Obesity is a significant United States’ public health concern. However, high relapse rates continue to be a problem for obesity treatment programs while the focus remains on weight loss, not body composition change. This study examined whether a clinic-based obesity treatment program, focused on body composition change through resistance training, lead to improved body composition, exercise behaviors, and attitude change from focus on weight loss to body composition change. Improvements in self efficacy, outcome expectations and stages of change were also examined. Forty-eight physician-referred overweight or obese adult women (mean body fat 41%, SD = 6.65%), completed assessments and questionnaires focused on body composition, weight, change in attitude, self-efficacy, outcome expectations, stage of change, exercise behavior(s) and duration at baseline and three months. This study used an experimental pretest-posttest design with random assignment to: 1) support group (n= 24) with required attendance to one Total Wellness Class and one Total Wellness Support Group class, or 2) support group plus individual appointments (n= 24) with attendance to one Total Wellness class, one Total Wellness Support Group class and two individual appointments. Randomization to groups specifically examined whether there were differences in assessed items for those subjects who received group versus group and individual support. There were no significant differences between the support group only and support group plus individual support treatment groups at baseline or post intervention for any study variables. However, there were significant improvements across groups in attitude toward resistance training (from 22.31, SD = 3.45 to 24.25, SD = 2.72; p <0.001), stages of change (from 2.44, SD = 1.01 to 2.77, SD = 0.99; p<0.05), outcome expectations (from 28.69, SD = 3.48 to 30.42, SD = 3.54; p<0.05) and days of the week exercised (from 2.01, SD = 2.0 to 2.71, SD = 2.13; p<0.05). Although there were no significant improvements in body composition or weight, this study demonstrates that a body composition focused obesity management program can be successful at promoting stages of change progression, improved attitude and self-efficacy, increased resistance training exercise and days spent exercising, for certain people.


School of Public Health

First Advisor

Helen Hopp Marshak

Second Advisor

Ernie Medina

Third Advisor

Christine Neish

Degree Name

Doctor of Public Health (DrPH)

Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Obesity -- therapy; Body Composition; Health Promotion.



Page Count

x; 126

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives