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Abstract

Long-term behavioral self-regulation is the hallmark of successful weight control. We tested mediators of weight loss and weight loss maintenance in middle-aged women who participated in a randomized controlled 12-month weight management intervention. Overweight and obese women (N = 225, BMI = 31.3 4.1kg/m 2) were randomly assigned to a control or a 1-year group intervention designed to promote autonomous self-regulation of body weight. Key exercise, eating behavior, and body image variables were assessed before and after the program, and tested as mediators of weight loss (12 months, 86% retention) and weight loss maintenance (24 months, 81% retention). Multiple mediation was employed and an intention-to-treat analysis conducted. Treatment effects were observed for all putative mediators (Effect size: 0.32-0.79, P <0.01 vs. controls). Weight change was 7.3 5.9% (12-month) and 5.5 5.0% (24-month) in the intervention group and 1.7 5.0% and 2.2 7.5% in controls. Change in most psychosocial variables was associated with 12-month weight change, but only flexible cognitive restraint (P <0.01), disinhibition (P <0.05), exercise self-efficacy (P 0.001), exercise intrinsic motivation (P <0.01), and body dissatisfaction (P 0.05) predicted 24-month weight change. Lower emotional eating, increased flexible cognitive restraint, and fewer exercise barriers mediated 12-month weight loss (R 2 = 0.31, P< 0.001; effect ratio: 0.37), but only flexible restraint and exercise self-efficacy mediated 24-month weight loss (R 2 = 0.17, P< 0.001; effect ratio: 0.89). This is the first study to evaluate self-regulation mediators of weight loss and 2-year weight loss maintenance, in a large sample of overweight women. Results show that lowering emotional eating and adopting a flexible dietary restraint pattern are critical for sustained weight loss. For long-term success, interventions must also be effective in promoting exercise intrinsic motivation and self-efficacy.

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... Eating styles, such as restrained, emotional and external eating, are known to be associated with weight loss and weight loss maintenance in individuals with overweight [9][10][11]. Restrained eating [12], that is, restricting food intake because of weight concerns, facilitates successful weight loss and weight loss maintenance [11]. ...
... Eating styles, such as restrained, emotional and external eating, are known to be associated with weight loss and weight loss maintenance in individuals with overweight [9][10][11]. Restrained eating [12], that is, restricting food intake because of weight concerns, facilitates successful weight loss and weight loss maintenance [11]. In contrast, higher levels of reported emotional eating [12], that is, eating because of emotional states, such as anger or sadness, seem to present a barrier to weight loss [10,13,14] and pose a risk factor for weight regain after treatment [15]. ...
... Our results show that men and women in the intervention group, compared to controls, showed improvements in restrained eating immediately after the intervention (three months after baseline), which were also observed at follow-up at 9-months and, with marginal significance at 15 months. This result is promising because in face-toface intervention studies increased levels of restrained eating are known to be predictors of weight loss and weight loss maintenance [11] and related to long-term success [67]. Research also shows that restrained eating has a preventive effect on weight gain, even when eating habits that are normally associated with weight gain are prevalent, for example, loss of control eating [17]. ...
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Addressing cognitive behavioral factors is associated with a favorable development of eating styles (i.e., increased levels of restrained eating, decreased levels of external and emotional eating) in individuals with overweight and obesity. Research suggests that the use of digital interventions that consider gender aspects regarding prevalence, comorbidities, and weight-related behaviors could enhance existing treatment options. This randomized controlled trial aimed to evaluate the effectiveness of the self-guided gender-sensitive mobile health intervention I-GENDO on restrained, emotional and external eating, body mass index, and physical activity at the end of the intervention, and at a 9- and 15-month follow-up. Two hundred thirteen individuals (67% female, body mass index: 33.35 ± 3.79 kg/m2) were randomly assigned to the intervention or control group. Multilevel models were calculated to investigate differences between groups. I-GENDO offered interactive modules addressing psychological content associated with obesity. Users were able to self-tailor intervention content based on their individual needs and life realities. Restrained eating was higher in the intervention group after the intervention (95% CI: 0.20, 0.36) and at 9-months (95% CI: 0.07, 0.24). At 9-months, emotional eating among women was lower in the intervention group compared to the control group (95% CI: -0.44, -0,19). In the intervention group, external eating was lower after the intervention, which remained significant for women at 9 (95% CI: -0.40, -0.19) and 15-months (95% CI: -0.34, -0.13). Body mass index of men in the intervention group was 1.44 lower at 15-months than in the control group. No significant effects on physical activity were found. The I-GENDO intervention was effective in changing restrained eating of both women and men in the long-term, suggesting that a self-guided, gender-sensitive approach is promising. However, the differential effects on the outcome measures indicate that more research is warranted to examine distinct gender-sensitive mechanisms of digital psychological interventions (i.e., dose–response relationship, blended counselling). ClinicalTrials.gov identifier: NCT04080193, 06–09-2019.
... These findings are consistent with research that primarily assessed selfregulation and/or mood as a predictor of weight loss in a cross-sectional manner or failed to account for the effects of exercise amounts on psychological predictors of exercise (Andrade et al., 2010;Teixeira et al., ...
... However, findings did not align with research that suggests that amounts of exercise far in excess of those within this investigation are required for meaningful amounts of weight loss (Donnelly et al., 2009). Much of that line of research viewed exercise for its direct impact on weight via its energy-expenditure properties, as opposed to its associated psychosocial and selfregulatory improvements that might foster sustained behavioral improvements and longterm weight loss (Annesi et al., 2022;Teixeira et al., 2010). As with the present study, much of the previous related research was with women participants who are more likely to access behavioral weight-loss treatments (Crane et al., 2017) and be more impacted by the psychological effects of eating and weight (Péneau et al., 2013). ...
... Those were likely accountable via the different treatment foci. Assessment of treatment-associated changes in related factors that were previously proposed as relevant (e.g., self-efficacy through effects of self-regulation on perceived ability; emotional eating through effects on negative mood; Annesi & Walsh, 2021; Teixeira et al., 2010) might be productive in extensions of this research. This is particularly true given the associations with both self-regulation and mood that occurred in favor of the selfregulation-focused group (Paths a, Figure 1), and beyond exercise itself. ...
... 16 It has been posited that the benefit of exercise in weight reduction is largely through psychosocial change, rather than energy expenditure, pathways. 16,19,20 More specifically, the self-regulation needed to overcome lifestylerelated obstacles to maintaining exercise, even in dosages below those recommended, can carry over to eating-related improvements in self-regulation and more healthy eating behaviors. 21 This is consistent with the construct of "coaction," which can be defined as the advancement of a second health behavior emanating from success at improving an initial health behavior (eg, improved eating proceeding from a newly established regimen of exercise). ...
... 4 even though the phenomenon of coaction from exercise to other health behaviors has been observed absent specific treatment attempts to generalize self-regulation from one context to another, 23 research suggests effects will be greater in the presence of such an intentional focus. 16 Selfregulation theory (which posits benefits of the use of limited existing self-regulatory resources and the development and strengthening of new selfregulation skills), 24 social cognitive theory (which suggests reciprocal relations between psychosocial, environmental, and behavioral factors during change processes), 25,26 and health behavior research 16,19 advocate for the development of selfregulatory skills to counter persistent challenges to behavioral changes. Thus, interventions have been suggested that first facilitate self-regulated exercise then, several weeks/months later, seek to carry over the same (but adapted) self-regulatory skills to better-controlled eating. ...
... 1,2 Future research is required to determine the extent this "carry over" occurs spontaneously vs when it is purposefully nurtured (as within the present treatment). as expected, and consistent with other research, 16,19 increase in eating self-regulation was significantly linked to weight loss, also with no interaction effect from exercise amount grouping. ...
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Introduction: The aim of this study was to evaluate 1) if completed exercise amounts were associated with short- and long-term weight loss within a cognitive behavioral intervention and 2) if changes in theory-based psychosocial factors significantly explained weight change. Methods: A total of 110 women with obesity participated in a yearlong treatment focused on self-regulation and were grouped based on their amount of completed exercise and assessed on changes in weight, self-regulation, and self-efficacy. Results: There were significant overall improvements in all study measures from baseline-month 6 and baseline-month 12. Overall weight loss means (-5.8 and -5.3 kg, respectively) did not significantly differ across groups averaging the equivalent of < 2.5; 2.6-4.5; 4.6-7.0; and > 7.0 moderate-intensity exercise sessions per week. Similarly, psychosocial improvements did not significantly differ by exercise amount grouping. Increase in exercise self-regulation significantly predicted eating self-regulation gains over both 6 and 12 months. Over the same time periods, the significant prediction of weight loss by eating self-regulation increase was mediated by change in eating self-efficacy. Conclusion: Results suggest attainment of government-recommended amounts of exercise are not associated with significantly greater weight loss than lower amounts of exercise within an intervention focused on self-regulation. Associations of exercise with psychosocial correlates of weight loss should be a treatment consideration.
... The CBT intervention addresses psychological processes that interfere with weight loss and can be focused on beliefs about eating, body image acceptance, self-image, and problem-solving. The most commonly used theories in CBT for weight loss are social cognitive theory (SCT) and self-determination theory (SDT) (Teixeira et al., 2010). The concept in SDT (Deci & Ryan, 1985) is that successful maintenance of weight loss would occur when people choose eating and exercise behaviors because they consider weight loss maintenance and its health benefits as a personal value. ...
... From all the proposed cognitive mechanisms of change, results indicated a significant association only between motivation changes and self-efficacy changes and weight outcomes at the end of the intervention. These results are in line with other findings (Clifford, Tan, & Gorsuch, 1991;Jeffery et al., 1984;Linde, Rothman, Baldwin, & Jeffery, 2006;Palmeira et al., 2007;Teixeira et al., 2002Teixeira et al., , 2004Teixeira et al., , 2010Williams, Grow, Freedman, Ryan, & Deci, 1996). We did not find other significant associations between other cognitive (body image and self-regulation) factors and weight outcomes. ...
... Many studies (Elfhag & Rossner, 2005;Teixeira et al., 2010Teixeira et al., , 2015 show psychological factors, such as autonomous motivation, self-efficacy, self-regulation skills, flexible eating restraint, and positive body image are mediators of weight loss. Although there are reviews that summarize findings of psychological weight-loss interventions, only a few studies reported cognitive components (e.g., motivation, self-efficacy, self-regulation, body image acceptance) as a primary or secondary outcome, besides quantitative assessments of weight change. ...
... For example, eating in response to positive emotions has shown to be negatively correlated with eating in response to negative emotions (e.g., Nolan et al. 2010;van Strien et al. 2016). There is also currently no conclusive evidence that eating in response to positive emotions is associated with being overweight or obese (e.g., van Strien et al. 2016;van Strien et al. 2013), whereas eating in response to negative emotions is negatively associated with weight outcomes (e.g., Delahanty et al. 2013;Koenders and van Strien 2011;Teixeira et al. 2010). Additionally, it has been observed that eating in response to positive emotions is associated with partaking in social situations (Patel and Schlundt 2001). ...
... Decreased emotional eating was associated with increased weight loss success (7% decrease in initial body weight or higher) at both 6 months (B = 0.30) and 12 months (B = 0.53) post-intervention. Teixeira et al. (2010) administered the DEBQ in the context of a weight loss intervention. Weight loss was assessed upon completion of the intervention at 12 months and weight maintenance was measured at the 24-month follow-up. ...
... Participants who reported less frequent baseline emotional eating (measured by the Blair et al. questionnaire in Table 1) were more likely to achieve 7% weight loss at six months than those who reported more frequent emotional eating (odds ratio = 0.88). However, similar to the findings of Teixeira et al. (2010), baseline emotional eating was not predictive of weight loss upon completion of the intervention. The DPP encourages a low-fat diet and addresses barriers to achieving this diet, which may have helped mitigate the effect of emotional eating on consuming high fat, high calorie foods. ...
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Emotional eating is the tendency to overeat in response to negative emotions and has shown to be associated with weight outcomes, both in respect to weight gain over time and difficulties with weight loss and weight loss maintenance. It is thus important to develop treatments to improve weight loss outcomes in emotional eaters. The purpose of this review is to explore adults’ relationship between emotional eating and weight by: (1) describing self-report measures used to assess emotional eating such as the Dutch Eating Behavior Questionnaire (DEBQ), the Three Factor Eating Questionnaire (TFEQ), and the Emotional Eating Scale (EES), (2) exploring the relationship between emotional eating and weight outcomes, namely examining weight gain in longitudinal studies and difficulties with weight loss and weight loss maintenance in intervention studies, and (3) reviewing current interventions that target emotional eating, using techniques such as mindfulness, Acceptance and Commitment Therapy (ACT), Cognitive Behavior Therapy (CBT), and Dialectical Behavior Therapy (DBT). A better understanding of adults’ emotional eating and its impact on weight is important to develop interventions that effectively target weight loss struggles unique to emotional eaters and improve weight outcomes for this population.KeywordsEmotional eatingWeightWeight lossReview
... Many studies (Edell et al., 1987;Jeffery et al., 1984;Linde et al., 2006;Palmeira et al., 2007;Teixeira et al., 2010) found self-efficacy (SE) to be positively associated with weight loss, weight maintenance, and corresponding weight-loss behaviors (Linde et al., 2006). ...
... Behavioral factors, such as cognitive restraint, uncontrolled, and emotional eating, have been documented to predict weight change or weight maintenance (Teixeira et al., 2010(Teixeira et al., , 2015. Also, Varkevisser et al., (2019) found a moderate level of evidence that uncontrolled eating and emotional eating during weight loss and weight loss maintenance were negatively predictive of weight loss maintenance. ...
... Our results align with previous research, which found that self-efficacy and eating behaviors are important psychological factors in weight loss and weight maintenance (Elfhag & Rossner, 2005;Teixeira et al., 2010Teixeira et al., , 2015Varkevisser et al., 2019;Byrne, 2002) also found that the Regainers have more dysfunctional thoughts in terms of dichotomous thinking than the Maintainers. We found that different types of irrationality: food-related and need for approval, are also factors that can be characteristic to a category or another and, therefore, can be essential to address in weight management. ...
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To improve the long-term results of psychological treatments, it is important to know why some people constantly have a healthy weight and others face difficulties in losing weight or maintaining it. This study aimed to identify psychological factors associated with maintaining or regaining weight loss and determine the psychological characteristics of individuals with different BMI levels. 282 adult participants responded to questionnaires measuring eating behaviors, general and specific irrational beliefs, and self-efficacy. We used MANOVA analysis to identify the differences between the categories of participants. Our results showed that there are differences between the regainers and maintainers VS those with healthy stable weight in terms of self-efficacy (F (2, 84) = 7.17, p = .001), irrationality (F (2, 84) = 8.15, p < .001), and eating behaviors (F (2, 84) = 7.95, p < .001). Furthermore, people with healthy weight had more self-efficacy about their eating behaviors (F (2,273) = 6.49, p = .002), and more cognitive restraint (F (2, 273) = 3.58, p = .029), lower levels of specific irrational beliefs (F (2, 273) = 10.17, p < .000) and emotional eating (F (2, 273) = 20.24, p < .000) than participants with obesity or overweight. Some psychological factors are relevant for weight loss and explain why some people with overweight or obesity find it difficult to lose weight and maintain it.
... The included studies were published from 2010 to 2021, representing a total of 1203 participants with mean ages ranging from 21.8 to 57.3 years old (Afari et al., 2019;Cesa et al., 2013;Czepczor-Bernat et al., 2020;Forman et al., 2013;Gade et al., 2013;Goldbacher et al., 2016;Hjelmesaeth et al., 2019;Jarvela-Reijonen et al., 2018;Kim et al., 2020;Kristeller et al., 2014;Kullgren et al., 2013;Manzoni et al., 2016;Mason et al., 2019;Meekums et al., 2012;Nourizadeh et al., 2020;Nurkkala et al., 2015;Paul et al., 2021;Simos et al., 2019;Stapleton et al., 2016Stapleton et al., , 2020Teixeira et al., 2010;Weineland et al., 2012;Yancy et al., 2019;Supp. 3). ...
... Not-specified ( Kullgren et al., 2013;Manzoni et al., 2016;Meekums et al., 2012;Nourizadeh et al., 2020;Nurkkala et al., 2015;Simos et al., 2019;Stapleton et al., 2020), 39% of studies scored an overall rating of moderate RoB (Afari et al., 2019;Cesa et al., 2013;Gade et al., 2013;Hjelmesaeth et al., 2019;Kim et al., 2020;Mason et al., 2019;Paul et al., 2021;Stapleton et al., 2016;Yancy et al., 2019) and 26% of studies scored an overall rating of low RoB (Czepczor-Bernat et al., 2020;Forman et al., 2013;Goldbacher et al., 2016;Kristeller et al., 2014;Teixeira et al., 2010;Weineland et al., 2012). Interrater agreement was high (kappa = 0.92). ...
... T A B L E 4 Subgroup analyses on emotional eating, uncontrolled eating, cognitive restraint, weight and BMI Czepczor-Bernat et al., 2020;Hjelmesaeth et al., 2019;Jarvela-Reijonen et al., 2018;Nurkkala et al., 2015;Paul et al., 2021;Teixeira et al., 2010) 8 0.11 ...
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Objectives: To evaluate the effectiveness of weight-loss interventions on emotional eating among adults with high body mass index (BMI). Methods: A systematic review, meta-analysis and meta-regression were performed on randomized controlled trials published from inception until 19 March 2021. Results: Thirty-one studies were included, representing 1203 participants with mean ages ranging from 21.8 to 57.3 years old and BMI 27.2-43.5 kg/m2 . We found small-to-medium interventional effects on emotional eating (n = 18; Hedges' g = 0.22; p = 0.01, I2 = 61.7%), uncontrolled eating (n = 16; Hedges' g = 0.46; p < 0.001, I2 = 71.6%) and cognitive restraint (n = 18; Hedges' g = 0.42; p < 0.001, I2 = 75.8%). Small-to-medium interventional effects were only found for emotional eating (n = 8; Hedges' g = 0.45; p = 0.02, I2 = 74.3%) 3-month post-intervention, and on BMI (n = 4; Hedges' g = 0.43; p < 0.05, I2 = 33.4%) and weight (n = 6; Hedges' g = 0.36; p < 0.01, I2 < 10.4%) 12-month post-intervention. Age, male proportion, baseline BMI, attrition rate and intervention length were not significant moderators of the heterogeneity between studies. Conclusion: Interventions improved emotional eating and weight loss along a year-long trajectory.
... Increased dietary restraint measured by DEBQ (Dutch Eating Behavior Questionnaire) [24] predicted better long-term weight loss among people with IGT and elevated fasting plasma glucose after a mean follow-up of 2.8 years according to a non-controlled sub-study of the US Diabetes Prevention Program (DPP) [25,26]. Only one previous intervention study has investigated eating behavior dimensions as mediators of weight loss and weight loss maintenance, although not specifically in those with IGT [27]. It used mediation models to identify mediators of 12-month weight loss and 24-month weight loss maintenance in women with overweight/obesity who underwent a 1-year behavioral treatment program. ...
... Also in the previous 3-year weight gain prevention study an increase in all three measures of dietary restraint was associated with decrease in weight at year three [18]. Instead, another intervention study investigating eating behavior dimensions as mediators of weight loss maintenance found that increase in flexible, but not rigid restraint, mediated a greater 24-month weight loss [27]. However, the participants of that study were all female and younger and study period substantially shorter than in the present study which might at least partly explain the different outcomes. ...
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Background Behavioral processes through which lifestyle interventions influence risk factors for type 2 diabetes (T2DM), e.g., body weight, are not well-understood. We examined whether changes in psychological dimensions of eating behavior during the first year of lifestyle intervention would mediate the effects of intervention on body weight during a 9-year period. Methods Middle-aged participants (38 men, 60 women) with overweight and impaired glucose tolerance (IGT) were randomized to an intensive, individualized lifestyle intervention group (n = 51) or a control group (n = 47). At baseline and annually thereafter until nine years body weight was measured and the Three Factor Eating Questionnaire assessing cognitive restraint of eating with flexible and rigid components, disinhibition and susceptibility to hunger was completed. This was a sub-study of the Finnish Diabetes Prevention Study, conducted in Kuopio research center. Results During the first year of the intervention total cognitive (4.6 vs. 1.7 scores; p < 0.001), flexible (1.7 vs. 0.9; p = 0.018) and rigid (1.6 vs. 0.5; p = 0.001) restraint of eating increased, and body weight decreased (−5.2 vs. −1.2 kg; p < 0.001) more in the intervention group compared with the control group. The difference between the groups remained significant up to nine years regarding total (2.6 vs. 0.1 scores; p = 0.002) and rigid restraint (1.0 vs. 0.4; p = 0.004), and weight loss (−3.0 vs. 0.1 kg; p = 0.046). The first-year increases in total, flexible and rigid restraint statistically mediated the impact of intervention on weight loss during the 9-year study period. Conclusions Lifestyle intervention with intensive and individually tailored, professional counselling had long-lasting effects on cognitive restraint of eating and body weight in middle-aged participants with overweight and IGT. The mediation analyses suggest that early phase increase in cognitive restraint could have a role in long-term weight loss maintenance. This is important because long-term weight loss maintenance has various health benefits, including reduced risk of T2DM.
... To improve the use of successful weight management behaviors and promote habit formation, some studies showed that (1) adherence to a meal plan, (2) a good social support system, (3) limiting certain types of food or/and having healthy foods at home, (4) problem-solving abilities could be relevant, (5) exercise Motivation and self-efficacy, (6) reduced perceived barriers, and (7) weight management tools, such as calorie counting apps (Teixeira et al., 2009;Andrés et al., 2011;Kapoor et al., 2017;Cheng et al., 2018;Paixão et al., 2020). However, the available instruments, which evaluate weight management, focus only on a small set of possible approaches and spotlight strategies centered on behavior change interventions (Keller and Siegrist, 2015;Hartmann-Boyce et al., 2016). ...
... Also, it might be postulated that an acceptance-based strategy facilitates flexibility development, and subsequently, more effective selfregulation of eating behavior. The acceptance is associated with lower impulsivity and may be related to more psychological flexibility (e.g., tolerating the physical sensations and impulses while not acting on them), being a stronger predictor of weight loss (Teixeira et al., 2009;Hartmann-Boyce et al., 2016). ...
Article
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Background The Oxford Food and Activity Behaviors (OxFAB) taxonomy systematize the cognitive-behavioral strategies adopted by individuals who are attempting to manage their weight. The present study aimed to (1) develop a questionnaire based on the OxFAB taxonomy, specifically adapted for middle-aged women—the OxFAB-MAW—stage of life and sex, which present a high incidence of obesity, (2) assess the psychometric properties of this tool, and (3) evaluate the discriminative power of the OxFAB-MAW (normal weight vs. obesity). Methods Overall, 1,367 Portuguese middle-aged women between 45 and 65 years (M = 52.3, SD = 5.15) filled in a sociodemographic, health, and menopause-related questionnaire, as well as the OxFAB-MAW. Results Confirmatory factor analysis demonstrated an acceptable model fit (comparative fit index = 0.928, Tucker–Lewis index = 0.913, root mean square error of approximation = 0.072, and standardized root mean square residual = 0.054). Five domains with one item were grouped into other domains, and the Weight Management Aids domain was also removed. The OxFAB-MAW showed factorial, convergent, discriminant, and external validity, as well as composite reliability. Conclusion The OxFAB-MAW questionnaire is a valid, reliable, and theory-driven tool for assessing weight management strategies in middle-aged women, being able to discriminate between clinical and non-clinical groups (normal weight vs. obesity) in several domains. This instrument can be used to gather valid and reliable data, useful in both research and clinical settings (especially focused on structuring interventions and preventive obesity programs within this specific life cycle stage).
... The reduction in cognitive restraint in the ME group differs from that of other studies that evaluated mindfulness-based interventions, in which an increase was observed (10,13,14,19) . Studies that evaluated the association between cognitive restraint and weight yielded conflicting results (27,(56)(57)(58) . Since patients with obesity have reduced activity in the prefrontal cortex, which is responsible for decision-making and cognitive control (25) , a greater cognitive restraint would be protective, facilitating weight loss. ...
... Since patients with obesity have reduced activity in the prefrontal cortex, which is responsible for decision-making and cognitive control (25) , a greater cognitive restraint would be protective, facilitating weight loss. Furthermore, previous studies have already observed that a flexible restraint, which is implicated in greater knowledge related to the effects of food on energy balance, predicts greater weight loss than a rigid restraint, which is a type of restraint that comes with a dichotomous approach, emphasising food restriction and generating an emotional response and, as a consequence, compensatory behaviours such as a more rigid cognitive restraint, binging or compulsive exercising (56,57) . As well as for metabolic parameters, the positive outcomes related to eating behaviours in the control group could be explained by the structured nutritional guidance, which also informs about food choices, thereby allowing healthier habits. ...
Article
Mindful eating has been linked to improvement in binge eating disorder, but this approach in obesity management has shown conflicting results. Our aim was to assess the effect of mindful eating associated with moderate calorie restriction on weight loss in women with obesity. Metabolic parameters, dietary assessment, eating behavior, depression, anxiety, and stress were also evaluated. A total of 138 women with obesity were randomly assigned to three intervention groups: mindful eating associated with moderate calorie restriction (ME + MCR), moderate calorie restriction (MCR), and mindful eating (ME), and they were followed up monthly for 6 months. ME + MCR joined seven monthly mindfulness-based intervention group sessions each lasting 90 minutes and received an individualized food plan with moderate calorie restriction (deficit of 500 kcal/d). MCR received an individualized food plan with moderate calorie restriction (deficit of 500 kcal/d), and ME joined seven monthly mindfulness-based intervention group sessions each lasting 90 minutes. Seventy patients completed the intervention. Weight loss was significant, but no statistically significant difference was found between the groups. There was a greater reduction in uncontrolled eating in the ME group than in the MCR group and a greater reduction in emotional eating in the ME group than in both the MCR and the ME+MCR groups. No statistically significant differences were found in the other variables evaluated between groups. The association between mindful eating with calorie restriction did not promote greater weight loss than mindful eating or moderate calorie restriction.
... The association between perceived stress and flexible restraint is interesting, because earlier research has suggested that flexible restraint may be preferable to rigid restraint in supporting longterm weight maintenance [19,20]. In the present study, successful 3-year weight reduction was associated with both dimensions of cognitive restraint. ...
... In the present study, successful 3-year weight reduction was associated with both dimensions of cognitive restraint. However, the association was stronger with flexible restraint, which gives support to earlier findings [19,20]. The benefit of cognitive restraint regarding weight management has been questioned [40,41]. ...
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Background: To better support participants to achieve long-lasting results within interventions aiming for weight loss and maintenance, more information is needed about the maintenance of behavioral changes. Therefore, we examined whether perceived stress predicts the maintenance of changes in eating behavior (flexible and rigid restraint of eating, disinhibition, and hunger). Methods: The present study was a secondary analysis of the PREVIEW intervention including participants with overweight (BMI ≥ 25 kg/m2) at baseline and high risk of type 2 diabetes (n = 1311). Intervention included a 2-month low-energy diet phase and a 34-month subsequent weight maintenance phase. The first 6 months were considered an active behavior change stage and the remaining 2.5 years were considered a behavior maintenance stage. Eating behavior was measured using the Three Factor Eating Questionnaire and stress using the Perceived Stress Scale. The associations between stress and eating behavior were analyzed using linear mixed effects models for repeated measurements. Results: Perceived stress measured after the active behavior change stage (at 6 months) did not predict changes in eating behavior during the behavior maintenance stage. However, frequent high stress during this period was associated with greater lapse of improved flexible restraint (p = 0.026). The mean (SD) change in flexible restraint from 6 to 36 months was -1.1 (2.1) in participants with frequent stress and -0.7 (1.8) in participants without frequent stress (Cohen's ds (95% CI) = 0.24 (0.04-0.43)). Higher perceived stress at 6 months was associated with less flexible restraint and more disinhibition and hunger throughout the behavior maintenance stage (all p < 0.001). Conclusions: Perceived stress was associated with features of eating behavior that may impair successful weight loss maintenance. Future interventions should investigate, whether incorporating stress reduction techniques results in more effective treatment, particularly for participants experiencing a high stress level.
... 14,15 Some researchers have suggested that, in the context of treating obesity, the benefits of exercise for weight loss stem more from its ability to foster psychological changes that affect improved eating than direct caloric expenditures, which are nominal in adults of high weight. [16][17][18] This assertion is supported by research indicating that adherence, rather than exercise frequency and intensity, best predicts sustained weight loss in adults with obesity. [19][20][21] Whereas attempts to advance obesity treatments beyond simply educating individuals on specific eating practices and mandating severely reduced caloric intakes are scarce, state-of-the-science behavioral approaches seeking to deal with challenges to the required behavior changes have also had limited long-term success. ...
... Such differences between weight-loss and weight-lossmaintenance "phases" were also being advanced elsewhere in the research literature. 3,17,31 Through the lens of social cognitive theory, 26,27 the investigation of psychosocial predictors of exercise, eating, and weight loss and their interrelations could lend itself to explanatory models capable of effectively shaping treatments. Further investigation of correlates and embedded paths toward behavioral improvements could refine those models and corresponding interventions. ...
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Introduction Behavioral interventions targeting sustained weight loss have largely failed for decades, with little chance of improvement using prevailing methods. Objective To address treatment limitations, a focused 25-year research program was reviewed through the lens of social cognitive theory, probative investigations, and original predictive models. Innovative, but evidence-based, treatment suggestions were sought. Results Task 1 of the research program addressed adherence to exercise, a well-established requirement for maintained weight loss. A culminating model addressing this treatment aspect suggested that interrelations among changes in self-regulatory skills usage, self-efficacy, and mood should guide exercise-support programming. Task 2 attached an eating-behavior change component and probed for malleable psychosocial variables predictive of success over the weight-loss phase (initial 6 months after treatment initiation). After thorough evaluation of selected theory- and research-driven psychosocial variables, changes in self-regulation, self-efficacy, and mood were again deemed to be the most salient predictors driving eating change. In Task 3, treatment foci related to changes in the 3 psychosocial variables were supported into the weight-loss maintenance phase (beyond 6 months), and the carry-over of changes in self-regulation and self-efficacy from exercise- to eating-related contexts was identified and leveraged. Task 4 suggested value in additionally addressing emotional eating as a distinct factor. Conclusion Suggestions informing principles and extensions of a treatment approach previously demonstrating atypically high degrees of success with maintaining weight loss in field- and community-based settings are provided. Those methods emanate from the reviewed research program, which shaped novel procedures to leverage exercise-induced psychosocial changes for their carry-over benefits for controlling eating.
... Regarding app objectives, all the applications except one were centered on weight loss. In some cases, this was linked to fitness (increase in muscular mass or getting into shape) which is crucial as weight loss is not only about shedding kilos but long-term maintenance [28]. In fact, only one placed particular emphasis on healthy habits. ...
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Mobile applications for weight loss have arisen the interest of private companies and developers, who have put great efforts on the development of this kind of apps. This topic has attracted the interest of the scientific community, both in terms of usability and design. Two main issues have, however, arisen: firstly, research focus has been on the apps themselves, but little attention has been paid to how they are presented in the application stores, and secondly, current literature focuses solely on applications in English. The study objective is to observe how the most popular weight loss applications for the Spanish market are presented in the stores. Using thematic analysis, this study is aimed at discovering the themes featured in the store descriptions and to observe what functionalities are highlighted in these descriptions. The initial sample was based on 247 weight loss applications, which after revision was reduced to 7 applications. Our results show that they focused on efficacy, speed, and, to a much lesser degree, safety in weight loss. Among the main results, we found that app descriptors analyzed did not employ a scientific language and demonstrate technical expertise, or user testimonials. On the other hand, the claims made by the apps about weight loss were mainly based on effectiveness. This sometimes included the concept of quick results and, to a lesser extent, health and safety. Lastly, we observed that there is room for improvement in the linguistic and cultural adaptation of the texts of these application descriptions. Regarding the study limitations, the reduced number of the sample is because our study focuses on applications with features that follow international weight loss guidelines, which most of them did not follow.
... Some evidence suggests that weight loss success is related to changes in eating behavior traits, with increased flexible restraint and decreased rigid restraint being related to greater weight loss, and decreased disinhibition predicting weight loss at 12 months [33]. An increase in flexible cognitive restraint during the weight loss intervention has been found to be related to greater weight loss and better maintenance, which is in accordance with earlier findings [31,34]. By contrast, rigid control of eating behavior was not associated with success during weight loss and its maintenance. ...
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Purpose of Review There is a large variability between individuals in the weight loss response to any given diet treatment, which fuels interest into personalized or precision nutrition. Although most efforts are directed toward identifying biological or metabolic factors, several behavioral and psychological factors can also be responsible for some of this interindividual variability. Recent Findings There are many factors that can influence the response to dietary weight loss interventions, including factors related to eating behavior (emotional eating, disinhibition, restraint, perceived stress), behaviors and societal norms related to age and sex, psychological and personal factors (motivation, self-efficacy, locus of control, self-concept), and major life events. Summary The success of a weight loss intervention can be influenced by many psychological and behavioral constructs and not merely by physiological factors such as biology and genetics. These factors are difficult to capture accurately and are often overlooked. Future weight loss studies should consider assessing such factors to better understand the underlying reasons for the large interindividual variability to weight loss therapy.
... Thus, Hayes PROCESS macro was utilized to compute total, direct, and indirect effects, including both total and specific effects for each mediator, and perform significance tests using BC bootstrap procedures. There is a growing body of research that prefers bootstrap procedures over the Sobel test and other traditional procedures because they do not require the normality assumption of the distribution of the indirect effects, leading to more robust protection against type II error (Teixeira et al., 2010). Therefore, the study presents results for bootstrap tests using a resample procedure of 5,000 bias-corrected bootstrap samples with 95% confidence intervals. ...
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Introduction With the inevitable technological boom enforced by the COVID-19 lockdowns and online emergency remote teaching practices, the prevalence of nomophobia (NMP) and smartphone addiction (SA) among adolescents has become a pressing issue, which has come under scrutiny. However, the impact of social media tools usage (SMTU) and digital gaming behavior (DGB) on these phenomena remains unclear since there is little research focusing on the complex interplay among these variables. Regarding this context, the present study aimed to explore the parallel mediating role of secondary school students’ SMTU and DGB in the relation between NMP and SA. Methods In line with this aim, we employed a cross-sectional design with a critical case sampling strategy and collected data through an online survey from a total of 427 secondary school students in Istanbul in the 2021-2022 academic year. In order to test the parallel mediation model, we employed multiple linear regression models by utilizing PROCESS models with 5000 BC bootstrap samples and 95% CI. Results and discussion Results illustrated that there was an increase in the prevalence of NMP and SA during the COVID-19 home confinement as consistent with the previous research. The results also indicated that among the multiple mediators, the mediating role of SMTU was significant in the relation between NMP and SA. This means NMP has direct and indirect significant impact on SA through SMTU. However, the mediating role of DGB was found nonsignificant in this relationship. Our results are robust and hold key contributions to both theoria and praxis in educational psychology research realm by disentangling the complex underlying mechanism between NMP, SMTU, DGB, and SA. On the practical side, our results provide insightful implications for school boards and researchers in the development of effective interventions.
... Compensatory restraint is not related to body weight, possibly because this kind of flexible dietary restraint eating is less strict and might offset the consequences of external eating. Additionally, compensatory restraint eaters are allowed to adjust their energy intake, which could avoid the negative effects of rigid dietary restraint, such as disinhibition and overeating [36,37,40,49]. ...
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This study aimed to assess the relationships between routine and compensatory restraints and body mass index (BMI), as well as to explore the mediating role of emotional and external eating in the relationships between routine and compensatory restraints and BMI. Chinese adults aged ≥18 years with different weight statuses were invited to fill out an online questionnaire. Routine and compensatory restraints and emotional and external eating were assessed using the validated 13-item Chinese version of the Weight-Related Eating Questionnaire. Mediation analyses tested the mediation effects of emotional and external eating on the relationship between routine and compensatory restraints and BMI. In total, 949 participants (26.4% male) responded to the survey (mean age = 33 years, standard deviation (SD) = 14, mean BMI = 22.0 kg/m2, SD = 3.8). The mean routine restraint score was higher in the overweight/obese group (mean ± SD = 2.13 ± 0.76, p < 0.001) than in the normal weight (2.08 ± 0.89) and underweight (1.72 ± 0.94) groups. However, the normal weight group scored higher in compensatory restraint (2.88 ± 1.03, p = 0.021) than the overweight/obese (2.75 ± 0.93) and underweight (2.62 ± 1.04) groups. Routine restraint was related to higher BMI both directly (β = 0.07, p = 0.02) and indirectly through emotional eating (β = 0.04, 95% confidence interval (CI) = 0.03, 0.07). Compensatory restraint was only indirectly related to higher BMI through emotional eating (β = 0.04, 95% CI = 0.03, 0.07).
... Cognitive flexibility allows individuals to move from black-and-white thinking surrounding weight loss and behavioral change towards more sustainable and accepting thought patterns, even in the midst of negative thoughts or feelings [38]. Our speculation is based on qualitative user feedback and on research showing that cognitive flexibility is associated with higher maintenance [39,40]. ...
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Background Behavioral weight loss programs often lead to significant short‐term weight loss, but long‐term weight maintenance remains a challenge. Most weight maintenance data come from clinical trials, in‐person programs, or general population surveys, but there is a need for better understanding of long‐term weight maintenance in real‐world digital programs. Methods This observational survey study examined weight maintenance reported by individuals who had used Noom Weight, a digital commercial behavior change program, and identified factors associated with greater weight maintenance. The cross‐sectional survey was completed by 840 individuals who had lost at least 10% of their body weight using Noom Weight 6–24 months prior. Results The study found that 75% of individuals maintained at least 5% weight loss after 1 year, and 49% maintained 10% weight loss. On average, 65% of initial weight loss was maintained after 1 year and 57% after 2 years. Habitual behaviors, such as healthy snacking and exercise, were associated with greater weight maintenance, while demographic factors were not. Conclusion This study provides real‐world data on the long‐term weight maintenance achieved using a fully digital behavioral program. The results suggest that Noom Weight is associated with successful weight maintenance in a substantial proportion of users. Future research will use a randomized controlled trial to track weight maintenance after random assignment and at a 2 year follow‐up.
... Behavioral interventions are the most commonly used psychological treatments for weight loss and maintaining lost weight (Teixeira et al., 2010). The efficacy of behavioral treatments is about 10% of weight loss, but this loss is almost always regained (Cooper & Fairburn, 2001). ...
... Boredom, loneliness, anxiety, and stress are reported triggers to EE in females [19]. Reductions in EE are associated with greater weight loss in individuals living with obesity, especially in females [20]. At least 40% of individuals living with obesity are reported to experience EE [21]. ...
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Background: Emotional eating (EE) may be defined as a tendency to eat in response to negative emotions and energy-dense and palatable foods, and is common amongst adults with overweight or obesity. There is limited evidence regarding the effectiveness of interventions that address EE. Objectives: To synthesize evidence on the effectiveness of EE interventions for weight loss and EE in adults living with overweight or obesity. Methods: This is a systematic review and meta-analysis. Adhering to the PRISMA guidance, a comprehensive electronic search was completed up to February 2022. Random effects meta-analysis was carried out to determine the percentage change in weight and EE scores. Results: Thirty-four studies were included. The combined effect size for percentage weight change was -1.08% (95% CI: -1.66 to -0.49, I2 = 64.65%, n = 37), once adjusted for publication bias. Similarly, the combined effect size for percentage change in EE was -2.37%, (95% CI: -3.76 to -0.99, I2 = 87.77%, n = 46). Cognitive Behavioural Therapy showed the most promise for reducing weight and improving EE. Conclusions: Interventions to address EE showed promise in reducing EE and promoted a small amount of weight loss in adults living with overweight or obesity.
... Information may be delivered face to face, individually or within groups, and should be reinforced by resources (e.g., written, web-based, or audiovisual materials). Initial approaches include discussing techniques to support behavioral change, which can be supported in primary health care [ [151]. The following techniques (Table 9) can be used: ...
... For instance, some food and beverage companies have increased the risk of adolescents' exposure toand overconsumption ofunhealthy foods and beverages through appealing social media advertisements, which has to a certain extant resulted in over 20% of adolescents in the US living with obesity (Kucharczuk et al., 2022). In essence, food overconsumption and emotional eating due to advertising are some of the drivers of weight gain (Kemp et al., 2013;Koenders and van Strien, 2011;Teixeira et al., 2010;Bogomolova et al., 2021). Research shows two main ways of preventing and managing obesity: physical exercise and scientific dietary plans (Annesi, 2019). ...
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Purpose This study aims to empirically investigate how the interaction effect of occasion-setting cues and consumers’ cognitive styles (e.g. field dependence levels) influences their food intake intention. Design/methodology/approach In this research, several scenario simulation studies were conducted to verify the hypotheses. A total of 646 participants were recruited for the experiments, and samples were obtained through well-established online research platforms. Findings In the occasion-setting cue advertisement condition, field-dependent (vs field-independent) consumers displayed increased cravings for food and purchase intention, with mental simulation playing a mediating role and cognitive load playing a moderating role. Research limitations/implications The influence of others (e.g. servers and other consumers) was not taken into consideration in this study. Future research can extend this study by conducting field experiments. Practical implications The research conclusions can help various organisations reduce consumers’ food overconsumption intention and encourage healthier food choices by adjusting occasion-setting cues in marketing stimuli and identifying the target consumers’ cognitive styles. Originality/value Based on embodied cognition theory, this study reveals the influence and internal mechanism of the interaction effect between occasion-setting cues and individual cognitive style on eating desire.
... Princípios baseados na consciência, conexão mente-corpo, redução da alimentação emocional e na autorregulação da alimentação são mais eficazes na regulação e manutenção de peso (9,(20)(21)(22). Diversos autores referem outros determinantes relevantes na mudança de comportamento, como a autoeficácia relacionada com aspectos alimentares, definida pela crença na capacidade de autorregular comportamentos relacionados com a alimentação (23)(24)(25)(26)(27). ...
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INTRODUÇÃO: A dificuldade na manutenção do peso perdido e consequente variação cíclica ponderal está relacionada com o comportamento alimentar. Ao contrário da restrição alimentar, a alimentação intuitiva e consciente e a autoeficácia alimentar parecem favorecer atitudes alimentares adaptativas e favoráveis à manutenção do peso. OBJETIVOS: Relacionar dimensões do comportamento alimentar (controlo rígido e flexível, alimentação intuitiva, alimentação consciente e autoeficácia alimentar) com a variação ponderal. METODOLOGIA: Estudou-se uma amostra de conveniência de 252 adultos portugueses (71,8% sexo feminino) com idade média de 37 anos (DP = 12) e média do IMC de 24,5 kg/m2 (DP = 4,6). Os dados antropométricos (altura, peso atual e variação de peso no último ano) foram autorelatados. A variação de peso foi classificada em: “peso estável”, “perda de peso”, “ganho de peso” e “peso cíclico”. Para o comportamento alimentar aplicaram-se as Sub-Escalas de Controlo Flexível e Rígido do Comportamento Alimentar, a Escala de Alimentação Intuitiva, o Questionário de Alimentação Consciente e a Escala de Auto-Eficácia Alimentar Global. RESULTADOS: Quer o controlo rígido quer o flexível foram mais elevados em mulheres com variação ponderal cíclica. Por outro lado, e para ambos os sexos, a pontuação em algumas subescalas da alimentação intuitiva foi superior nos participantes com “peso estável” quando comparados com os do grupo com “ganho de peso”. No sexo masculino, os grupos “ganho de peso” e “peso cíclico” tinham um nível inferior de alimentação intuitiva do que o grupo com “peso estável”. Verifcou-se maior autoeficácia alimentar no grupo com “perda de peso” comparativamente ao grupo com “ganho de peso”. CONCLUSÕES: Pesquisas longitudinais podem esclarecer e aprofundar a direção das relações encontradas. Todavia, esta pesquisa salienta a implicação de estratégias comportamentais baseadas nos princípios estudados que visem a gestão do peso.
... 위험도가 낮은 J 형 상관관계를 보인다고 알려져 있지만 [5], 젊은 연령에서는 과체중 혹은 비만에서 정상체중에 비해 사 망률이 유의하게 증가한다 [4,6]. 젊은 [7,8], 고혈압을 호전시킬 수 있다 [9,10]. 대한 비만학회 [2]를 비롯해 미국임상내분비 ...
Article
Background: The prevalence of obesity has been rapidly increasing in the Korean population. Obesity is a well-known risk factor for various chronic diseases, including diabetes mellitus, hypertension, dyslipidemia, atherosclerosis, chronic kidney disease, degenerative arthritis, and autoimmune diseases. It also increases the risks of different malignancies, gall bladder disease, and pancreatitis.Current Concepts: Lifestyle intervention assisted by frequent behavioral therapy is crucial despite the modest amount of weight loss achieved. Energy intake restriction combined with increased physical activity can not only facilitate weight loss but also improve metabolic health. Furthermore, this combination can help maintain weight reduction during and after lifestyle interventions. Energy intake restriction with a daily deficit of 500–1,000 kcal and physical activity including aerobic exercise for 150 minutes or more per week and resistance training 2–4 times a week are generally recommended for obesity management.Discussion and Conclusion: Comprehensive lifestyle intervention should be individualized and supported by a multidisciplinary team. A long-term behavioral intervention is necessary for success in obesity treatment.
... might contribute to the maintenance of body dissatisfaction. As body dissatisfaction negatively influences psychological well-being and weight-loss success [39], targeting these attentional biases might help to enhance obesity treatment outcomes. ...
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Purpose Despite the claim to integrate body image interventions in obesity treatment, little is known about the mechanisms involved in maintaining body dissatisfaction in persons with overweight and obesity. Therefore, the present study sought to investigate attentional processing of body stimuli in women with overweight and obesity (OW). Methods Women with OW (n = 82) and normal weight controls (NW; n = 44) conducted two eye-tracking paradigms. In the first paradigm, fixation duration on the subjectively most beautiful and ugliest body part of one’s own and a weight-matched control body were analyzed. In the second paradigm, picture pairs including the own and a control body or object were presented and initial fixation orientation was measured. Automatic and intentional processing of the body pictures was manipulated by either indicating on which side which stimuli would appear or not. Results Women with OW displayed a bias towards the ugliest as opposed to the most beautiful body part, whereas women with NW showed a balanced viewing pattern. Furthermore, both groups showed a preference for bodies relative to the object. However, only women with OW preferred their own relative to the control body during intentional processing. Conclusion Taken together, results point towards a self-focused and deficit-oriented gaze pattern in women with overweight and obesity. Targeting these processes might help to improve obesity treatment outcomes. Level of evidence Level I, experimental study.
... This program is based on cognitive behavioral therapy (CBT) and third-wave CBT, which seek to improve cognitive flexibility, helping individuals to reframe their goals and experiences in broader and more accepting contexts [65,66]. Greater cognitive flexibility is also more generally associated with greater weight loss [67,68]. Thus, it is possible that positive emotion and insight words reflected cognitive flexibility and broadening, which was then related to weight loss. ...
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Behavioral weight loss reduces risk of weight-related health complications. Outcomes of behavioral weight loss programs include attrition and weight loss. There is reason to believe that individuals’ written language on a weight management program may be associated with outcomes. Exploring associations between written language and these outcomes could potentially inform future efforts towards real-time automated identification of moments or individuals at high risk of suboptimal outcomes. Thus, in the first study of its kind, we explored whether individuals’ written language in actual use of a program (i.e., outside of a controlled trial) is associated with attrition and weight loss. We examined two types of language: goal setting (i.e., language used in setting a goal at the start of the program) and goal striving (i.e., language used in conversations with a coach about the process of striving for goals) and whether they are associated with attrition and weight loss on a mobile weight management program. We used the most established automated text analysis program, Linguistic Inquiry Word Count (LIWC), to retrospectively analyze transcripts extracted from the program database. The strongest effects emerged for goal striving language. In striving for goals, psychologically distanced language was associated with more weight loss and less attrition, while psychologically immediate language was associated with less weight loss and higher attrition. Our results highlight the potential importance of distanced and immediate language in understanding outcomes like attrition and weight loss. These results, generated from real-world language, attrition, and weight loss (i.e., from individuals’ natural usage of the program), have important implications for how future work can better understand outcomes, especially in real-world settings.
Article
Purpose The purpose of the study was to explore factors surrounding management of simultaneous dietary recommendations for heart failure and type 2 diabetes among patient-caregiver dyads. Methods Qualitative description was used to explore dyad experiences managing a dual diet. Semi-structured interviews were conducted with patients with a concurrent diagnosis of type 2 diabetes and heart failure and their family caregiver. Each 60-minute interview was conducted virtually. Interviews were audio recorded and transcribed verbatim. Thematic analysis was conducted with coding used for themes at dyadic-and individual levels. Results Twelve patient-caregiver dyads (N = 24) were interviewed. The mean age was 57 years (±15 years). Most participants were white (75%); patients were predominantly male, and caregivers were predominantly female (83.3% for both). Dyadic-level themes that emerged included factors that influence simultaneous management of dual diet recommendations. Themes included shared barriers, facilitators, motivators, and strategies for dual diet management. Individual-level themes discussed by patients were barriers and motivators to dual diet management, and caregivers discussed barriers to supporting dual diet management. Conclusions Findings from the study highlight that patients and caregivers often work together and share similar barriers, facilitators, motivators, and strategies for adhering to a dual diet. The results provide insight into chronic disease management at the family level and can guide health care providers’ efforts to promote family involvement with dietary recommendations for patients with multiple comorbidities.
Article
The predominant method for treating obesity has been suggesting and providing information on a controlled diet and, to a lesser extent, increased exercise. That approach has largely failed beyond the short term for many decades as obesity rates continue to rise. Therefore, leveraging improvements in psychosocial correlates of weight-loss behaviors has sometimes been suggested instead. The aim of this study was evaluation of targeted improvements in self-regulation and self-efficacy within a theoretically derived weight-loss program. Women with obesity ( N = 103) participated in a year-long community-based program emphasizing self-regulatory skills development to counter lifestyle barriers/challenges to first exercise, then controlled eating. Within a structured treatment protocol administered by community facility employees–and based on tenets of social cognitive theory, self-regulation theory, self-efficacy theory, and coaction theory–self-regulatory skills were initially developed to foster adherence to exercise. Those skills were then adapted to promote eating-behavior changes, emphasizing fruit and vegetable intake. Improvements in measures of exercise self-regulation, eating self-regulation, and self-efficacy for controlling eating, their corresponding behaviors, and weight and waist circumference were significant. Greater within-participant carry-over of changes in exercise self-regulation to eating self-regulation was significantly associated with more weight and waist circumference reductions over both 6 and 12 months. Change in eating-related self-efficacy significantly mediated those relationships. The mean weight reduction of approximately 6% indicated positive effects on obesity-related health risks. The community-based setting indicated potentials for large-scale dissemination of theory- and evidence-driven behavioral obesity treatments focused primarily on self-regulatory skills development.
Article
Issue addressed: Obesity is an increasing worldwide health issue. In affluent English-speaking countries, obesity ranges from ~28% (Australia) to ~42% (United States) of the adult population. Enabling weight loss beyond an initial 6 months is an unresolved challenge. Methods: Women with obesity participated in community-based obesity treatments incorporating either cognitive-behavioural methods emphasizing self-regulatory skills development (n = 106) or typical information/education processes (n = 47). Psychosocial, behavioural, and weight changes were measured. Results: Significant overall improvements in exercise-related self-regulation and self-efficacy, mood, physical activity/exercise (PA/exercise), diet, and weight were found from baseline-month 6 (weight-loss phase) and baseline-month 12, but not from months 6-12 (weight-loss maintenance phase). Significantly greater improvements were found in the cognitive-behavioural group. Within the weight-loss phase, changes in both PA/exercise and diet significantly contributed to the explained variance in weight loss, whereas within the weight-loss maintenance phase, only change in PA/exercise was a significant predictor. There was no significant relationship of weight loss across phases. Months 6-12 change in PA/exercise significantly mediated relationships of changes in self-regulation→weight, mood→weight, and self-efficacy→weight. Earlier scores and score changes in mood and self-efficacy significantly impacted the subsequent parallel relationships. Conclusions: Cognitive-behavioural methods affect psychosocial changes leading to initial changes in diet, PA/exercise, and weight. Those changes then impact subsequent changes in PA/exercise-a primary malleable correlate of maintained weight loss. SO WHAT?: This research extended previous findings to better-inform behavioural obesity-treatment foci to address the pervasive public health problem of attaining and sustaining weight loss. Findings related to PA/exercise will help impact health-promotion outcomes.
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This protocol describes the planned delivery and analysis of the Eating Freely programme to a group of 15 UK based adults living with obesity and emotional eating. The intervention will be delivered online with weekly group meetings facilitated by 2 Eating Freely Practitioners. The intervention uses a combination of second and third wave CBT approaches to help adults overcome emotional eating. The analysis is a mixed methods approach involving a process evaluation. A basic study design and overview has been previously published (https://aspredicted.org/S52_GS2), whilst this protocol provides a more in-depth description the theoretical underpinnings of the programme and how it has been adapted to a UK audience.
Article
The aim of this study was to evaluate behavioral mediators of relationships between increased self-regulation of eating and weight loss so that findings on psychosocial correlates of treatment-associated weight change could be extended. Participants were women enrolled in 6-month community-based obesity treatments using primarily self-regulatory (SR-treatment, n = 52) or education-focused (Didactic training, n = 54) methods. Changes from baseline in self-regulation of eating, self-efficacy for controlled eating, emotional eating propensity, exercise, and the diet were first calculated. There were significant overall improvements in each psychosocial and behavioral measure, and weight. Except for emotional eating change from baseline–Month 12, improvements were each significantly greater in the SR-treatment group. Mediation of the relationships of change in self-regulation with 6-, 12-, and 24-month weight changes, by changes in self-efficacy and emotional eating, were significant, R ² s = .19–.26, ps < .001. Only changes in emotional eating over 6 and 12 months were significant mediators. Mediations of the same self-regulation-weight change relationships by changes in exercise and the diet were also significant, R ² s = .19–.28, ps < .001, and only changes in exercise over 12 and 24 months were significant mediators. Although group membership did not moderate effects on weight, substitution of sweets for the (composite) diet demonstrated it to be a significant mediator over 6 and 12 months. In women with obesity, self-regulation improvement was associated with short- and longer-term weight loss through changes in emotional eating, exercise, and sweets consumption. Thus, behavioral treatments will benefit from targeting those variables.
Article
Study background Limited knowledge of psychological correlates of weight loss is associated with continuing failures of behavioral obesity treatments beyond the short term. Purpose This study aimed to inform health professionals’ obesity interventions via an increased knowledge of mediators of the exercise-weight loss maintenance relationship. Methods Women participated in 6-month obesity treatments within community settings emphasizing moderate exercise and self-regulation skills development via primarily in-person ( n = 54) or primarily written ( n = 54) means. Changes in mood, self-regulating eating, and weight over 6, 12, and 24 months were assessed. A moderated mediation model was tested using the PROCESS macro instruction. Results Improvements in mood, self-regulating eating, and weight were significantly greater in the in-person group. The relationship between a dichotomous measure of completing at least 3 sessions of exercise per week (or not) and change in weight over 6 months was no longer significant when the mediators of changes in negative mood and self-regulation of eating were sequentially entered. Paths of exercise→negative mood reduction→eating self-regulation increase→weight loss over 6, 12 and 24 months were significant. Exercise self-regulation at Month 3 significantly moderated the mood change→eating self-regulation change relationship. Conclusions Based on the identified paths, scalable obesity-treatment content and emphases were informed. This could help guide health professionals’ actions concerning the management of obesity.
Article
Obesity remains a medical issue of great concern. Behavioural methods attempting to induce weight loss have largely failed because of a minimal understanding of stress‐ and depression‐associated psychosocial correlates. This study extended research into the effects of exercise on weight loss through psychological pathways to improve treatments. Women with obesity ( N = 108), participating in an original theory‐driven cognitive‐behavioural treatment within community‐based health promotion centres, were evaluated over 24 months. Their mean scores on anxiety, depression, and anger at baseline were significantly higher than normative data from a general sample of United States women. Three serial mediation models were specified assessing mediation of the significant exercise→dietary change relationship. These yielded two significant paths: changes in exercise→anxiety→anxiety‐associated emotional eating→self‐efficacy→diet, and changes in exercise→depression→depression‐associated emotional eating→self‐efficacy→diet; and one non‐significant path: changes in exercise→anger→anger‐associated emotional eating→self‐efficacy→diet. In a subsequent moderated moderation model, change in eating‐related self‐regulation moderated the relationship between changes in anxiety and anxiety‐associated emotional eating, where exercise‐associated self‐regulation moderated effects from eating‐related self‐regulation. Dietary improvement was significantly related to weight loss over 6 ( β = −0.40), 12 ( β = −0.42), and 24 ( β = −0.33) months. Findings indicated an increased treatment focus on the completion of moderate amounts of exercise for weight loss and, following that, attention to improvements in anxiety, depression, anxiety‐ and depression‐associated emotional eating, self‐efficacy for controlled eating, and the transfer of exercise‐related self‐regulation to eating‐related self‐regulation. Given the scope of the obesity problem, extensions of this research within field settings are warranted to accelerate application opportunities.
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This comprehensive overview explores sociocultural challenges in healthy eating and weight management, focusing on pharmacological interventions and psychotherapeutic options for care. The article evaluates the efficacy and safety of amphetamines, GLP-1 receptor agonists, and lipase blockers for weight loss. The emergence of GLP-1 agonists, such as liraglutide, semaglutide, and tirzepatide, is examined, emphasizing their potential benefits and drawbacks. The discussion delves into the complexities of weight loss pharmacology, considering societal influences, individual factors, and the importance of sustained behavioral changes. The vignette of Taylor's journey further underscores the need for a holistic approach, integrating psychological, behavioral, and environmental aspects for long-term weight management success.
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This study aimed to examine the relationship between difficulties in emotion regulation and emotional eating and the role of impulsivity and depressive symptoms in mediating this chain. Four hundred ninety-four undergraduate students participated in the study. A self-designed questionnaire was used in the survey from February 6 to 13, 2022, to finish our purpose, including the Emotional Eating Scale (EES-R), Depression Scale (CES-D), Short Version of the Impulsivity Behavior Scale (UPPS-P) and Difficulties in Emotion Regulation Scale (DERS). The results showed that 1) difficulties in emotion regulation, impulsivity, depressive symptoms, and emotional eating were correlated; 2) impulsivity and depressive symptoms separately mediated the relationship between difficulties in emotion regulation and emotional eating; 3) impulsivity and depressive symptoms played a chain mediating role between difficulties in emotion regulation and emotional eating. The current study provided a better understanding of the psychologically related pathway of emotional eating. The results would be helpful for prevention and intervention of emotional eating among undergraduate students.
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Background: Obesity is a public health issue worldwide. Conversational agents (CAs), also frequently called chatbots, are computer programs that simulate dialogue between people. Owing to better accessibility, cost-effectiveness, personalization, and compassionate patient-centered treatments, CAs are expected to have the potential to provide sustainable lifestyle counseling for weight management. Objective: This systematic review aimed to critically summarize and evaluate clinical studies on the effectiveness and feasibility of CAs with unconstrained natural language input for weight management. Methods: PubMed, Embase, the Cochrane Library (CENTRAL), PsycINFO, and ACM Digital Library were searched up to December 2022. Studies were included if CAs were used for weight management and had a capability for unconstrained natural language input. No restrictions were imposed on study design, language, or publication type. The quality of the included studies was assessed using the Cochrane risk-of-bias assessment tool or the Critical Appraisal Skills Programme checklist. The extracted data from the included studies were tabulated and narratively summarized as substantial heterogeneity was expected. Results: In total, 8 studies met the eligibility criteria: 3 (38%) randomized controlled trials and 5 (62%) uncontrolled before-and-after studies. The CAs in the included studies were aimed at behavior changes through education, advice on food choices, or counseling via psychological approaches. Of the included studies, only 38% (3/8) reported a substantial weight loss outcome (1.3-2.4 kg decrease at 12-15 weeks of CA use). The overall quality of the included studies was judged as low. Conclusions: The findings of this systematic review suggest that CAs with unconstrained natural language input can be used as a feasible interpersonal weight management intervention by promoting engagement in psychiatric intervention-based conversations simulating treatments by health care professionals, but currently there is a paucity of evidence. Well-designed rigorous randomized controlled trials with larger sample sizes, longer treatment duration, and follow-up focusing on CAs' acceptability, efficacy, and safety are warranted.
Article
Hedonic hunger, reward-driven eating outside of biological need, is a newer construct in eating behavior research. During behavioral weight loss (BWL), greater improvements in hedonic hunger are associated with higher weight loss, but it remains unclear if hedonic hunger predicts weight loss independent of more well-established, similar constructs (uncontrolled eating and food craving). Research also is needed to understand how hedonic hunger interacts with contextual factors (e.g., obesogenic food environment) during weight loss. Adults (N = 283) in a 12-month randomized controlled trial of BWL were weighed at 0, 12, and 24 months, and completed questionnaires assessing hedonic hunger, food craving, uncontrolled eating, and the home food environment. All variables improved at 12 and 24 months. Decreases in hedonic hunger at 12 months were associated with higher concurrent weight loss, but not when accounting for improvements in craving and uncontrolled eating. At 24 months, reduction in craving was a stronger predictor of weight loss than hedonic hunger, but improvement in hedonic hunger was a stronger predictor of weight loss than change in uncontrolled eating. Changes to the obesogenic home food environment failed to predict weight loss, regardless of levels of hedonic hunger. This study adds novel information on the individual and contextual factors associated with short- and long-term weight control, which can help refine conceptual models and treatment strategies.
Article
Background: Understanding the effect lifestyle intervention (LI) has on important psychological and behavioral variables that are associated with weight loss can help inform LI design, content, and delivery. Objective: The aim was to determine the modifiable psychological and behavioral factors that are associated with percent weight loss (%WL) and their relative importance in predicting %WL at 12, 24, and 36 months in the REAL HEALTH-Diabetes randomized controlled trial (RHD RCT) LI. Design: This is a secondary analysis of LI arms of the RHD RCT LI cohort over a 24-month intervention period and 12-month follow-up period. Patient-reported outcomes were measured using validated questionnaires that were either self-administered or administered by a research coordinator. Participants/setting: Adults with type 2 diabetes and overweight/obesity (n=142) from community health centers, primary care, and local endocrinology practices affiliated with Massachusetts General Hospital in Boston, MA between 2015 and 2020, were randomized to LI and were included in the analysis. Intervention: The LI was a lower intensity adaptation of Look AHEAD's evidence-based LI delivered either in-person or via telephone. Registered dietitians delivered 19 group sessions in the first six months followed by 18 monthly sessions. Main outcome measures: The association of psychological (diabetes-related distress, depression, autonomous motivation, diet and exercise self-efficacy, and social support for healthy behaviors) and behavioral (fat-related diet and dietary self-regulation) variables with %WL. Statistical analysis: Baseline and six-month change scores in psychological and behavioral variables were modeled as predictors of %WL at 12, 24, and 36 months using linear regression. Random forests were used to compare the relative importance of changes in the variables in predicting %WL. Results: Six-month improvement in autonomous motivation, exercise self-efficacy, diet self-efficacy, and dietary self-regulation were associated with %WL at 12 and 24 months, but not at 36 months. Improvement in fat-related diet behavior and depressive symptoms were the only variables associated with %WL at all three timepoints. Autonomous motivation, dietary self-regulation, and low-fat diet behaviors were the three most important predictors of %WL during the two-year LI. Conclusions: The RHD RCT LI resulted in six-month improvements in modifiable psychological and behavioral factors that were associated with %WL. LI programs for weight loss should focus on skills and strategies to promote autonomous motivation, flexible dietary self-regulation, and habituation of low-fat eating habits during the intervention period.
Article
Background Knowing which theoretical constructs work best to design effective interventions is essential for populations with increased disease burden. African American women (AAW) experience a greater prevalence of chronic diseases and fewer benefits from weight loss interventions compared to White women. Purpose To examine how theoretical constructs were associated with lifestyle behaviors and weight outcomes in the Better Me Within (BMW) Randomized Trial. Methods BMW used a tailored diabetes prevention program implemented in churches among AAW with BMI ≥ 25. Regression models assessed relationships between constructs (self-efficacy, social support, and motivation), and outcomes (physical activity (PA), calories, and weight). Results Among 221 AAW, mean (SD) age 48.8 years (11.2); mean weight 215.1 pounds (50.5), several significant relationships were found including an association between change in motivation for activity and change in PA (p = <0.01), and weight loss self-efficacy and weight at follow-up (p = <0.01). Discussion The clearest relationships emerged for PA with motivation for activity and weight management social support demonstrating significance in all models. Translation to Health Education Practice Self-efficacy, motivation, and social support show promise to promote changes in PA and weight among church-going AAW. Opportunities to keep engaging AAW in research are essential for eliminating health inequities in this population.
Article
Background Psychological contributing factors in obesity include attachment style and emotion dysregulation. Little is known about the relationship between attachment style and responses to treatment in obesity. Aims This study set out to identify the average weight loss for a group treatment for obesity based on diet changes and cognitive behavioural therapy (CBT) strategies, investigate whether attachment style predicts weight loss, and explore participants’ experience of the group treatment. Method 52 participants completed an attachment measure at the start of treatment. Body Mass Index (BMI) measures were taken at the start and end of treatment. The average weight loss was calculated and a backwards multiple regression tested whether the five attachment dimensions could predict participants’ change in BMI. Seven of the participants then took part in semi-structured interviews about the experience of the treatment. Transcripts were subjected to Interpretative Phenomenological Analysis (IPA). Results The average weight loss was 2.2 per cent of the starting body weight. Quantitative findings produced a model which showed that the participants who scored higher on attachment security lost less weight than those with insecure attachments. Qualitative findings centred around four themes regarding the group experience: Dependency; Identification; Comparison to Others; and Negative Aspects of the Group Experience. Participants also described having difficulties with self-soothing, having had unmet needs in childhood, and the experience of recurrent depression. Conclusions This study demonstrates poor weight loss from group treatments for obesity based on diet changes and CBT strategies. However, it suggests that those with insecure attachment may be better suited to CBT-type courses than those who are securely attached. The qualitative themes offer possible explanations as to why the treatment did not result in significant weight loss and potential reasons for the well documented weight regain following treatment for obesity. The implications are that treatment for obesity should be tailor-made, consider attachment style, and consider the need to attend to emotion regulation.
Article
Objective: Weight regain prevention is a critical public health challenge. Digital behaviour change interventions provide a scalable platform for applying and testing behaviour change theories in this challenging context. This study's goal was to analyse reciprocal effects between psychosocial variables (i.e., needs satisfaction, eating regulation, self-efficacy) and weight over 12 months using data from a large sample of participants engaged in a weight regain prevention trial. Methods: The NoHoW study is a three-centre, large-scale weight regain prevention trial. Adults who lost >5% of their weight in the past year (N = 1627, 68.7% female, 44.10 ± 11.86 years, 84.47 ± 17.03 kg) participated in a 12-month' digital behaviour change-based intervention. Weight and validated measures of basic psychological needs satisfaction, eating regulation and self-efficacy were collected at baseline, six- and 12 months. Correlational, latent growth models and cross-lagged analysis were used to identify potential reciprocal effects. Results: Baseline higher scores of needs satisfaction and self-efficacy were associated with six- and 12-month' weight loss. Baseline weight was linked to all psychosocial variables at six months, and six-months weight was associated with needs satisfaction and self-efficacy at 12 months. During the 12 months, increases in eating regulation, needs satisfaction and self-efficacy were associated with weight loss over the same period, and reciprocal effects were observed between the variables, suggesting the existence of Weight Management Cycles. Conclusions: While further studies are needed, during long-term weight regain prevention, weight decrease, needs satisfaction and self-efficacy may lead to Weight Management Cycles, which, if recurrent, may provide sustained prevention of weight regain.
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Background Cognitive behavioral therapy (CBT) has become one of the most commonly used psychotherapeutic treatments for obesity. It stems from CBT for bulimia nervosa and binge eating disorder, which focuses on amelioration of the eating behavior and body image dissatisfaction (BID), but usually does not focus on weight loss. In contrast, CBT for obesity focuses on weight loss, as well as eating behavior and BID. It is at present unclear whether the improvement of BID during CBT for obesity is associated with improvement of factors other than weight loss. Objective The purpose of this study was to determine whether improvement of BID during CBT for obesity was associated with improvement of factors other than weight loss. Methods One hundred and sixty-five women (BMI 31.8 ± 5.2 kg/m², age 49.3 ± 10.5 years) with overweight or obesity completed a 7-month CBT-based weight loss intervention. BID, depression, anxiety, binge eating, and perfectionism were assessed at both baseline and the end of the intervention through the use of psychological questionnaires. Results Percent total weight loss, baseline BID, baseline binge eating disorder (BED), change in depression (Δdepression), Δstate anxiety, Δtrait anxiety, Δbinge eating, and Δperfectionism were significantly correlated with ΔBID. Multiple regression analysis showed that baseline BID, baseline BED, percent total weight loss, Δbinge eating, and Δdepression were independently associated with ΔBID. Conclusion Improvement of binge eating, and improvement of depression, as well as weight loss, were independently associated with amelioration of BID. Clinical trial registration [https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000008052], identifier [UMIN000006803] and [https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R0000 55850], identifier [UMIN000049041].
Article
Objective Body dissatisfaction is highly prevalent in overweight and obesity, while evidence for the efficacy of body image interventions is still scarce. This interventional pilot study investigates the efficacy and mechanisms of change of two stand-alone body image interventions in women with overweight and obesity. Methods Women with overweight and obesity (n = 76) were randomly assigned to five weekly sessions of either mirror exposure (ME) or a cognitive restructuring intervention (CR, weekly over 5 weeks) or to a wait-list control group (WCG). Primary outcome measures were self-reported and interview-based body dissatisfaction; depression, self-esteem and emotional eating served as secondary outcome measures. Experimental paradigms were used prior to and after the interventions to analyze possible mechanisms of change: (a) Implicit Associations Tests to assess weight-related attitudes (b) eye-tracking experiments to assess visual processing of body pictures and (c) a thought-sampling procedure to assess body-related cognitions and arousal. Results According to intent-to-treat analyses using linear mixed-models, both interventions lead to significant improvements in body image, while there were no changes in the WCG. Different mechanisms of change were identified. Conclusions Both types of interventions might be effective in the reduction of self-reported body dissatisfaction and interview-based shape concerns in overweight and obesity. However, as different mechanisms drive the effect, future research should clarify which individual might best benefit from which intervention.
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Résumé L’évolution des technologies de santé connectée dans la prise en charge du surpoids et de l’obésité nécessite de mieux connaître les raisons pour lesquelles certains patients adhèrent et d’autre pas. Les objectifs de cette revue des revues systématiques sont d’examiner comment l’adhésion aux interventions de santé connectée dans la gestion du poids est conceptualisée et d’identifier les facteurs qui influencent l’adhésion et comment ils l’influencent. Sept revues systématiques publiées entre 2010 et 2022 ont été incluses. Les définitions et les mesures de l’adhésion ainsi que les conceptions de l’intervention sont très hétérogènes dans la littérature existante, ce qui rend difficiles les conclusions sur les réels niveaux d’adhésion. Quatre composantes ont été identifiées comme favorisant l’adhésion aux interventions de gestion de poids auprès de patients en situation de surpoids ou d’obésité : (1) l’auto-surveillance dont la facilité et la rapidité d’emploi lui confèrent un bon niveau d’adhésion ; (2) l’entretien motivationnel avec une relation soignant-patient via la vidéo ou le téléphone qui favorise l’adhésion ; (3) la thérapie comportementale demandant surtout des échanges fréquents, au mieux hebdomadaires ; (4) et la personnalisation qui doit être effective tout au long de l’intervention pour rester pertinente au regard des objectifs du patient. Cependant, la complexité des phénomènes impliqués dans l’obésité impose une analyse plus fine de l’adhésion qui ne se focalise pas simplement sur l’outil, mais qui importe également de prendre en considération leurs appropriations dans des contextes variés et donc de l’étudier du point de vue des utilisateurs.
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Aim: The purpose of this study was to asset the effectiveness of complex manual therapy usage in patients with lumbar flexion dysfunction after discectomy, in comparison to standard physiotherapy based on physical therapy, balneotherapy and sensorimotor exercises. Material and methods: The study was conducted in the participation of 40 patients attending outpatient rehabilitation at ORNR “Krzeszowice” SP ZOZ. Participants were divided into two groups (control and experimental) each one including 20 people. The average patients’ age was 52.75 (± 11.58). The patients had been medically examined before the rehabilitation process implementation and after its completion. The test was carried out using the patient’s card, Laitinen’s scale and mobility tests with a plurimeter. Rehabilitation has taken place for four weeks daily. The exercises of the patients from the experimental group were based on comprehensive manual therapy meanwhile the control group underwent a standard package of physical therapy, balneotherapy and sensorimotor exercises. Results: Two statistically significant phenomena were observed in both groups: decrease of pain in the lower spine and the range motion improvement, nevertheless, both results were significantly greater in the experimental group. Conclusions: Both therapeutic programs indicate an advantageous impact in terms of reducing pain and functioning in everyday life, but the manual therapy is much more effective.
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Aim: The objective of the article is to demonstrate the research on the effectiveness of physical therapy in renewal of health of women with alimentary-constitutional type of I degree obesity. The task was also to study the initial level of obesity of women, to develop the structure of the therapeutic rehabilitation complex, to implement the developed programme of physical therapy and evaluate its effectiveness. Materials and Methods: The study was conducted for six months on the basis of a sports and recreation complex, which includes a gym, aerobics and a swimming pool with professional equipment. It was attended by 40 people aged from 33 to 56, with overweight and obesity of I degree. They were divided into two groups: the main (20 people) and control (20 people). The main group used a set of strength physical exercises of aerobic and anaerobic types, diet therapy andconstant online psychological support. The women in the control group performed the standard set of physical exercises that are usually offered in sports facilities and ate at their own discretion. We also used elements of therapeutic exercise to increase energy expenditure, reduce excess weight and strengthen muscles, restore and maintain physical and professional performance. There wereno people with serious disorders of the cardiovascular, endocrine and other body systems among the participants of the study. Results: During the therapeutic programme, we performed monthly control measurements of body parameters and body weight in order to monitor their dynamics and compare it with that in the control group, which was engaged in the standard complex. At the beginning of the study, the results in both groups were quite positive, after some time the rate of weight loss began to slow down, and in the control group, among some participants it even worsened – the weight returned. 6 months after the initial control, a final control of both groups of women of second adulthood was performed. When comparing the data obtained before and after rehabilitation measures, we observed a significant decrease in body weight in individuals of the study group in contrast to the control, where there was a decrease in body weight, but it was statistically insignificant. Analysis of the dynamics of monthly weight loss for the entire rehabilitation period showed that in the control group there was a decrease in body weight in the first and second months of the rehabilitation complex, relative to the main group, then the dynamics was marked by significant weight loss in the 1st, 2nd, 3rd month. Conclusions: Based on the obtained results, we proved the high efficiency of the proposed therapeutic and rehabilitation complex (combination of diet therapy, exercises of aerobic and anaerobic directions) for the treatment of persons with I degree of obesity (significantly reduced body weight and reduced the size of body parts). Rehabilitation measures used in our study activate metabolic processes, increase energy expenditure, reduce excess body weight, strengthen the body. By following a healthy lifestyle, eating rationally, you can prevent a number of diseases, improve efficiency and general well-being, avoid premature aging. Physical therapy of obese patients requires a combination of dietary and physiotherapeutic methods (massage, physiotherapy, psychological training), which allows to achieve sustainable weight loss for a long period.
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Purpose: Improvements in hedonic hunger (HH; reward-driven eating outside of biological need) during behavioral weight loss (BWL) treatments relate to greater weight loss. However, it is unknown how HH is associated with BWL outcomes when accounting for the effects of theoretically similar constructs, including uncontrolled eating and food craving, and relevant contextual factors, like exposure to the obesogenic food environment. Methods: Adults (N = 283) in a 12-month BWL program were weighed at baseline, post-treatment (12 months) and follow-up (24 months), and completed questionnaires assessing HH, food craving, uncontrolled eating, and their home food environment (HFE). Results: HH, uncontrolled eating, craving, and the obesogenic HFE improved during BWL and reductions were maintained at 24 months. Decreases in HH from baseline to post-treatment were associated with higher concurrent weight loss, but not when accounting for concurrent improvements in cravings and uncontrolled eating. At 24 months, decreases in cravings accounted for more variability in weight loss than changes in HH, but improvement in HH was a stronger predictor of 24-month weight loss than decreases in uncontrolled eating. Changes to the obesogenic HFE failed to predict weight loss, regardless of baseline levels of HH. Conclusion: This study adds novel information on which individual and environmental factors are most strongly associated with short- versus long-term weight control, which can impact intervention development. Improvements to the obesogenic HFE may be less important than previously conceived, as BWL participants (with varying levels of HH) were able to achieve weight loss regardless of changes to the HFE. Level of Evidence: Level II: Evidence obtained from well-designed controlled trials without randomization
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In this article, we attempt to distinguish between the properties of moderator and mediator variables at a number of levels. First, we seek to make theorists and researchers aware of the importance of not using the terms moderator and mediator interchangeably by carefully elaborating, both conceptually and strategically, the many ways in which moderators and mediators differ. We then go beyond this largely pedagogical function and delineate the conceptual and strategic implications of making use of such distinctions with regard to a wide range of phenomena, including control and stress, attitudes, and personality traits. We also provide a specific compendium of analytic procedures appropriate for making the most effective use of the moderator and mediator distinction, both separately and in terms of a broader causal system that includes both moderators and mediators. (46 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Research has shown a negative relationship between perceived body size discrep-ancies and exercise participation among women. This might be explained from a self-determination theory perspective by perceived discrepancies between actual and ideal body size causing individuals to feel less autonomous in the regulation of their exercise behaviour. The aim of this study was to test the mediating role of exercise behavioural regulations in the relationship between body size discrepancies and physical activity participation. Participants were 102 women who completed measures of body size discrepancies, beha-vioural regulations and physical activity. Analyses showed that a reduction in more autonomous regulations mediated a negative relationship between discrepancies and physical activity. Less autonomous regulations did not play a mediating role. Thus it appears that body size discrepancies exert a negative influence on physical activity by decreasing feelings that exercise is a valued and enjoyable activity rather than by leading people to feel more externally or internally controlled in their behaviour.
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Objective: Successful weight management relies on at least two health behaviors, eating and exercise. However, little is known about their interaction on a motivational and behavioral level. Based on the Hierarchical Model of Motivation the authors examined whether exercise-specific motivation can transfer to eating regulation during a lifestyle weight control program. The authors further investigated whether general, treatment-related, and exercise motivation underlie the relation between increased exercise and improved eating regulation. Design: Overweight/obese women participated in a 1-year randomized controlled trial (N = 239). The intervention focused on promoting physical activity and internal motivation for exercise and weight loss, following Self-Determination Theory. The control group received general health education. Main Outcome Measures: General and exercise specific self-determination, eating self-regulation variables, and physical activity behavior. Results: General self-determination and more autonomous exercise motivation predicted eating self-regulation over 12 months. Additionally, general and exercise self-determination fully mediated the relation between physical activity and eating self-regulation. Conclusion: Increased general self-determination and exercise motivation seem to facilitate improvements in eating self-regulation during weight control in women. These motivational mechanisms also underlie the relationship between improvements in exercise behavior and eating regulation.
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Overweight and obesity affects more than 66% of the adult population and is associated with a variety of chronic diseases. Weight reduction reduces health risks associated with chronic diseases and is therefore encouraged by major health agencies. Guidelines of the National Heart, Lung, and Blood Institute (NHLBI) encourage a 10% reduction in weight, although considerable literature indicates reduction in health risk with 3% to 5% reduction in weight. Physical activity (PA) is recommended as a component of weight management for prevention of weight gain, for weight loss, and for prevention of weight regain after weight loss. In 2001, the American College of Sports Medicine (ACSM) published a Position Stand that recommended a minimum of 150 min wk(-1) of moderate-intensity PA for overweight and obese adults to improve health; however, 200-300 min wk(-1) was recommended for long-term weight loss. More recent evidence has supported this recommendation and has indicated more PA may be necessary to prevent weight regain after weight loss. To this end, we have reexamined the evidence from 1999 to determine whether there is a level at which PA is effective for prevention of weight gain, for weight loss, and prevention of weight regain. Evidence supports moderate-intensity PA between 150 and 250 min wk(-1) to be effective to prevent weight gain. Moderate-intensity PA between 150 and 250 min wk(-1) will provide only modest weight loss. Greater amounts of PA (>250 min wk(-1)) have been associated with clinically significant weight loss. Moderate-intensity PA between 150 and 250 min wk(-1) will improve weight loss in studies that use moderate diet restriction but not severe diet restriction. Cross-sectional and prospective studies indicate that after weight loss, weight maintenance is improved with PA >250 min wk(-1). However, no evidence from well-designed randomized controlled trials exists to judge the effectiveness of PA for prevention of weight regain after weight loss. Resistance training does not enhance weight loss but may increase fat-free mass and increase loss of fat mass and is associated with reductions in health risk. Existing evidence indicates that endurance PA or resistance training without weight loss improves health risk. There is inadequate evidence to determine whether PA prevents or attenuates detrimental changes in chronic disease risk during weight gain.
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Overweight and obesity are increasing in the United States. Changes in diet and physical activity are important for weight control. To examine the prevalence of attempting to lose or to maintain weight and to describe weight control strategies among US adults. The Behavioral Risk Factor Surveillance System, a random-digit telephone survey conducted in 1996 by state health departments. Setting The 49 states (and the District of Columbia) that participated in the survey. Adults aged 18 years and older (N = 107 804). Reported current weights and goal weights, prevalence of weight loss or maintenance attempts, and strategies used to control weight (eating fewer calories, eating less fat, or using physical activity) by population subgroup. The prevalence of attempting to lose and maintain weight was 28.8% and 35.1 % among men and 43.6% and 34.4% among women, respectively. Among those attempting to lose weight, a common strategy was to consume less fat but not fewer calories (34.9% of men and 40.0% of women); only 21.5% of men and 19.4% of women reported using the recommended combination of eating fewer calories and engaging in at least 150 minutes of leisure-time physical activity per week. Among men trying to lose weight, the median weight was 90.4 kg with a goal weight of 81.4 kg. Among women, the median weight was 70.3 kg with a goal weight of 59.0 kg. Weight loss and weight maintenance are common concerns for US men and women. Most persons trying to lose weight are not using the recommended combination of reducing calorie intake and engaging in leisure-time physical activity 150 minutes or more per week.
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Developed, based on S. Harter's (1985) methodology, a physical self-perception (SP) profile that applied self-esteem theory to the study of SP in the physical domain. Open-ended questionnaire responses of 1,191 male and female undergraduates were used. Four subdomain subscales (SUBs) were constructed along with a physical self-worth subscale as the basis of the profile. The sensitivity, reliability, and stability of the SUBs were supported for both genders across 3 samples. The discriminant validity of the SUBS was indicated, supporting the concept of multidimensionality within the physical domain. Also, results consistent with a 3-tier hierarchical structure among SP elements were provided, and initial predictive validity of the SUBs was demonstrated through their association with degree and type of involvement in physical activity. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Self determination theory proposes that behavior change will occur and persist if it is autonomously motivated. Autonomous motivation for a behavior is theorized to be a function both of individual differences in the autonomy orientation from the General Causality Orientations Scale and of the degree of autonomy supportiveness of relevant social contexts. We tested the theory with 128 patients in a 6-month, very-low-calorie weight-loss program with a 23-month follow-up. Analyses confirmed the predictions that (a) participants whose motivation for weight loss was more autonomous would attend the program more regularly, lose more weight during the program, and evidence greater maintained weight loss at follow-up, and (b) participants' autonomous motivation for weight loss would be predicted both by their autonomy orientation and by the perceived autonomy supportiveness of the interpersonal climate created by the health-care staff. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Recently, body dissatisfaction has been conceptualized as the discrepancy between self and ideal body size estimates. This study evaluated the validity of this conceptualization using three methods for estimating actual and ideal body size: (a) the Body Image Assessment, (b) the Body Image Testing System, and (c) the Body Image Detection Device. The three body image assessment procedures were concurrently administered to a sample of 110 women diagnosed: bulimia nervosa (n=18),obese (n=34),and non-eating disorder (n=58).The Eating Disorder Inventory Body Dissatisfaction scale was also used to measure body dissatisfaction. Measures of self-ideal body size discrepancy were found to correlate more highly with measures of body dissatisfaction than were measures of current body size perception, ideal body size, body size estimation accuracy, or indices based on actual body size. Estimation of both current and ideal body size were found to significantly predict overall body dissatisfaction; thus, both self and ideal body size measures were found to be significant components in determining body size dissatisfaction. These data were interpreted as supportive of the conceptualization of body dissatisfaction as the discrepancy between self and ideal body size estimates.
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The development of consensus guidelines for obesity is complex. It involves recommending both treatment interventions and interventions related to screening and prevention. With so many publications and claims, and with the awareness that success for the individual is short-lived, many find it difficult to know what action is appropriate in the management of obesity. Furthermore, the significant variation in existing service provision both within countries as well as across the regions of Europe makes a standardised approach, even if evidence-based, difficult to implement. In formulating these guidelines, we have attempted to use an evidence-based approach while allowing flexibility for the practicing clinician in domains where evidence is currently lacking and ensuring that in treatment there is recognition of clinical judgment and of regional diversity as well as the necessity of an agreed approach by the individual and family. We conclude that i) physicians have a responsibility to recognise obesity as a disease and help obese patients with appropriate prevention and treatment, ii) treatment should be based on good clinical care and evidence-based interventions and iii) obesity treatment should focus on realistic goals and lifelong management.
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Successful weight management relies on at least two health behaviors, eating and exercise. However, little is known about their interaction on a motivational and behavioral level. Based on the Hierarchical Model of Motivation the authors examined whether exercise-specific motivation can transfer to eating regulation during a lifestyle weight control program. The authors further investigated whether general, treatment-related, and exercise motivation underlie the relation between increased exercise and improved eating regulation. Overweight/obese women participated in a 1-year randomized controlled trial (N = 239). The intervention focused on promoting physical activity and internal motivation for exercise and weight loss, following Self-Determination Theory. The control group received general health education. General and exercise specific self-determination, eating self-regulation variables, and physical activity behavior. General self-determination and more autonomous exercise motivation predicted eating self-regulation over 12 months. Additionally, general and exercise self-determination fully mediated the relation between physical activity and eating self-regulation. Increased general self-determination and exercise motivation seem to facilitate improvements in eating self-regulation during weight control in women. These motivational mechanisms also underlie the relationship between improvements in exercise behavior and eating regulation.
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Changes in body image and subjective well-being variables (e.g. self-esteem) are often reported as outcomes of obesity treatment. However, they may, in turn, also influence behavioral adherence and success in weight loss. The present study examined associations among obesity treatment-related variables, i.e., change in weight, quality of life, body image, and subjective well-being, exploring their role as both mediators and outcomes, during a behavioral obesity treatment. Participants (BMI = 31.1 +/- 4.1 kg/m2; age = 38.4 +/- 6.7 y) were 144 women who attended a 12-month obesity treatment program and a comparison group (n = 49), who received a general health education program. The intervention included regular group meetings promoting lasting behavior changes in physical activity and dietary intake. Body image, quality of life, subjective well-being, and body weight were measured at baseline and treatment's end. Mediation was tested by multiple regression and a resampling approach to measure indirect effects. Treatment group assignment was the independent variable while changes in weight and in psychosocial variables were analyzed alternatively as mediators and as dependent variables. At 12 months, the intervention group had greater weight loss (-5.6 +/- 6.8% vs. -1.2 +/- 4.6%, p < .001) and larger decreases in body size dissatisfaction (effect size of 1.08 vs. .41, p < .001) than the comparison group. Significant improvements were observed in both groups for all other psychosocial variables (effect sizes ranging from .31-.75, p < .05). Mediation analysis showed that changes in body image and body weight were concurrently mediators and outcomes of treatment, suggesting reciprocal influences. Weight loss partially mediated the effect of treatment on quality of life and on self-esteem but the reciprocal effect was not observed. Changes in weight and body image may reciprocally affect each other during the course of behavioral obesity treatment. No evidence of reciprocal relationships was found for the other models under analysis; however, weight changes partially explained the effects of treatment on quality of life and self-esteem. Weight and psychosocial changes co-occur during treatment and will probably influence each other dynamically, in ways not yet adequately understood. Results from this study support the inclusion of intervention contents aimed at improving body image in weight management programs.
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Few studies have examined predictors of weight regain after significant weight losses. This prospective study examined behavioral and psychological predictors of weight regain in 261 successful weight losers who completed an 18-month trial of weight regain prevention that compared a control condition with self-regulation interventions delivered face-to-face or via the Internet. Linear mixed effect models were used to examine behavioral and psychological predictors of weight regain, both as main effects and as interactions with treatment group. Decreases in physical activity were related to weight regain across all 3 groups, and increased frequency of self-weighing was equally protective in the 2 intervention groups but not in the control group. Increases in depressive symptoms, disinhibition, and hunger were also related to weight regain in all groups. Although the impact of changes in restraint was greatest in the Internet group and weakest in the face-to-face group, the latter was the only group with increases in restraint over time and consequent decreases in magnitude of weight regain. Future programs should focus on maintaining physical activity, dietary restraints, and frequent self-weighing and should include stronger components to modify psychological parameters.
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Self-efficacy is an important mediating mechanism in advancing understanding of the treatment of obesity. This study developed and validated the Weight Efficacy Life-Style Questionnaire (WEL), improving on previous studies by the use of clinical populations, cross-validation of the initial factor analysis, exploration of the best fitting theoretical model of self-efficacy, and examination of change in treatment. The resulting 20-item WEL consists of five situational factors: Negative Emotions, Availability, Social Pressure, Physical Discomfort, and Positive Activities. A hierarchical model was found to provide the best fit to the data. Results from two separate clinical treatment studies (total N = 382) show that the WEL is sensitive to changes in global scores as well as to a subset of the five situational factor scores. Treatment programs may be incomplete if they change only a subset of the situational dimensions of self-efficacy. Theoretical and clinical implications are discussed.
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In this article, we attempt to distinguish between the properties of moderator and mediator variables at a number of levels. First, we seek to make theorists and researchers aware of the importance of not using the terms moderator and mediator interchangeably by carefully elaborating, both conceptually and strategically, the many ways in which moderators and mediators differ. We then go beyond this largely pedagogical function and delineate the conceptual and strategic implications of making use of such distinctions with regard to a wide range of phenomena, including control and stress, attitudes, and personality traits. We also provide a specific compendium of analytic procedures appropriate for making the most effective use of the moderator and mediator distinction, both separately and in terms of a broader causal system that includes both moderators and mediators.
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There is a general perception that almost no one succeeds in long-term maintenance of weight loss. However, research has shown that ≈20% of overweight individuals are successful at long-term weight loss when defined as losing at least 10% of initial body weight and maintaining the loss for at least 1 y. The National Weight Control Registry provides information about the strategies used by successful weight loss maintainers to achieve and maintain long-term weight loss. National Weight Control Registry members have lost an average of 33 kg and maintained the loss for more than 5 y. To maintain their weight loss, members report engaging in high levels of physical activity (≈1 h/d), eating a low-calorie, low-fat diet, eating breakfast regularly, self-monitoring weight, and maintaining a consistent eating pattern across weekdays and weekends. Moreover, weight loss maintenance may get easier over time; after individuals have successfully maintained their weight loss for 2–5 y, the chance of longer-term success greatly increases. Continued adherence to diet and exercise strategies, low levels of depression and disinhibition, and medical triggers for weight loss are also associated with long-term success. National Weight Control Registry members provide evidence that long-term weight loss maintenance is possible and help identify the specific approaches associated with long-term success.
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Concerns about body shape are common among young women in Western cultures, and, in an extreme form, they constitute a central feature of the eating disorders anorexia nervosa and bulimia nervosa. To date there has been no satisfactory measure of such concerns. A self-report instrument, the Body Shape Questionnaire (BSQ) has therefore been developed. The items that constitute this measure were derived by conducting semistructured interviews with various groups of women including patients with anorexia nervosa and bulimia nervosa. The BSQ has been administered to three samples of young women in the community as well as to a group of patients with bulimia nervosa. The concurrent and discriminant validity of the measure have been shown to be good. The BSQ provides a means of investigating the role of concerns about body shape in the development, maintenance, and treatment of anorexia nervosa and bulimia nervosa.
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The development of the Dutch Eating Behaviour Questionnaire (DEBQ) with scales for restrained, emotional, and external eating is described. Factor analyses have shown that all items on restrained and external eating each have high loadings on one factor, but items on emotional eating have two dimensions, one dealing with eating in response to diffuse emotions, and the other with eating in response to clearly labelled emotions. The pattern of corrected item-total correlation coefficients and of the factors was very similar for various subsamples, which indicates a high degree of stability of dimensions on the eating behavior scales. The norms and Cronbach's alpha coefficients of the scales and also the Pearson's correlation coefficients to assess interrelationships between scales indicate that the scales have a high internal consistency and factorial validity. However, their external validity has yet to be investigated.
Book
I: Background.- 1. An Introduction.- 2. Conceptualizations of Intrinsic Motivation and Self-Determination.- II: Self-Determination Theory.- 3. Cognitive Evaluation Theory: Perceived Causality and Perceived Competence.- 4. Cognitive Evaluation Theory: Interpersonal Communication and Intrapersonal Regulation.- 5. Toward an Organismic Integration Theory: Motivation and Development.- 6. Causality Orientations Theory: Personality Influences on Motivation.- III: Alternative Approaches.- 7. Operant and Attributional Theories.- 8. Information-Processing Theories.- IV: Applications and Implications.- 9. Education.- 10. Psychotherapy.- 11. Work.- 12. Sports.- References.- Author Index.
Article
Many problems in randomized clinical trial design, execution, analysis, presentation and interpretation stem in part from an inadequate understanding of the roles of moderators and mediators of treatment outcome. As a result, 1) the results of clinical research are slow to have an impact on clinical decision making and thus to benefit patients; 2) it is difficult for clinicians or patients to apply randomized clinical trial results comparing two treatments (treatment versus control); 3) when such trials are conducted at various sites, the results often do not replicate; 4) when the results influence clinical decision making, the results clinicians obtain do not match what researchers report; and 5) the treatment effects comparing treatment and control conditions, particularly for psychiatric treatments, often seem trivial. In this review article, the author reviews and integrates the methodological literature concerning dealing with covariates in trials to emphasize their impact on clinical decision making. The goal of trials should ultimately be to establish who should get the treatment condition rather than the control condition (moderators) and to determine how to obtain the best outcomes with whatever is the preferred treatment (mediators). The author makes recommendations to clinicians as to which trials might best be ignored and which carefully considered, and urges clinical researchers to focus on studies best designed to reduce the burden of mental illness on patients.
Article
There is a general perception that almost no one succeeds in long-term maintenance of weight loss. However, research has shown that approximately 20% of overweight individuals are successful at long-term weight loss when defined as losing at least 10% of initial body weight and maintaining the loss for at least 1 y. The National Weight Control Registry provides information about the strategies used by successful weight loss maintainers to achieve and maintain long-term weight loss. National Weight Control Registry members have lost an average of 33 kg and maintained the loss for more than 5 y. To maintain their weight loss, members report engaging in high levels of physical activity ( approximately 1 h/d), eating a low-calorie, low-fat diet, eating breakfast regularly, self-monitoring weight, and maintaining a consistent eating pattern across weekdays and weekends. Moreover, weight loss maintenance may get easier over time; after individuals have successfully maintained their weight loss for 2-5 y, the chance of longer-term success greatly increases. Continued adherence to diet and exercise strategies, low levels of depression and disinhibition, and medical triggers for weight loss are also associated with long-term success. National Weight Control Registry members provide evidence that long-term weight loss maintenance is possible and help identify the specific approaches associated with long-term success.
Article
The development of the Dutch Eating Behaviour Questionnaire (DEBQ) with scales for restrained, emotional, and external eating is described. Factor analyses have shown that all items on restrained and external eating each have high loadings on one factor, but items on emotional eating have two dimensions, one dealing with eating in response to diffuse emotions, and the other with eating in response to clearly labelled emotions. The pattern of corrected item-total correlation coefficients and of the factors was very similar for various subsamples, which indicates a high degree of stability of dimensions on the eating behavior scales. The norms and Cronbach's alpha coefficients of the scales and also the Pearson's correlation coefficients to assess interrelationships between scales indicate that the scales have a high internal consistency and factorial validity. However, their external validity has yet to be investigated.
Article
Accurate prediction of weight loss success and failure has eluded researchers for many years. Thus, we administered a comprehensive psychometric battery before a 4-month lifestyle behavioral weight reduction program and analyzed weight changes during that period to identify baseline characteristics of successful and unsuccessful participants, among 112 overweight and obese middle-aged women (age, 47.8 ± 4.4 years; BMI, 31.4 ± 3.9 kg/m2). Mean weight and percentage fat losses among the 89 completers were -5.4 kg and -3.4%, respectively ( p Keywords: overweight women; psychosocial predictors; readiness; weight loss Document Type: Research Article Affiliations: 1: Department of Nutritional Sciences, Body Composition Research Laboratory, University of Arizona, Tucson, Arizona 85721. Exercise and Health Laboratory, Faculty of Human Movement, Technical University of Lisbon, Lisbon, Portugal 2: Department of Nutritional Sciences, Body Composition Research Laboratory, University of Arizona, Tucson, Arizona 85721 3: Department of Physiology, Body Composition Research Laboratory, University of Arizona, Tucson, Arizona 85721 4: Exercise and Health Laboratory, Faculty of Human Movement, Technical University of Lisbon, Lisbon, Portugal 5: Department of Physiology, Body Composition Research Laboratory, University of Arizona, Tucson, Arizona 85721; Lohman@u.arizona.edu Publication date: December 1, 2002 $(document).ready(function() { var shortdescription = $(".originaldescription").text().replace(/\\&/g, '&').replace(/\\, '<').replace(/\\>/g, '>').replace(/\\t/g, ' ').replace(/\\n/g, ''); if (shortdescription.length > 350){ shortdescription = "" + shortdescription.substring(0,250) + "... more"; } $(".descriptionitem").prepend(shortdescription); $(".shortdescription a").click(function() { $(".shortdescription").hide(); $(".originaldescription").slideDown(); return false; }); }); Related content In this: publication By this: publisher By this author: Teixeira, P.J. ; Going, S.B. ; Houtkooper, L.B. ; Cussler, E.C. ; Martin, C.J. ; Metcalfe, L.L. ; Finkenthal, N.R. ; Blew, R.M. ; Sardinha, L.B. ; Lohman, T.G. GA_googleFillSlot("Horizontal_banner_bottom");
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The consistent increase in the prevalence of obesity that currently occurs in industrialised countries can be explained by the existence of multiple behavioural actions that exert continuous pressure toward a positive energy balance. The present study examined the clustering of intrapersonal determinants of five energy balance-related behaviours (i.e., consumption of energy-dense snacks, the use of high-fat sandwich fillings, fruit consumption, active transport and physical activity during leisure time). The research population consisted of a large sample of Dutch adolescents (n = 3859; mean age 14.8; 55.2% girls). Attitude, subjective norm, perceived behavioural control and intention measures related to the various behaviours clustered more strongly than the behaviours themselves, with correlations ranging from 0.09 to 0.55. The consequences of adopting an energy balance approach are discussed.
Article
This study tested predictions from restraint theory [(1984). A boundary model for the regulation of eating. In: A. J. Stunkard, & E. Stellar (Eds.), Eating and its disorders (pp. 141–156) New York: Raven Press.] and the three-factor model of dieting [Psychol. Bull. 114 (1993) 100.] using an eating regulation paradigm. Participants were 42 obese, nonbinge eaters assigned to either a weight loss group (restrictive dieters or RDs) or a group designed to eliminate dieting (“undieters” or UDs). Participants took part in an ostensible ice cream taste test with or without a preload, both before and after the weight control intervention. At pretest, restraint theory's prediction that participants would engage in counter-regulatory eating was not supported. At posttest, after 8 weeks of the dieting interventions, RDs increased and UDs decreased their intake following a preload, a pattern most consistent with the predictions of restraint theory. This counter-regulatory trend was observed in spite of a significant decrease in RDs' Disinhibition scale scores following treatment. Implications of these findings for restraint theory, the three-factor model of dieting, and relapse in obesity treatment were discussed.
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Evaluated the reliability and validity of the Body Image Assessment (BIA), a measure designed to assess body image disturbances. 659 female Ss participated and represented 6 diagnostic groups (normals, bulimia nervosa, anorexia nervosa, bulimic binge-eaters, obese, and atypical eating disorder). Diagnoses were made using Diagnostic and Statistical Manual of Mental Disorders-III—Revised (DSM-III—R) criteria. Test–retest reliability was satisfactory. In 2 validity studies, the BIA was associated with other measures of eating disorder problems and differentiated eating disorder groups from normals. Normative data were presented as a function of actual body size so that raw scores could be interpreted in terms of standardized scores. The reliability and validity of the BIA was supported, especially for bulimia nervosa and binge-eater groups. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
The prevalence of obesity in developed countries has been steadily increasing. Comprehensive lifestyle change programs for the treatment of obesity have garnered considerable empirical support, but most weight lost in lifestyle interventions is regained within several years. The outcome of obesity prevention programs has also been disappointing. One reason for this state of affairs may be that most weight control programs are based on an assumption of equipotentiality of their intervention components. That is, obesity prevention and treatment programs consist of a multitude of behavioral, cognitive, nutritional, physical activity, and interpersonal techniques, all of which are assumed to be of roughly equal importance in weight control. However, there is considerable evidence that our evolutionary heritage has made most humans highly sensitive to the availability and nature of food in the environment. It therefore may be unrealistic to expect that enhancing self-regulatory skills will be sufficient to overcome the combined influence of our appetitive predispositions and the obesigenic environment. However, there is growing evidence that weight control interventions that focus on the availability, structure, composition, and portion size of foods in the diet improve long-term weight control. Concerted efforts to change the availability and nature of foods at both the individual and population level may hold considerable promise for the treatment and prevention of obesity.