Abstract

Cognitive factors involved in successful weight maintenance include thoughts and thinking processes, both directly influence action and behavior. This grounded theory study explored cognitive factors (thoughts) involved in successful weight loss maintenance. The data revealed that weight maintenance is a dynamic process involving three phases: initiation to action, action to maintenance, (successful maintenance); and finally maintenance itself, which is based on the ability to sustain a target weight, within a few pounds, over an extended period of time (advanced maintenance). Within the last two phases of weight maintenance (successful and advanced), different “activating thoughts” and “sustaining thoughts” are described that are specific to the phase. The properties of “epiphany,” “goal,” and “self-regulation” were integrated to the category of activating thoughts, whereas “mindset,” “self-efficacy,” “motivation,” “love-hate relationship with food,” and “always thinking about maintenance” were related to the category of sustaining thoughts. The data revealed a difference among the group of successful weight maintainers, indicating that some were able to maintain their weight although they struggled with the process, while the rest were advanced weight maintainers, akin to transcendent individuals. Two different theories for successful and advanced maintainers emerged from the data. Sustaining thoughts for advanced maintainers uncovered the following different properties: “mental issue,” “self-efficacy,” “intrinsic motivation,” “positive relationship with food,” and “maintenance is programmed.” Results find weight maintenance as a dynamic process with individuals moving back and forth across the processes of sustaining thoughts. The dichotomy of a “love-hate relationship with food” appears to be the most problematic and could drive an individual into becoming an unsuccessful maintainer while “always thinking about maintenance” appears to be the next challenge among successful maintainers. Advanced maintainers reported a positive relationship with food and no longer thought about maintenance.