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Weighing the Options: Criteria for Evaluating Weight-Management Programs (1995)

Chapter: Appendix B: The Diet Readiness Test and the General Well-Being Schedule

« Previous: Appendix A: Assessment Instruments of Relevance to Obesity Treatment
Suggested Citation:"Appendix B: The Diet Readiness Test and the General Well-Being Schedule." Institute of Medicine. 1995. Weighing the Options: Criteria for Evaluating Weight-Management Programs. Washington, DC: The National Academies Press. doi: 10.17226/4756.
×

B The Diet Readiness Test and the General Well-Being Schedule

In Chapters 7 and 8, we recommended that all individuals assess their psychological status prior to beginning a weight-management program or have it assessed by the program. We suggested use of the Dieting Readiness Test or a comparable test to help point out potential problems with motivation and attitudes toward dieting and exercise. In addition to the Dieting Readiness Test, we recommended that clinical programs administer the General Well-Being Schedule or a comparable test to their potential clients to identify any psychological pathologies (e.g., depression) and determine whether an individual should be referred for more in-depth psychological assessment before beginning the program. This appendix provides both the Dieting Readiness Test and the General Well-Being Schedule in their entirety.

THE DIETING READINESS TEST

Answer the questions below to see how well your attitudes equip you for a weight-loss program. For each question, circle the answer that best describes your attitude. As you complete each of the six sections, add the numbers of your answers and compare them with the scoring guide at the end of each section.

Suggested Citation:"Appendix B: The Diet Readiness Test and the General Well-Being Schedule." Institute of Medicine. 1995. Weighing the Options: Criteria for Evaluating Weight-Management Programs. Washington, DC: The National Academies Press. doi: 10.17226/4756.
×
Section 1: Goals and Attitudes
  1. Compared to previous attempts, how motivated to lose weight are you this time?

    1. Not at all motivated

    2. Slightly motivated

    3. Somewhat motivated

    4. Quite motivated

    5. Extremely motivated

  1. How certain are you that you will stay committed to a weight loss program for the time it will take you to reach your goal?

    1. Not at all certain

    2. Slightly certain

    3. Somewhat certain

    4. Quite certain

    5. Extremely certain

  1. Consider all outside factors at this time in your life (the stress you're feeling at work, your family obligations, etc.). To what extent can you tolerate the effort required to stick to a diet?

    1. Cannot tolerate

    2. Can tolerate somewhat

    3. Uncertain

    4. Can tolerate well

    5. Can tolerate easily

  1. Think honestly about how much weight you hope to lose and how quickly you hope to lose it. Figuring a weight loss of 1 to 2 pounds per week, how realistic is your expectation?

    1. Very unrealistic

    2. Somewhat unrealistic

    3. Moderately unrealistic

    4. Somewhat realistic

    5. Very realistic

  1. While dieting, do you fantasize about eating a lot of your favorite foods?

    1. Always

    2. Frequently

    3. Occasionally

    4. Rarely

    5. Never

Suggested Citation:"Appendix B: The Diet Readiness Test and the General Well-Being Schedule." Institute of Medicine. 1995. Weighing the Options: Criteria for Evaluating Weight-Management Programs. Washington, DC: The National Academies Press. doi: 10.17226/4756.
×
  1. While dieting, do you feel deprived, angry and/or upset?

  1. Always

  2. Frequently

  3. Occasionally

  4. Rarely

  5. Never

Section 1—TOTAL Score _____

If you scored:

6 to 16:

This may not be a good time for you to start a weight loss program. Inadequate motivation and commitment together with unrealistic goals could block your progress. Think about those things that contribute to this, and consider changing them before undertaking a diet program.

17 to 23:

You may be close to being ready to begin a program but should think about ways to boost your preparedness before you begin.

24 to 30:

The path is clear with respect to goals and attitudes.

Section 2: Hunger and Eating Cues
  1. When food comes up in conversation or in something you read, do you want to eat even if you are not hungry?

    1. Never

    2. Rarely

    3. Occasionally

    4. Frequently

    5. Always

  1. How often do you eat because of physical hunger?

    1. Always

    2. Frequently

    3. Occasionally

    4. Rarely

    5. Never

  1. Do you have trouble controlling your eating when your favorite foods are around the house?

    1. Never

    2. Rarely

    3. Occasionally

    4. Frequently

    5. Always

Suggested Citation:"Appendix B: The Diet Readiness Test and the General Well-Being Schedule." Institute of Medicine. 1995. Weighing the Options: Criteria for Evaluating Weight-Management Programs. Washington, DC: The National Academies Press. doi: 10.17226/4756.
×

Section 2—TOTAL Score ___

If you scored:

3 to 6:

You might occasionally eat more than you would like, but it does not appear to be a result of high responsiveness to environmental cues. Controlling the attitudes that make you eat may be especially helpful.

7 to 9:

You may have a moderate tendency to eat just because food is available. Dieting may be easier for you if you try to resist external cues and eat only when you are physically hungry.

10 to 15:

Some or most of your eating may be in response to thinking about food or exposing yourself to temptations to eat. Think of ways to minimize your exposure to temptations, so that you eat only in response to physical hunger.

Section 3: Control Over Eating

If the following situations occurred while you were on a diet, would you be likely to eat more or less immediately afterward and for the rest of the day?

  1. Although you planned on skipping lunch, a friend talks you into going out for a midday meal.

    1. Would eat much less

    2. Would eat somewhat less

    3. Would make no difference

    4. Would eat somewhat more

    5. Would eat much more

  1. You "break" your diet by eating a fattening, "forbidden" food.

    1. Would eat much less

    2. Would eat somewhat less

    3. Would make no difference

    4. Would eat somewhat more

    5. Would eat much more

  1. You have been following your diet faithfully and decide to test yourself by eating something you consider a treat.

    1. Would eat much less

    2. Would eat somewhat less

    3. Would make no difference

    4. Would eat somewhat more

    5. Would eat much more

Suggested Citation:"Appendix B: The Diet Readiness Test and the General Well-Being Schedule." Institute of Medicine. 1995. Weighing the Options: Criteria for Evaluating Weight-Management Programs. Washington, DC: The National Academies Press. doi: 10.17226/4756.
×

Section 3—TOTAL Score ___

If you scored:

3 to 7:

You recover rapidly from mistakes. However, if you frequently alternate between eating out of control and dieting very strictly, you may have a serious eating problem and should get professional help.

8 to 11:

You do not seem to let unplanned eating disrupt your program. This is a flexible, balanced approach.

12 to 15:

You may be prone to overeat after an event breaks your control or throws you off the track. Your reaction to these problem-causing eating events can be improved.

Section 4: Binge Eating and Purging
  1. Aside from holiday feasts, have you ever eaten a large amount of food rapidly and felt afterward that this eating incident was excessive and out of control?

    1. Yes

    2. No

  1. If you answered yes to #13 above, how often have you engaged in this behavior during the last year?

    1. Less than once a month

    2. About once a month

    3. A few times a month

    4. About once a week

    5. About three times a week

    6. Daily

  1. Have you ever purged (used laxatives, diuretics or induced vomiting) to control your weight?

    1. Yes

    2. No

  1. If you answered yes to #15 above, how often have you engaged in this behavior during the last year?

    1. Less than once a month

    2. About once a month

    3. A few times a month

    4. About once a week

    5. About three times a week

    6. Daily

Suggested Citation:"Appendix B: The Diet Readiness Test and the General Well-Being Schedule." Institute of Medicine. 1995. Weighing the Options: Criteria for Evaluating Weight-Management Programs. Washington, DC: The National Academies Press. doi: 10.17226/4756.
×

Section 4—TOTAL Score ___

If you scored:

0 to 1:

It appears that binge eating and purging is not a problem for you.

2 to 11:

Pay attention to these eating patterns. Should they arise more frequently, get professional help.

12 to 19:

You show signs of having a potentially serious eating problem. See a counselor experienced in evaluating eating disorders right away.

Section 5: Emotional Eating
  1. Do you eat more than you would like to when you have negative feelings such as anxiety, depression, anger, or loneliness?

    1. Never

    2. Rarely

    3. Occasionally

    4. Frequently

    5. Always

  1. Do you have trouble controlling your eating when you have positive feelings—do you celebrate feeling good by eating?

    1. Never

    2. Rarely

    3. Occasionally

    4. Frequently

    5. Always

  1. When you have unpleasant interactions with others in your life, or after a difficult day at work, do you eat more than you'd like?

    1. Never

    2. Rarely

    3. Occasionally

    4. Frequently

    5. Always

Section 5—TOTAL Score ___

If you scored:

3 to 8:

You do not appear to let your emotions affect your eating.

9 to 11:

You sometimes eat in response to emotional highs and lows. Monitor this behavior to learn when and why it occurs and be prepared to find alternate activities.

Suggested Citation:"Appendix B: The Diet Readiness Test and the General Well-Being Schedule." Institute of Medicine. 1995. Weighing the Options: Criteria for Evaluating Weight-Management Programs. Washington, DC: The National Academies Press. doi: 10.17226/4756.
×

12 to 15:

Emotional ups and downs can stimulate your eating. Try to deal with the feelings that trigger the eating and find other ways to express them.

Section 6: Exercise Patterns and Attitudes
  1. How often do you exercise?

    1. Never

    2. Rarely

    3. Occasionally

    4. Somewhat

    5. Frequently

  1. How confident are you that you can exercise regularly?

    1. Not at all confident

    2. Slightly confident

    3. Somewhat confident

    4. Highly confident

    5. Completely confident

  1. When you think about exercise, do you develop a positive or negative picture in your mind?

    1. Completely negative

    2. Somewhat negative

    3. Neutral

    4. Somewhat positive

    5. Completely positive

  1. How certain are you that you can work regular exercise into your daily schedule?

    1. Not at all certain

    2. Slightly certain

    3. Somewhat certain

    4. Quite certain

    5. Extremely certain

Section 6—TOTAL Score ___

If you scored:

4 to 10:

You're probably not exercising as regularly as you should. Determine whether your attitudes about exercise are blocking your way, then change what you must and put on those walking shoes.

11 to 16:

You need to feel more positive about exercise so you can do it more often. Think of ways to be more active that are fun and fit your lifestyle.

Suggested Citation:"Appendix B: The Diet Readiness Test and the General Well-Being Schedule." Institute of Medicine. 1995. Weighing the Options: Criteria for Evaluating Weight-Management Programs. Washington, DC: The National Academies Press. doi: 10.17226/4756.
×

17 to 20:

It looks like the path is clear for you to be active. Now think of ways to get motivated.

After scoring yourself in each section of this questionnaire, you should be able to better judge your dieting strengths and weaknesses. Remember that the first step in changing eating behavior is to understand the conditions that influence your eating habits.

 

SOURCE: Brownell, 1990. Reprinted with permission.

GENERAL WELL-BEING SCHEDULE

This section of the examination contains questions about how you feel and how things have been going with you. For each question, fill in the circle next to the answer which best applies to you.

  1. How have you been feeling in general? (DURING THE PAST MONTH)

    • In excellent spirits

    • In very good spirits

    • In good spirits mostly

    • I have been up and down in spirits a lot

    • In low spirits mostly

    • In very low spirits

  1.  Have you been bothered by nervousness or your "nerves"? (DURING THE PAST MONTH)

    • Extremely so—to the point where I could not work or take care of things

    • Very much so

    • Quite a bit

    • Some—enough to bother me

    • A little

    • Not at all

  1.  Have you been in firm control of your behavior, thoughts, emotions OR feelings? (DURING THE PAST MONTH)

    • Yes, definitely so

    • Yes, for the most part

    • Generally so

Suggested Citation:"Appendix B: The Diet Readiness Test and the General Well-Being Schedule." Institute of Medicine. 1995. Weighing the Options: Criteria for Evaluating Weight-Management Programs. Washington, DC: The National Academies Press. doi: 10.17226/4756.
×
  • Not too well

  • No, and I am somewhat disturbed

  • No, and I am very disturbed

  1. Have you felt so sad, discouraged, hopeless, or had so many problems that you wondered if everything was worthwhile? (DURING THE PAST MONTH)

    • Extremely so—to the point that I have just about given up

    • Very much so

    • Quite a bit

    • Some—enough to bother me

    • A little bit

    • Not at all

  1. Have you been under or felt you were under any strain, stress, or pressure? (DURING THE PAST MONTH)

    • Yes—almost more than I could bear or stand

    • Yes—quite a bit of pressure

    • Yes—some, more than usual

    • Yes—some, but about usual

    • Yes—a little

    • Not at all

  1. How happy, satisfied, or pleased have you been with your personal life? (DURING THE PAST MONTH)

    • Extremely happy—could not have been more satisfied or pleased

    • Very happy

    • Fairly happy

    • Satisfied—pleased

    • Somewhat dissatisfied

    • Very dissatisfied

  1. Have you had any reason to wonder if you were losing your mind, or losing control over the way you act, talk, think, feel, or of your memory? (DURING THE PAST MONTH)

    • Not at all

    • Only a little

    • Some—but not enough to be concerned or worried about

    • Some and I have been a little concerned

    • Some and I am quite concerned

    • Yes, very much so and I am very concerned

Suggested Citation:"Appendix B: The Diet Readiness Test and the General Well-Being Schedule." Institute of Medicine. 1995. Weighing the Options: Criteria for Evaluating Weight-Management Programs. Washington, DC: The National Academies Press. doi: 10.17226/4756.
×
  1. Have you been anxious, worried, or upset?

    • Extremely so—to the point of being sick or almost sick

    • Very much so

    • Quite a bit

    • Some—enough to bother me

    • A little bit

    • Not at all

  1. Have you been waking up fresh and rested? (DURING THE PAST MONTH)

    • Every day

    • Most every day

    • Fairly often

    • Less than half the time

    • Rarely

    • None of the time

  1. Have you been bothered by any illness, bodily disorder, pains, or fears about your health?

    • All the time

    • Most of the time

    • A good bit of the time

    • Some of the time

    • A little of the time

    • None of the time

  1. Has your daily life been full of things that were interesting to you? (DURING THE PAST MONTH)

    • All the time

    • Most of the time

    • A good bit of the time

    • Some of the time

    • A little of the time

    • None of the time

  1. Have you felt down-hearted and blue? (DURING THE PAST MONTH)

    • All the time

    • Most of the time

    • A good bit of the time

    • Some of the time

    • A little of the time

    • None of the time

Suggested Citation:"Appendix B: The Diet Readiness Test and the General Well-Being Schedule." Institute of Medicine. 1995. Weighing the Options: Criteria for Evaluating Weight-Management Programs. Washington, DC: The National Academies Press. doi: 10.17226/4756.
×
  1. Have you been feeling emotionally stable and sure of yourself? (DURING THE PAST MONTH)

    • All the time

    • Most of the time

    • A good bit of the time

    • Some of the time

    • A little of the time

    • None of the time

  1. Have you felt tired, worn out, used up, or exhausted? (DURING THE PAST MONTH)

    • All the time

    • Most of the time

    • A good bit of the time

    • Some of the time

    • A little of the time

    • None of the time

For each of the four scales below, note that the words at each end of the 0 to 10 scale describe opposite feelings. Fill in the circle along the bar which seems closest to how you have generally felt DURING THE PAST MONTH.

15.

How concerned or worried about your HEALTH have you been? (DURING THE PAST MONTH)

0

1

2

3

4

5

6

7

8

9

10

__

__

__

__

__

___

__

__

__

__

__

Not concerned at all

 

 

 

 

 

 

 

 

 

Very concerned

16.

How RELAXED or TENSE have you been? (DURING THE PAST MONTH)

0

1

2

3

4

5

6

7

8

9

10

__

__

__

__

__

__

__

__

__

__

__

Very relaxed  

 

 

 

 

 

 

 

 

 

Very tense

Suggested Citation:"Appendix B: The Diet Readiness Test and the General Well-Being Schedule." Institute of Medicine. 1995. Weighing the Options: Criteria for Evaluating Weight-Management Programs. Washington, DC: The National Academies Press. doi: 10.17226/4756.
×

17.

How much ENERGY, PEP, and VITALITY have you felt (DURING THE PAST MONTH)

0

1

2

3

4

5

6

7

8

9

10

__

__

__

__

__

__

__

__

__

__

__

No energy at all, listless

 

 

 

 

 

 

 

 

 

Very energetic, dynamic

18.

How DEPRESSED or CHEERFUL have you been? (DURING THE PAST MONTH)

0

1

2

3

4

5

6

7

8

9

10

__

__

__

__

__

__

__

__

__

__

__

Very depressed

 

 

 

 

 

 

 

 

 

Very cheerful

Scoring

For questions 1, 3, 6, 7, 9, 11, and 13, score 1=5, 2=4, 3=3, 4=2, 5=1, and 6=0.

For questions 2, 4, 5, 8, 10, 12, and 14, score 1=0, 2=1, 3=2, 4=3, 5=4, and 6=5.

For questions 15 and 16, score 0=10, 1=9, 2=8, 3=7, 4=6, 5=5, 6=4, 7=3, 8=2, 9=1, and 10=0.

For questions 17 and 18, score 1=1, 2=2, 3=3, 4=4, 5=5, 6=6, 7=7, 8=8, 9=9, and 10=10.

Interpretation of Scores

0 to 60 equals ''Severe distress."

61 to 72 equals "Moderate distress."

73 to 110 equals "Positive Well-Being."

 

SOURCE: NCHS, 1977; McDowell and Newell, 1987

Suggested Citation:"Appendix B: The Diet Readiness Test and the General Well-Being Schedule." Institute of Medicine. 1995. Weighing the Options: Criteria for Evaluating Weight-Management Programs. Washington, DC: The National Academies Press. doi: 10.17226/4756.
×
Page 198
Suggested Citation:"Appendix B: The Diet Readiness Test and the General Well-Being Schedule." Institute of Medicine. 1995. Weighing the Options: Criteria for Evaluating Weight-Management Programs. Washington, DC: The National Academies Press. doi: 10.17226/4756.
×
Page 199
Suggested Citation:"Appendix B: The Diet Readiness Test and the General Well-Being Schedule." Institute of Medicine. 1995. Weighing the Options: Criteria for Evaluating Weight-Management Programs. Washington, DC: The National Academies Press. doi: 10.17226/4756.
×
Page 200
Suggested Citation:"Appendix B: The Diet Readiness Test and the General Well-Being Schedule." Institute of Medicine. 1995. Weighing the Options: Criteria for Evaluating Weight-Management Programs. Washington, DC: The National Academies Press. doi: 10.17226/4756.
×
Page 201
Suggested Citation:"Appendix B: The Diet Readiness Test and the General Well-Being Schedule." Institute of Medicine. 1995. Weighing the Options: Criteria for Evaluating Weight-Management Programs. Washington, DC: The National Academies Press. doi: 10.17226/4756.
×
Page 202
Suggested Citation:"Appendix B: The Diet Readiness Test and the General Well-Being Schedule." Institute of Medicine. 1995. Weighing the Options: Criteria for Evaluating Weight-Management Programs. Washington, DC: The National Academies Press. doi: 10.17226/4756.
×
Page 203
Suggested Citation:"Appendix B: The Diet Readiness Test and the General Well-Being Schedule." Institute of Medicine. 1995. Weighing the Options: Criteria for Evaluating Weight-Management Programs. Washington, DC: The National Academies Press. doi: 10.17226/4756.
×
Page 204
Suggested Citation:"Appendix B: The Diet Readiness Test and the General Well-Being Schedule." Institute of Medicine. 1995. Weighing the Options: Criteria for Evaluating Weight-Management Programs. Washington, DC: The National Academies Press. doi: 10.17226/4756.
×
Page 205
Suggested Citation:"Appendix B: The Diet Readiness Test and the General Well-Being Schedule." Institute of Medicine. 1995. Weighing the Options: Criteria for Evaluating Weight-Management Programs. Washington, DC: The National Academies Press. doi: 10.17226/4756.
×
Page 206
Suggested Citation:"Appendix B: The Diet Readiness Test and the General Well-Being Schedule." Institute of Medicine. 1995. Weighing the Options: Criteria for Evaluating Weight-Management Programs. Washington, DC: The National Academies Press. doi: 10.17226/4756.
×
Page 207
Suggested Citation:"Appendix B: The Diet Readiness Test and the General Well-Being Schedule." Institute of Medicine. 1995. Weighing the Options: Criteria for Evaluating Weight-Management Programs. Washington, DC: The National Academies Press. doi: 10.17226/4756.
×
Page 208
Suggested Citation:"Appendix B: The Diet Readiness Test and the General Well-Being Schedule." Institute of Medicine. 1995. Weighing the Options: Criteria for Evaluating Weight-Management Programs. Washington, DC: The National Academies Press. doi: 10.17226/4756.
×
Page 209
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Nearly one out of every three adults in America is obese and tens of millions of people in the United States are dieting at any one time. This has resulted in a weight-loss industry worth billions of dollars a year and growing. What are the long-term results of weight-loss programs? How can people sort through the many programs available and select one that is right for them? Weighing the Options strives to answer these questions. Despite widespread public concern about weight, few studies have examined the long-term results of weight-loss programs. One reason that evaluating obesity management is difficult is that no other treatment depends so much on an individual's own initiative and state of mind.

Now, a distinguished group of experts assembled by the Institute of Medicine addresses this compelling issue. Weighing the Options presents criteria for evaluating treatment programs for obesity and explores what these criteria mean—to health care providers, program designers, researchers, and even overweight people seeking help.

In presenting its criteria the authors offer a wealth of information about weight loss: how obesity is on the rise, what types of weight-loss programs are available, how to define obesity, how well we maintain weight loss, and what approaches and practices appear to be most successful.

Information about weight-loss programs—their clients, staff qualifications, services, and success rates—necessary to make wise program choices is discussed in detail.

The book examines how client demographics and characteristics—including health status, knowledge of weight-loss issues, and attitude toward weight and body image—affect which programs clients choose, how successful they are likely to be with their choices, and what this means for outcome measurement. Short- and long-term safety consequences of weight loss are discussed as well as clinical assessment of individual patients.

The authors document the health risks of being overweight, summarizing data indicating that even a small weight loss reduces the risk of disease and depression and increases self-esteem. At the same time, weight loss has been associated with some poor outcomes, and the book discusses the implications for program evaluation.

Prevention can be even more important than treatment. In Weighing the Options, programs for population groups, efforts targeted to specific groups at high risk for obesity, and prevention of further weight gain in obese individuals get special attention.

This book provides detailed guidance on how the weight-loss industry can improve its programs to help people be more successful at long-term weight loss. And it provides consumers with tips on selecting a program that will improve their chances of permanently losing excess weight.

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