Table 4 Summary of factors favoring treatment initiation and favoring non-initiation included in Anticipated Pleasantness of Treatment theme
Both initiators and non-initiators | Initiators only | Non-Initiators only | Representative Quote | |
|---|---|---|---|---|
Social aspects influencing enjoyment | Favoring initiation • Starting treatment with friend/family member Favoring non-initiation • Concern about disappointing others or feeling judged | Favoring initiation • Use strategies to manage anxiety Favoring non-initiation • Frustration with input of some group members • Competition can be intimidating, discouraging | Favoring non-initiation • Concern about relating to group members • Concern about disclosing sensitive information in group | “I didn’t want to talk. The one thing I worried about when you go to these meetings is, will it go bad if you don’t talk and are you required to talk? So I talked the instructor before I signed up and she was like, ‘I will not make you talk.’” (Initiator) |
Anticipated dietary and monitoring recommendations | Favoring non-initiation • Treatment approach requiring eating prescribed foods or meals | Favoring initiation • Willingness to rearrange schedule to fit food preparation demands • Treatment approach to food is compatible with family • Treatment approach to food does not contribute to feeling deprived. • Program makes tracking diet easy | Favoring initiation • Treatment approach to food is quick and easy Favoring non-initiation • Treatment requiring complicated diet tracking | “I think I am lazy. If somebody could deliver me some meals and they are already ready, I am going to eat what you put in front of me. That would help me a lot because, if I am on the move and I am coming home from work, I might stop somewhere that is convenient. Or I might cook something that’s convenient, but it is not really that healthy.” (Non-initiator) |
Identity and self-reliance factors | Favoring non-initiation • Embarrassed to need help | Favoring initiation • Accepting that they cannot do it on own | Favoring non-initiation • Desire to not rely on others for weight loss • Desire to avoid loss of autonomy by a program • Treatment use not compatible with identity | “I mean that’s for big fat people, and I’m not like that.” (non-initiator) |