An investigation of Locus of Control, Health Beliefs and Self-Efficacy in relation to weight control and obesity in two South Wales populations

The Welsh Government has recently developed the All-Wales Weight Management Pathway (Welsh Government, 2021c) which aims to address the increasing prevalence of obesity; this pathway makes changes in practice that promote inclusion of psychological approaches to weight management. This pathway has implications for dietitians working in specialised weight management environments within the NHS and for the training of dietitians. This thesis presents the findings of a systematic review of the efficacy of psychological informed weight management programmes (focusing on the impact of health locus of control (HLOC), self-efficacy (SE), and health beliefs). The empirical chapters explored the influence of psycho- social factors that underpin weight gain in two areas of Wales (Cardiff and the Vale (CVHB) and Aneurin Bevan (ABHB). This research demonstrated that SE, HLOC, health beliefs were predictors of adult weight status underpinned by self-regulation strategies. The findings from this research were synthesized, and used to develop a potential intervention which could support dietitians in Wales to incorporate psychological approaches to their weight management practice. Interviews with key stakeholders were used to establish the feasibility and acceptability of this proposed intervention. Findings indicate that dietitians were open to using psychological theory and tools and viewed these as enablers of patient focused weight management plans. This thesis clearly defines a need for psychological training for dietitians. The findings from this thesis have implications for dietetic training, dietetic practice, resource, and commissioning intentions at policy level.