Ask the Expert: Can You Think Your Way to Weight Loss?

Weight scale image via Shutterstock.

We recently read about the Health Belief Model (HBM), which is a model of behavior change often used to help people add healthy behaviors into their lives, especially preventative behaviors like getting mammograms or heading to the doctor for STD testing. The model is all about perception — your perceived susceptibility to a disease, your perceived severity of that disease, the perceived benefits of making a change, and the perceived barriers of making those changes. Once people knew what the risks of their behaviors were, the creators of the HBM believed that they would be more likely to adopt healthier behaviors.

Sounds reasonable, right? But some research claimed that the HBM could help people lose weight, too, and we were skeptical. Could weight loss and healthy living really be all in our heads? So we turned to Lisa Quintiliani, a professor at Boston University’s School of Public Health for some answers.

Can the HBM actually help people change their behaviors?

Yes, the HBM is still used to shape the implementation and evaluations of interventions designed to change behavior. A lot of research has been devoted to behaviors that are more one-time events, like obtaining a cancer screening (mammography, colonoscopy, etc.). The HBM has been less widely applied to health behaviors such as eating and physical activity, which are behaviors that are done repeatedly.

How can people use the health belief model to lose weight?

Someone could use the components of the HBM to help think about why they do what they do, which is why the HBM works. For example, someone could make a list of the perceived benefits and barriers to eating healthier. Or, they could learn more about their personal susceptibility to obesity-related diseases and how severe the consequences of these diseases are. That might convince them to lose weight.

So are you saying that we could actually think our way to weight loss?

Well, one issue that all of this raises is that eating and physical activity behaviors have strong emotional components. By this I mean that people’s eating and physical activity behaviors are not shaped only by things we actively think about. For example, using a small plate versus a large plate, or tall and skinny glasses versus a short and wide glasses, may cause you to eat or drink less without you actively deciding to do so. So while the HBM might help you lose weight, you’d probably have to pair the HBM with other models to have it be effective.

What do you encourage people to do when they decide that they want to live a healthier lifestyle?

I usually encourage people to begin tracking the foods and activities they do using a paper, web, or app-based method. This doesn’t need to be about counting calories, but instead it’s about paying more attention to the choices you make on a daily basis. Self-monitoring methods are consistently used to facilitate weight loss.

So what’s the bottom line here? Is healthy living all in our heads?

Engaging in multiple levels is important. What I mean is that you might be able to increase your motivation, confidence, and commitment to the goal of changing your eating and physical activity behaviors through the HBM. But, moving beyond individually-based psychological methods, including engaging your social network for support, and modifying your home environment to include healthy foods, is important to long-term behavior change for weight.