THE EFFECTS OF HEALTH BELIEFS ON WEIGHT-LOSS IN INDIVIDUALS AT HIGH-RISK FOR NIDDM

OBJECTIVE - To determine whether perceived risk and other health belie fs held by individuals at high risk for developing NIDDM predict weigh t loss and behavior change during a behavioral weight loss program to reduce the risk of NIDDM. RESEARCH DESIGN AND METHODS - Health beliefs and objective risk factors for diabetes were examined in 154 overweig ht men and women with a family history of NIDDM. The effects of these factors on adherence, dietary intake, weight. loss, and changes in glu cose levels were examined in a subset of 79 of these subjects who part icipated in a 2-year behavioral weight control program. RESULTS - Thos e subjects who perceived themselves at highest risk of developing diab etes had a stronger family history of the disease and were more likely to be women than subjects considering themselves at more moderate ris k. These participants also rated diabetes as a more serious disease, b ut were less likely to believe that weight loss would lower their risk . None of these health beliefs were related to attendance at meetings, dietary intake, weight loss, or fasting glucose, but higher perceived seriousness predicted larger reductions in BMI at 1 year. Of the obje ctive risk factors for NIDDM, higher baseline BMI predicted larger wei ght losses throughout the program, and a stronger family history of di abetes was related to greater weight regain after an initial weight lo ss. CONCLUSIONS - Perceived risk of developing diabetes and other heal th beliefs did not predict performance in a behavioral weight loss pro gram. These data suggest that efforts to modify health beliefs by educ ating high-risk individuals about their risk and benefits of weight lo ss may not be effective in improving long-term weight loss results.