in the Classroom: Self-Report and Projective Assessments of Individual Differences in Children's Perceptions , 1986 .

[12]  R. Ryan,et al.  Two types of religious internalization and their relations to religious orientations and mental health. , 1993, Journal of personality and social psychology.

[13]  Dante Cicchetti,et al.  Developmental psychopathology: Theory and method , 1995 .

[14]  R. Kuczmarski,et al.  Prevalence of overweight and weight gain in the United States. , 1992, The American journal of clinical nutrition.

[15]  R. Ryan,et al.  Agency and organization: intrinsic motivation, autonomy, and the self in psychological development. , 1992, Nebraska Symposium on Motivation. Nebraska Symposium on Motivation.

[16]  R. Ryan,et al.  Autonomy in children's learning: an experimental and individual difference investigation. , 1987, Journal of personality and social psychology.

[17]  M. R. Fields.  HEALTH EDUCATION MONOGRAPHS , 1960 .

[18]  C. Grilo,et al.  The nature of environmental influences on weight and obesity: a behavior genetic analysis. , 1991, Psychological bulletin.

[19]  R. Ryan,et al.  Initial motivations for alcohol treatment: relations with patient characteristics, treatment involvement, and dropout. , 1995, Addictive behaviors.

[20]  E. Deci,et al.  A motivational approach to self: integration in personality. , 1990, Nebraska Symposium on Motivation. Nebraska Symposium on Motivation.

[21]  S. Taylor,et al.  Health psychology. The science and the field. , 1990, The American psychologist.

[22]  A. Mulley,et al.  Primary Care Medicine , 1981 .

[23]  David M. Garner,et al.  Confronting the failure of behavioral and dietary treatments for obesity , 1991 .

[24]  T. Wadden,et al.  Controlled trial of very low calorie diet, behavior therapy, and their combination in the treatment of obesity. , 1986, Journal of consulting and clinical psychology.

[25]  Kenneth A. Wallston,et al.  Development of the Multidimensional Health Locus of Control (MHLC) Scales , 1978, Health education monographs.

[26]  E. Deci,et al.  The general causality orientations scale: Self-determination in personality , 1985 .

[27]  Frank J. Bernieri,et al.  Self-Regulation and Consistency between Attitudes, Traits, and Behaviors , 1992 .

[28]  H J Montoye,et al.  The assessment of physical activity by questionnaire. , 1986, American Journal of Epidemiology.

[29]  T. Wadden,et al.  Treatment of Obesity by Moderate and Severe Caloric Restriction: Results of Clinical Research Trials , 1993, Annals of Internal Medicine.

[30]  R. Ryan,et al.  Perceived locus of causality and internalization: examining reasons for acting in two domains. , 1989, Journal of personality and social psychology.

[31]  A. Simopoulos,et al.  Body weight, health, and longevity. , 1984, Annals of internal medicine.

[32]  Edward L. Deci,et al.  Autonomy, relatedness, and the self: Their relation to development and psychopathology. , 1995 .

[33]  P. Lazarsfeld.  Principles of Topological Psychology , 1938 .

[34]  A. Stunkard,et al.  Behavior modification in the treatment of obesity. The problem of maintaining weight loss. , 1979, Archives of general psychiatry.

[35]  F. Pi‐Sunyer,et al.  Medical Hazards of Obesity , 1993, Annals of Internal Medicine.

[36]  Edward L. Deci,et al.  Intrinsic Motivation and Self-Determination in Human Behavior , 1975, Perspectives in Social Psychology.

[37]  N. Niven,et al.  Health psychology. , 1982, Nursing times.

[38]  D. Williamson,et al.  A comparison of measured and self-reported weights in a 4-year follow-up of spouse involvement in obesity treatment** , 1985 .

[39]  R. P. McDonald,et al.  Goodness-of-fit indexes in confirmatory factor analysis : The effect of sample size , 1988 .

[40]  J. Kincey.  Internal-external control and weight loss in the obese: predictive and discriminant validity and some possible clinical implications. , 1981, Journal of clinical psychology.

[41]  A. Bandura.  Social learning theory , 1977 .

[42]  E. Drenick,et al.  Weight reduction by fasting and semistarvation in morbid obesity: long-term follow-up. , 1978, International journal of obesity.

[43]  R. Decharms.  Personal causation : the internal affective determinants of behavior , 1968 .

[44]  Edward L. Deci,et al.  Inner resources for school achievement : motivational mediators of children's perceptions of their parents , 1991 .

[45]  C. Pratt.  Development of a Screening Questionnaire to Study Attrition in Weight-Control Programs , 1989, Psychological reports.

[46]  A. Stunkard,et al.  Socioeconomic status and obesity: a review of the literature. , 1989, Psychological bulletin.

[47]  F. M. Kramer,et al.  Long-term follow-up of behavioral treatment for obesity: patterns of weight regain among men and women. , 1989, International journal of obesity.

[48]  E. Deci,et al.  Self-determination in a work organization. , 1989 .

[49]  Stéphane Sabourin,et al.  Toward a motivational model of couple happiness , 1990 .

[50]  M. Becker,et al.  The Health Belief Model: A Decade Later , 1984, Health education quarterly.

[51]  Edward L. Deci,et al.  An Instrument to Assess Adults' Orientations toward Control versus Autonomy with Children: Reflections on Intrinsic Motivation and Perceived Competence. , 1981 .

[52]  E. Deci,et al.  Facilitating internalization: the self-determination theory perspective. , 1994, Journal of personality.

[53]  E. Deci,et al.  The support of autonomy and the control of behavior. , 1987, Journal of personality and social psychology.

[54]  Jacob Cohen,et al.  Applied multiple regression/correlation analysis for the behavioral sciences , 1979 .

[55]  E. Drenick,et al.  Excessive mortality and causes of death in morbidly obese men. , 1980, JAMA.

[56]  G A Marlatt,et al.  Understanding and preventing relapse. , 1986, The American psychologist.

[57]  A. Stunkard,et al.  The accuracy of self-reported weights. , 1981, The American journal of clinical nutrition.