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Role for a sense of self-worth in weight-loss treatments

Helping patients develop self-efficacy

Correspondence to: Dr Cochrane, 400—1681 Chestnut St, Vancouver, BC V6J 4M6; telephone 604 263-3312; e-mailgordon_cochrane{at}telus.net

OBJECTIVE To recommend strategies for enhancing patients’ sense of self-worth and self-efficacy in order to give them sufficient faith in themselves to make healthier choices about their weight.

SOURCES OF INFORMATION PubMed, PsycINFO, Google Scholar, and APA Journals Online were searched for original research articles on treatment models and outcome review articles from 1960 to the present. Key search terms were weight loss, weight-loss treatments, diets and weight loss, psychology and obesity, physiology and obesity, and exercise and weight loss. Most evidence was level I and level II.

MAIN MESSAGE In spite of extensive research, there is widespread belief that the medical system has failed to stem the tide of weight gain in North America. The focus has been on physiologic, behavioural, and cultural explanations for what is seen as a relatively recent phenomenon, while the self-perception of overweight individuals has been largely overlooked. Professional treatments have consisted mainly of cognitive-behavioural therapies and rest on the premise that overweight patients will effectively apply the cognitive-behavioural therapy principles. In the long run, professional and commercial programs are often ineffective. We need treatments that include strategies to repair ego damage, enhance the sense of self-worth, and develop self-efficacy so that overweight patients can become the agents of change in their pursuit of well-being.

CONCLUSION Self-efficacy correlates positively with success in all realms of personal endeavour, and we can help our overweight patients become more self-reliant.

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