STAGES OF CHANGE IN SUCCESSFUL WEIGHT CONTROL - A CLINICALLY DERIVED MODEL

Correlational studies, meta-analyses, and experimental research have revealed that long-term treatments for obesity (1 year or more) are far more likely to improve weight control than shorter-term interventions. As treatment durations increase, so do questions about the changes that clients frequently experience in their behaviors, cognitions, and affective states during such extended efforts. If we can provide answers to these questions, it could facilitate therapeutic change via appropriate modification and alignment of expectations (for both clients and therapists). The present paper describes a clinically derived model of the stages of change that are often observed during the process of long-term weight control. It includes three primary stages (those experienced by most people during the first two years within a cognitive-behavioral treatment program) and three secondary stages (those that seem to occur regularly but only for some participants). Behavioral, cognitive, affective, and temporal aspects of the primary stages (Honeymoon, Frustration, and Tentative Acceptance) and the secondary stages (Shock/Ambivalence, Fear of Success, and Lifestyle Change) are presented. Clinical uses and implications as well as directions for research, are discussed.