Review
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatr. Mar 22, 2015; 5(1): 56-67
Published online Mar 22, 2015. doi: 10.5498/wjp.v5.i1.56
Assessment of psychological predictors of weight loss: How and what for?
Lisa Lazzeretti, Francesco Rotella, Laura Pala, Carlo Maria Rotella
Lisa Lazzeretti, Psychiatric Unit, Careggi University Hospital, 50141 Florence, Italy
Francesco Rotella, Psychiatric Unit and Diabetes Agency, Careggi University Hospital, 50141 Florence, Italy
Laura Pala, Endocrinology Unit, Careggi University Hospital, 50139 Florence, Italy
Carlo Maria Rotella, Department of Biomedical Experimental and Clinical Sciences, Obesity Agency, Careggi University Hospital, 50139 Florence, Italy
Author contributions: All authors gave a substantial contribution in the conception of the work, in the selection of papers and in drafting and revising the paper; all authors gave their approval for publication to the final version of the article.
Conflict-of-interest: All authors do not have any conflict of interest to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Francesco Rotella, MD, PhD, Psychiatric Unit and Diabetes Agency, Careggi University Hospital, Largo Brambilla 3, 50141 Florence, Italy. francesco.rotella@unifi.it
Telephone: +39-055-7947487 Fax: +39-055-7947487
Received: November 13, 2014
Peer-review started: November 16, 2014
First decision: December 26, 2014
Revised: January 12, 2015
Accepted: February 4, 2015
Article in press: February 9, 2015
Published online: March 22, 2015
Abstract

Obesity is a multifactorial disease and the prominent factors playing a role in its pathogenesis are biological, environmental and psychological. There is a growing interest in understanding psychological functioning of obese subjects and the influence of psychological factors on treatment outcome. The aim of the present narrative review is to critically analyze the current literature, in order to point out the most common psychological constructs studied in obesity and to give an overview of the main existing tools investigating psychological features which have been considered significant for the prediction of success in weight loss and maintenance programs in obese patients. In this framework, the most common psychological constructs studied are: self-motivation, self-efficacy, locus of control, health related quality of life, self-esteem, self-control, concerns about body image, outcome expectations, and personality traits. These features have been explored through a wide variety of psychometric instruments. However, as an overall, studies evaluating the association between psychological features and treatment outcome failed to give consistent results. A possible explanation may consist on the fact that many tools widely used to explore psychological features were not specifically designed for obese patients and none of them was comprehensive of all possible psychological features involved. The identification of well-defined sub-groups of patients and the validation of more reliable and comprehensive tools, specifically designed for obese subjects, should be forecasted in order to reach a better knowledge of psychological functioning of obese individuals and to improve the outcome of weight loss programs.

Keywords: Obesity, Eating behaviors, Psychometrics, Psychological assessment, Psychological predictors

Core tip: A wide range of psychological conditions are bi-directionally linked to obesity. Psychological features may account for poor compliance and outcome in weight control programs but the current knowledge regarding this topic of research seems to be largely incomplete as studies investigating whether psychological factors could be reliable treatment predictors failed to give consistent results. The aim of the present narrative review is to critically analyze current literature in order to better identify which psychological features can predict outcome in weight loss and maintenance programs, and to summarize the psychological tools most widely used for this purpose.