The Frequency of Use and Perceived Helpfulness of Cognitive and Behavioral Weight- Related Coping Strategies in a Year-Long, Weight-Loss Intervention Study

Abstract

Introduction: Executing coping strategies can help overcome temptation and prevent relapse during weight loss. However, there is limited research assessing specific weight-related coping strategies reported at the initiation of a weight-loss program and how these strategies relate to weight loss. Our study therefore explored the frequency of use and perceived helpfulness of cognitive and behavioral weight-related coping strategies in a year-long, weight loss intervention program. Methods: Participants (n=372) were part of a larger randomized controlled trial that recruited 588 men and women from a free standing Health Maintenance Organization (HMO) and from the general population. Individuals with a BMI of 25 or above, or 24 plus one cardiovascular risk factor, were eligible to participate. Participants completed the Coping Response Survey (CRS) at baseline assessing the frequency of use and perceived helpfulness of cognitive and behavioral coping strategies. Cognitive coping strategies described various non-observable thoughts while behavior coping described overt actions. Weight and height was measured at baseline and weight again at 12 months. Results: Self-Motivation was the most frequently used and most helpful cognitive coping strategy while Social Consequences was the least frequently used and least helpful cognitive coping strategy. Alternate Activities were considered the most helpful behavioral coping strategy, but they were used the least frequently. The frequency of cognitive and behavioral coping strategies (p= 0.31, p<.01)) and the helpfulness of cognitive and behavioral coping strategies (p= 0.61, p<.01) were each significantly correlated. Baseline correlations revealed unexpected positive relationships between the frequency of Positive Thoughts (p= 0.14, p<.01) and the helpfulness of Social Consequences and BMI (p= 0.13, p=<.05). Additionally, the frequency of Disappointing Expectations (OR=1.42, 95% CI [1.01, 2.00], p<.05) significantly contributed to significant weight loss. Conclusions: Our results support cognitive and behavioral coping as complementary strategies. Coping strategies related to an individual's personal motivation for weight-loss appear more beneficial than emphasizing the social consequences of weight loss. The results for behavioral coping strategies provided some unclear findings warranting further research. Overall, the study provides valuable information for clinical practice, including the specific coping strategies to incorporate into weight loss programs to increase their effectiveness.