Self-efficacy targeted treatments for weight loss in postmenopausal women

Matching behavioral treatment programs to different types of obese clients is a rarely studied strategy, thus guidelines for identifying who might benefit most from which program remain elusive. This study categorized the weight control self-efficacy beliefs of obese, postmenopausal women, and determined the effects of self-efficacy targeted versus non-targeted (control) treatment on weight loss outcomes (body habitus, physical conditioning, affect, and eating behaviors). Obese (BMI 33 +/- 5), postmenopausal (60 +/- 6 years old) women (n = 59) participated in a 6-month weight loss program. The 37 women categorized by Q methodology as Assured (self-confident, independent) were randomized to Assured (AT) or Non-Targeted (NT) treatment; the 22 Disbelievers (doubtful, wavering) were randomized to Disbeliever (DT) or NT treatment. At baseline, the Assureds had significantly smaller body girths and reported significantly greater self-esteem, fewer symptoms of binge eating, and less negative affect overeating than the Disbelievers. Improvement in these variables with weight loss erased significant differences between the groups and was a desired outcome. Treatment delivery type may have influenced attrition rate, since significantly more Assureds dropped from NT than AT and significantly more Disbelievers dropped from DT than NT. Thus, the self-efficacy type may serve as a means to identify different types of treatment needs (flexible vs. rigid) to sustain women's adherence and success in the program. The significant weight loss outcomes for women in all groups argues for the incorporation of strategies to enhance self-efficacy but not the need for specific treatments that directly target self-efficacy types.