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Stages and Processes of Change for Weight Loss in Acute Stroke or TIA Patients Living with Obesity
BACKGROUND: Obesity is associated with an increased prevalence of vascular risk factors and incidence of stroke. As such weight loss is recommended for patients living with obesity in the secondary prevention of stroke. Few studies, however, have examined the stages and processes of change for weigh...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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S. Karger AG
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8958604/ https://www.ncbi.nlm.nih.gov/pubmed/34915499 http://dx.doi.org/10.1159/000521387 |
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author | Wilson, Mitch Orgass, Hailey Dearborn-Tomazos, Jennifer |
author_facet | Wilson, Mitch Orgass, Hailey Dearborn-Tomazos, Jennifer |
author_sort | Wilson, Mitch |
collection | PubMed |
description | BACKGROUND: Obesity is associated with an increased prevalence of vascular risk factors and incidence of stroke. As such weight loss is recommended for patients living with obesity in the secondary prevention of stroke. Few studies, however, have examined the stages and processes of change for weight loss in stroke patients living with obesity. OBJECTIVE: The aim of the study was to evaluate the stages and processes of change for weight loss in patients living with obesity who have had a recent stroke or TIA. METHODS: Using a validated questionnaire, we assessed each patient's stage of behavioral change according to the transtheoretical model (precontemplation, contemplation, preparation, action, and maintenance). We also examined 4 processes of behavioral change, which quantify activities and experiences that patients undergo on the way to behavioral change: emotional reevaluation (EMR), weight management action (WMA), weight consequence evaluation, and supporting relationships. Processes scores were compared between patients in the action and maintenance stages and those in the precontemplation, contemplation, and preparation stages. RESULTS: Out of 49 patients who provided informed consent, 44 met the inclusion/exclusion criteria. Of these 44 patients, 6 (14%) were in the precontemplation stage of change, 7 (16%) were in contemplation, 2 (5%) were in preparation, 13 (30%) were in action, and 16 (36%) were in maintenance. Those in the action and maintenance stages accounted for the majority of participants (n = 29, 66%). Patients in the action and maintenance stages (N = 29) had higher EMR scores (mean 79, SD 13 vs. mean 68, SD 19, t = 2.0, p = 0.03) and WMA scores (mean 69, SD 13 vs. mean 59, SD 19, t = 2.0, p = 0.03) as compared to those in the precontemplation, contemplation, and preparation stages (N = 15). CONCLUSIONS: Our results suggest that without counseling or specific intervention, approximately two-thirds of stroke/TIA patients living with obesity are in the action or maintenance stage of behavior change with respect to weight loss and therefore more likely to succeed in intensive lifestyle-based interventions targeted towards weight loss. Patients who score higher in EMR and WMA are more likely to be in the action or maintenance stage of change. |
format | Online Article Text |
id | pubmed-8958604 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | S. Karger AG |
record_format | MEDLINE/PubMed |
spelling | pubmed-89586042022-04-14 Stages and Processes of Change for Weight Loss in Acute Stroke or TIA Patients Living with Obesity Wilson, Mitch Orgass, Hailey Dearborn-Tomazos, Jennifer Cerebrovasc Dis Extra Original Paper BACKGROUND: Obesity is associated with an increased prevalence of vascular risk factors and incidence of stroke. As such weight loss is recommended for patients living with obesity in the secondary prevention of stroke. Few studies, however, have examined the stages and processes of change for weight loss in stroke patients living with obesity. OBJECTIVE: The aim of the study was to evaluate the stages and processes of change for weight loss in patients living with obesity who have had a recent stroke or TIA. METHODS: Using a validated questionnaire, we assessed each patient's stage of behavioral change according to the transtheoretical model (precontemplation, contemplation, preparation, action, and maintenance). We also examined 4 processes of behavioral change, which quantify activities and experiences that patients undergo on the way to behavioral change: emotional reevaluation (EMR), weight management action (WMA), weight consequence evaluation, and supporting relationships. Processes scores were compared between patients in the action and maintenance stages and those in the precontemplation, contemplation, and preparation stages. RESULTS: Out of 49 patients who provided informed consent, 44 met the inclusion/exclusion criteria. Of these 44 patients, 6 (14%) were in the precontemplation stage of change, 7 (16%) were in contemplation, 2 (5%) were in preparation, 13 (30%) were in action, and 16 (36%) were in maintenance. Those in the action and maintenance stages accounted for the majority of participants (n = 29, 66%). Patients in the action and maintenance stages (N = 29) had higher EMR scores (mean 79, SD 13 vs. mean 68, SD 19, t = 2.0, p = 0.03) and WMA scores (mean 69, SD 13 vs. mean 59, SD 19, t = 2.0, p = 0.03) as compared to those in the precontemplation, contemplation, and preparation stages (N = 15). CONCLUSIONS: Our results suggest that without counseling or specific intervention, approximately two-thirds of stroke/TIA patients living with obesity are in the action or maintenance stage of behavior change with respect to weight loss and therefore more likely to succeed in intensive lifestyle-based interventions targeted towards weight loss. Patients who score higher in EMR and WMA are more likely to be in the action or maintenance stage of change. S. Karger AG 2021-12-10 /pmc/articles/PMC8958604/ /pubmed/34915499 http://dx.doi.org/10.1159/000521387 Text en Copyright © 2021 by S. Karger AG, Basel https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article licensed under the Creative Commons Attribution-NonCommercial-4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense), applicable to the online version of the article only. Usage and distribution for commercial purposes requires written permission. |
spellingShingle | Original Paper Wilson, Mitch Orgass, Hailey Dearborn-Tomazos, Jennifer Stages and Processes of Change for Weight Loss in Acute Stroke or TIA Patients Living with Obesity |
title | Stages and Processes of Change for Weight Loss in Acute Stroke or TIA Patients Living with Obesity |
title_full | Stages and Processes of Change for Weight Loss in Acute Stroke or TIA Patients Living with Obesity |
title_fullStr | Stages and Processes of Change for Weight Loss in Acute Stroke or TIA Patients Living with Obesity |
title_full_unstemmed | Stages and Processes of Change for Weight Loss in Acute Stroke or TIA Patients Living with Obesity |
title_short | Stages and Processes of Change for Weight Loss in Acute Stroke or TIA Patients Living with Obesity |
title_sort | stages and processes of change for weight loss in acute stroke or tia patients living with obesity |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8958604/ https://www.ncbi.nlm.nih.gov/pubmed/34915499 http://dx.doi.org/10.1159/000521387 |
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