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Introduction
Therapies are usually designed to address the problems of weight loss that should lessen the risks for chronic diseases like diabetes and hypertension. In addition to this, many researchers happen to approve of the positive feelings and the improvement of wellbeing that physical therapies are able to provide (Bryan & Tiggemann, 2001, p.147). Significant weight loss is said to accompany both positive and negative emotions, and it is in this regard that psychological balance should be maintained to ensure success of the therapy. The aim of this project is to specify and define certain elements that come into view when maintaining weight loss. This project will focus mainly on three variables: (1) autonomy and self-motivation; (2) personal self-esteem; and (3) an improved quality of life. All these are important and will greatly improve during and after an effective weight loss program, as proven in therapeutic interventions that were implemented for the purpose of weight loss.
Background of the Problem
The medical community has long been aware of the benefits of maintaining optimum body weight, but the important of psychological aspects influencing the loss of significant weight, has not been properly emphasized. Diseases associated with obesity have great impact on the mental wellbeing of patients involved, as their general health are being greatly affected, mainly as a result of obesity. However, it is not easy to counteract obesity, and it is in this aspect that the three variables enter the scene. Autonomy, for example, has affected the interest of many people in its significance of its role in improving the quality of life. It is the same when it comes to self-esteem, and it is said that both variables, together with a good quality of life, can generate wellness and human capital (Woo, 1984, p.43). This is reflected in the self-determination theory, wherein autonomy remains to be a core concept of the theory, while relying on post-Kantian phenomenological traditions. The philosophical literature of autonomy flourished over the years, and now it has been proven that weight loss lead to some benefits not just on physical health but on the psychological wellbeing of a person. When treating obesity, psychological evaluations and interventions should be recommended, as it improves self-image and social relationships (Herpertz et al., 2003; Van Hout et al., 2006).
Theoretical Foundations and Review of the Literature/Themes
Theoretical foundations / conceptual framework. It is not currently known to what degree does weight loss influences feelings of wellbeing, as perceived in the variables of personal autonomy, self-esteem, and an improved quality of life. Although weight loss may lead to other variables pertaining to body image, social environment, and job opportunities, the theory that Ryff (2014) developed relate more to the mental and physical wellbeing. It incorporates the theories of Rogers (1961) on the fully functioning person, including Allport’s (1961) maturity theory and Neugarten’s (1973) executive processes of personality. There is also Buhler’s (1935) theory on basic life tendencies, Maslow’s (1969) theory of self-actualization, Erickson’s (1959) theory of personal development, Frankl’s (1959) will to meaning theory, Jahoda’s (1958) mental health theory, and Jung’s (1933) individuation. All these define the core dimensions of psychological wellbeing that, when taking into effect, lead to the three variables of autonomy, better self-esteem, and better quality of life.
Meanwhile, the theory model will be adapted from Markowitz et al. (2008) and Napolitano et al. (2008) to address pre-existing psychological influences. The model shows the relationship between common mental disorders and obesity. Understanding the two will help determine how weight loss affects the mental health of people and improve their state of autonomy, self-esteem, and their quality of life. The goal is to identify whether interventions on weight loss would lead to a positive outcome, specifically when it comes to personal autonomy, self-esteem, and a better quality of life, as reflected in the past theory.
Review of the literature / themes. Autonomy and self-motivation are very important elements in weight loss. A normal body mass is maintained if the individual is allowed appropriate control over himself/herself, as well as, the environment. According to Webber et al. (2010, p.4), promoting autonomous motivation is more beneficial to weight loss than controlled motivation. Furthermore, they said that controlled motivation was more effective than behavioral loss intervention (Webber et al., 2010, p.4). Also, Fuglestad, Jeffery, & Sherwood (2012, p.79) determined that subjects that used their own initiative in removing unhealthy food from their environment were more successful in decreasing their weight. Thus, it proves how important autonomy really is when it comes to weight loss.
Self-esteem is also an important element in weight loss. In the two studies of Nnaemeka & Solomon (2014) and Oktan & Sahin (2010), they were able to draw a correlation between the wellbeing component of self-esteem and that of body image. Gruber (2014) and Samuel-Holdge et al. (2010, on the other hand, focused more on the influence of family support when it comes to self-esteem. There are likewise studies (i.e., Jackson et al., 2014; Kubik et al., 2013) indicating that the level of self-esteem in in direct correlation with body image. All these prove the importance of self-esteem when it comes to weight loss, as the former is directly related to body image and family support.
Finally, it is evident that the quality of life is also important when it comes to weight loss, since there are studies that show how the quality of live greatly improves when body mass is being reduced. This perception is also relevant to having higher self-esteem, a decreased state of depression, plus other additional positive effects. These were proven in the studies of Warkentin et al. (2013) and that of Osama & Shehab (2015), who reported that there are improvements in a person’s quality of life whenever he/she loses body weight. This proves the importance of having a better quality of life, and its significance to weight loss.
Problem Statement
It is not known how or why weight loss is able to have a direct effect on self-autonomy, self-esteem, and the quality of life. This is very important, since these three variables are important determinants of having a good life. This is seen in several studies, especially those that relate to the self-determination theory, which proves “the importance of relative autonomy on human functioning (Ryan & Deci, 2006, p.1563). Thus, self-autonomy is said to affect performance, creativity, wellbeing, and the quality of relationships, insisting its significance even in terms of weight loss and other things that affect human functioning. Interventions related to psychology, are thus recommended when trying to drop body mass.
Clinical Questions, Hypotheses, and Variables
Phenomenon: The phenomenon to be studied is with regards to the influence that weight loss has in regards with the three variables of autonomy, self-esteem, and good quality of life. Studies have shown how weight loss is directly correlated with autonomy, self-esteem, and having a good quality of life. The following questions will guide the study:
R1: How does weight loss influence self-autonomy, self-esteem, and having a good quality of life?
R2: Are there other variables, aside from the three, that influence and have direct correlation with weight loss?
It is most probable that the three variables (i.e., autonomy, self-esteem, having good quality of life) will positively affect, and would have a positive correlation, with weight loss because they are variables that highly motivate the individual into pursuing his/her goal in life.
Significance of the Project
The purpose of the study appears to be significant for enhancing the psychological wellbeing of those who wanted to lose weight, as the study would help them determine the variables that are useful and effective when it comes to weight loss. There is a direct connection between obesity and the psychological wellbeing of a person, as proven in the study that Jackson et al. (2014) conducted. In this study, it proves how effective are the weight loss programs in the promotion of good health and wellbeing. In fact, research has promoted healthcare professionals to include the psychological effects of obesity, and how weight loss would decrease the volume of problems related to psychology and mental health. By having a high level of autonomy, self-esteem, and having a good quality of life, there appears to have an improved wellbeing, which motivates those seeking for a weight loss. If however, the rate of satisfaction is not adequate, then the long-term outcome may be at risk, thereby putting risk on the individual’s ability to lose weight and improve their quality of life.
Rationale for Methodology
Nature of the Project Design
This study will apply the qualitative research method or design to answer the research questions. This method is best when recognizing the relationship between the independent variable of psychological state, as well as, the dependent variables of participant-perceived levels of self-autonomy, self-esteem, and having good quality of life. In addition, the use of open-ended questions will allow better, deeper responses and thus, may lead to unexpected variables, which may arise during the course of research. These unexpected variables may then be used for further research and will then, be considered for future study.
In using the qualitative method, it is best to apply the grounded theory in doing the research, as it is effective in gathering word evidence to develop theoretical analysis through intellectual justification (Goulding, 1998). The main essence is to apply rigorous analysis of the data in order to conceptualize it (Charmaz, 2009). It uses inductive logic, wherein the researcher does not start with a theory or a hypothesis. Instead, the researcher would first collect data, and then analyzes it, thereby generating a hypothesis. This is effective whenever the researcher has no idea what the outcome of the data gathering would be, or if he/she has not idea about the beliefs of the interviewees in accordance with the research questions.
Purpose of the Project
The purpose of this qualitative study, set on the grounded theory, is to promote understanding of the psychological changes that take place, as prompted by weight loss in obese adults, and how different variables influence them. The study will make use of the phenomenological design, following 15 participants over a three-month period of time, with continuous monitoring of predetermined variables, at a commercial weight loss center. It will be done in one of the avenues at New York City, and will center most on individuals who are obese and who are taking up weight loss interventions for at least 3 months. They will be interviewed on how the weight loss programs have affected them psychologically, specifically when it comes to self-autonomy, self-esteem, and having good quality of life. Using the ground theory, their responses shall be analyzed rigorously, to come up with a phenomenon or concept being reflected in all their responses. The aim of the project is to identify how strong do the three variables influence their system of weight loss, and whether it is possible to reach their goal of lessening their body mass even without the three variables.
Sources of Data
For a qualitative research that uses the narrative approach, the best sources would be interviews and observations, as well as secondary accounts gathered from the interviewees’ friends and family members. The self-reporting of the participants would make way for subjective information, which is not measurable by direct observation nor by physical measurement. In gathering data and doing the interviews, the researcher will make use of a recording instrument and/or a video recording instrument, such as those seen in mobile phones and tablets. The researcher will likewise make use of writing tools for documentation and writing of notes, such as a notebook and a pen. Meanwhile, data analysis will begin after the first collection of data to be able to begin early. Analysis will make use of tools like written notes, transcript of interviewees, coding of the interview responses, and discussions with the rest of the researching team. The transcribed interviews will be imported into an MAXQDA software program, chosen to address variable functions, images, and texts.
Data Collection Procedures
The target population are the obese adults living in New York City. The sample study includes 15 obese adults who are enrolled in a weight loss program in the same city. The participants should be within the range of 18 to 40 years old, and should have no chronic illnesses that would prevent a positive attitude or be prevented from being motivated. However, because the evaluation system includes a measurement of the levels of depression, those who are experiencing stress, trauma, or depression may be included in the study. To be more concise with the participants, the study will be multi-cultural, and there will be 5 types of culture that will be applied in choosing the interviewees: (1) White American; (2) Black American; (3) Hispanic; (4) European; and (5) Asian. There will be 3 participants for each of the 5 cultures that were mentioned, although all of them should be within the district of New York City. There are three manners of collecting the information after sending them a letter requesting their approval to join the study, as well as a request for approval for a research to be held within the organization. One method of collecting data is through personal interview. Another method is through written interview. And lastly, information may be gathered through the use of computers and the World Wide Web (e.g., emails, Facebook, Skype).
Data Analysis Procedures
The data collected from the study will be analyzed using the MAXQDA software program that is designed to analyzing qualitative data, and is capable of analyzing interviews, reports, focus groups, audio files, and images (MAXQDA, 2016). Using the grounded theory, the aim is to contextualize the interviews and come up with distinguishing analyses centered on the three basic variables. The interviews will center on the following questions:
(1) How does weight loss affect your self-autonomy? How pleased are you about the effect of weight loss to your self-autonomy? Please rate from 1-5.
(2) How does weight loss affect your self-esteem? How pleased are you about the effect of weight loss to your self-esteem? Please rate from 1-5.
(3) How does weight loss affect your quality of life? How pleased are you about the effect of weight loss to you quality of life? Please rate from 1-5
(4) What do you expect to gain by trying to lose weight, aside from improving your physical attributes?
(5) What have you learned about the psychological effect of weight loss to a person’s wellbeing?
Ethical Considerations
Each participant of the sample population in the study, is enrolled in the same weight loss program in New York City. As clients of the company, utmost care will be taken into consideration to protect the business from liability that is associated with the study. Contact with the study participants will be kept to a minimum to decrease the possibility of contamination of data. To protect the research project, as well as the business and associated entities, each participant will sign a consent form that will be witnessed to and retained in the records of the study. The consent form shall also contain a section that would allow the information being gathered to be used in a way that would protect the confidentiality of the participants. Lastly, to conform to the standards of HIPPA, and the confidentiality regulations of the weight loss company, the data of each participant will be assigned to a code that has specific identifiers to patient charts. On completion of the study and the verification of data, the codes will be altered to avoid the possibility of coordinating the original identifiers with the company records. At no point will there be any contact with outside entities concerning the information being gathered in conjunction with the study.
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Appendix:
Qualitative Studies
