When weight management lasts. Lower perceived rule complexity increases adherence

Appetite. 2010 Feb;54(1):37-43. doi: 10.1016/j.appet.2009.09.004. Epub 2009 Sep 12.


Maintaining behavior change is one of the major challenges in weight management and long-term weight loss. We investigated the impact of the cognitive complexity of eating rules on adherence to weight management programs. We studied whether popular weight management programs can fail if participants find the rules too complicated from a cognitive perspective, meaning that individuals are not able to recall or process all required information for deciding what to eat. The impact on program adherence of participants' perceptions of eating rule complexity and other behavioral factors known to influence adherence (including previous weight management, self-efficacy, and planning) was assessed via a longitudinal online questionnaire given to 390 participants on two different popular weight management regimens. As we show, the regimens, Weight Watchers and a popular German recipe diet (Brigitte), strongly differ in objective rule complexity and thus their cognitive demands on the dieter. Perceived rule complexity was the strongest factor associated with increased risk of quitting the cognitively demanding weight management program (Weight Watchers); it was not related to adherence length for the low cognitive demand program (Brigitte). Higher self-efficacy generally helped in maintaining a program. The results emphasize the importance of considering rule complexity to promote long-term weight management.

MeSH terms

  • Adult
  • Cognition / physiology
  • Diet, Reducing / methods*
  • Diet, Reducing / statistics & numerical data
  • Female
  • Germany
  • Health Behavior*
  • Humans
  • Internet
  • Longitudinal Studies
  • Male
  • Obesity / diet therapy*
  • Patient Compliance / psychology*
  • Patient Compliance / statistics & numerical data
  • Perception / physiology*
  • Proportional Hazards Models
  • Self Efficacy
  • Surveys and Questionnaires
  • Time
  • Weight Loss / physiology*