DEFINITION OF KNOWLEDGE AND SELF-EFFICACY

Knowledge has not been shown to be sufficient as a motivating tool when trying to change a behavior [40]. This is particularly important when attempting to change diet and become physically active [41]. In this case, simply providing the patient with information that will help him or her lose weight, or handing out pamphlets with sample exercises to undertake, has not been shown to successfully alter behavior [41]. There are several factors that contribute to this lack of success.
One such barrier is the “cognitive barrier.” In the cognitive barrier, a lack of knowledge, low selfefficacy,
and a limited acceptance of personal risk can greatly affect a person’s desire to change [41].
Environment is also important in behavior change and can many times lead to program failure.
For example, an overweight child will likely fail if the parents are not supportive and continue to
stock the house with high-fat foods. There are also environments outside of the home that offer
cheap convenience food, such as movie theaters and shopping malls [41]. The suburban and urban
way of life demands the use of a car for transportation to be able to function. Other environmental
barriers to successful implementation include lack of access to care and social support for change,
and social and cultural factors such as fast food, sedentary lifestyles, and food preferences [41].
A lack of motivation can also prevent the obese patient from changing his or her behavior.
Many times this motivational barrier is deep-set in emotional fears. The fear of giving up a
“behavioral crutch” can sometimes limit a person who is trying to change his or her lifestyle.
Relapses are also cause for emotional/motivational barriers to behavioral changes. A person may
feel that “this is hopeless” because instead of losing weight, he or she has gained weight, or perhaps
has put on several pounds after having lost a solid amount. This failure to change may lead to
shame, demoralization, and helplessness [41].