Development and Validation of the Weight Control Strategies Scale

Behavioral obesity treatments that encourage individuals to lose weight by consuming a low-calorie, low-fat diet and engaging in regular physical activity are successful in achieving clinically important weight losses (1). Dietary recommendations for these programs include consumption of fruits, vegetables, whole grains, lean proteins, and low-fat dairy. Participants are given a daily calorie goal range and instructed to monitor calorie intake to stay within that range (2). These programs also promote regular physical activity in the form of brisk walking or similar exercise for 30–40 minutes per day. Individuals are taught a variety of behavioral techniques to help them change their eating and exercise habits, such as self-monitoring, goal-setting, stimulus control, and problem-solving, as well as cognitive and psychological coping skills (1, 2). While studies have shown that regular self-monitoring of eating and body weight promotes successful weight loss and weight loss maintenance (3–5), there is limited empirical evidence testing the effectiveness of other strategies presented in behavioral weight loss programs. The need to systematically examine the role of specific behaviors involved in weight control was identified over 30 years ago and led to the development of the Eating Behavior Inventory (EBI) (6). The EBI is comprised of items reflecting behaviors theoretically implicated in weight loss and taught in behavioral weight loss treatment programs at the time the EBI was developed. These items focus primarily on eating patterns such as monitoring food intake, restricting amount and type of food consumed, and regulating the location of eating. Research has supported the validity of the EBI, showing that EBI scores increase during weight loss treatment (7–10) and increases in EBI scores are related to posttreatment weight loss (7, 8, 11, 12). However, in the years since the EBI was developed, behavioral weight loss treatments have evolved to include additional components - beyond changes in eating behavior - that are thought to facilitate weight loss, such as nutrition education, cognitive and psychological coping skills, and physical activity (13–16). These are aspects of current treatments that are not assessed by the EBI. Further, a recent review examining the utility of the EBI in weight loss trials (17) reported that posttreatment EBI scores have declined over time, suggesting that current behavioral weight loss treatments are having a lesser effect on the specific eating behaviors measured by the EBI compared to earlier studies. The authors assert that this finding may be related to observed changes in the content of behavioral weight loss treatment such that present-day programs do not place as much emphasis on certain behaviors identified by the EBI as did earlier programs. Given the variety of techniques presented in current behavioral weight loss treatments, it would be helpful to identify the specific behaviors that are most effective in helping individuals to manage their weight. Thus, the purpose of the present investigation was to develop a self-report instrument to assess use of specific behaviors thought to facilitate weight loss, the Weight Control Strategies Scale (WCSS).