Are You Ready? Behavior Change and Weight Management
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Article By: The Weight Watchers Research Department
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Applying the Stages of Change model to weight loss is a challenge because of the multiple behaviors involved, and it can be difficult to determine what stage a person is in at any given time.
The Stages of Change model, which defines the six stages to making a sustained health-related behavior change, was originally developed to help people quit smoking. Applying the model to single behaviors, like smoking, drinking alcohol or fastening a seat belt, is relatively simple because the focus is limited to one specific behavior. Applying the Stages of Change model to weight loss is not simple, however, because achieving lasting weight loss requires multiple behavior changes in several areas of life, including physical activity and eating.
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Stages of Change: Exercise
One area that has demonstrated positive results to use of the Stages of Change model is exercise. Tools have been developed to determine a person's stage of readiness and stage-specific guidelines have been established to reach the desired goal of making physical activity a part of daily life.1
Stages of Change: Eating Behaviors
The Stages of Change model has also been applied to eating behaviors. This is more difficult because of the complexity that eating involves. Altering usual food portions, changing meal patterns, making different food choices and altering food preparation methods are all distinct food behaviors. Because of this complexity, the results in studies focused on using the model to change eating behaviors have been mixed and are difficult to interpret.2
Like all models, the Stages of Change has limitations. Because it is not specifically measurable or defined, it can be difficult to clearly determine what stage a person is in at any given time. Moreover, an absolute linear progression through the stages has not been established.3 This is particularly true in the area of weight loss, most likely because of the multiple behaviors involved.
For example, in a review of studies looking at eating behaviors, it was determined that it was not possible to predict progression from the preparation stage into the action stage. Because these two stages mark the transition from "getting ready to make a change" to "making a change," the ability to assess the person's status is especially important. 4
From Change to Commitment
Readiness to change is one aspect of weight loss; staying the course once a weight loss program is started is another. Quitting a weight-loss attempt is common. New techniques are being developed and tested to address this problem.
Motivational interviewing is an emerging area of study that has shown some promise. Specifically geared to deal with the natural ambivalence that is part any lifestyle change, motivational interviewing is a method used to enhance motivation and bolster commitment to the change process. 5
view footnotes
The Weight Watchers Approach:
The Stages of Change model is built into many facets of the Weight Watchers approach. For example, qualitative research has found that most people joining Weight Watchers meetings are in the Preparation or Action stages as it relates to food behaviors. With this in mind, the recommendations for getting started on a food plan are very specific and action-oriented. On the other hand, the readiness to begin an activity plan is less universal, and this too is factored in. With respect to sustaining the behaviors, ongoing reinforcement to continue new behaviors and the need to address relapse are stressed.
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This content is reviewed regularly. Last updated September 24, 2009.
Other Science Library Topics:
1Marcus BH, Simkin LR. The transtheoretical model: applications to exercise behavior. Med Sci Sports Exerc. 1994 Nov;26(11):1400-4.
2Ni Mhurchu C, Margetts BM, Speller VM. Applying the stages-of-change model to dietary change. Nutr Rev. 1997 Jan;55(1 Pt 1):10-6.
3Wilson GT, Schlam TR. The transtheoretical model and motivational interviewing in the treatment of eating and weight disorders. Clin Psychol Rev. 2004 Jul;24(3):361-78.
4Armitage CJ, Sheeran P, Conner M, Arden MA. Stages of change or changes of stage? Predicting transitions in transtheoretical model stages in relation to healthy food choice. J Consult Clin Psychol. 2004 Jun;72(3):491-9.
5Walitzer KS, Dermen KH, Connors GJ. Strategies for preparing clients for treatment. A review. Behav Modif. 1999 Jan;23(1):129-51.
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