Adherence to lifestyle intervention in adults with obesity

  • Emily Lewis

Student thesis: Doctoral Thesis


The prevalence of obesity is increasing rapidly worldwide, a problem commonly referred to as the obesity epidemic. Despite the broad body of evidence investigating obesity management, the rates of obesity, physical inactivity and poor dietary habits continue to rise. One of the key challenges lies in the poor rates of adherence to lifestyle intervention seen for adults with obesity. Poor treatment adherence reduces the effectiveness of any health intervention, resulting in poorer health care outcomes, reduced patient quality of life, increased health care costs, and underutilised health care resources. The aim of this thesis was therefore to explore the issue of adherence in obesity management.
A systematic review, meta-analysis, randomised controlled cross-over trial and a qualitative process evaluation was conducted to explore the issue of adherence in obesity management. The key barriers to lifestyle intervention for adults with obesity include: poor motivation, lack of time, environmental pressures, health limitations and negative moods. The most prominent predictors of adherence in obesity management are: early weight loss success, lower baseline body mass index, better baseline mood, being male and older age. Behavioural treatment strategies, such as problem solving, motivational interviewing and self-monitoring, were found to improve adherence to lifestyle intervention for adults with obesity. The addition of telephone and text message support to a community-based obesity management program was found to improve treatment adherence and clinical outcomes when compared to standard care. Focus group participants found the telephone and text message support to be highly beneficial, providing encouragement, motivation, focus and accountability.
The findings of this thesis make a significant contribution to both research and clinical realms, by demonstrating a resource effective improvement to obesity management service delivery, as well as to the broader field of services targeting health behaviour change.
Date of Award2019
Original languageEnglish
SupervisorKate Pumpa (Supervisor) & Peter Hassmen (Supervisor)

Cite this