No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Mediators of Weight Loss and Weight Loss Maintenance in Middle-aged Women
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.
... 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. ...
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. ...
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 ...
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.
... 15 Additionally, individuals who engage in flexible (less rigid) dietary approaches show better results in terms of sustained weight loss. 25 Notably, obsession-compulsion leads individuals to persist in actions and thoughts, and to be inflexible at 'unlearning' responses when they became obsolete. 26 Indeed, BS candidates also seem to report higher obsessive-compulsive behaviours compared to their peers. ...
... The literature also indicates that rigid eating patterns do not seem to work in the long run, whereas flexible approaches do. 25 It has been reported that being incapable to maintain 'all-or-nothing' (immutable) eating behaviours may increase compulsive eating, negative thoughts and emotions, and/or inadequate compensatory strategies. 25 Consequently, this can incite guideline abandonment. ...
... 25 It has been reported that being incapable to maintain 'all-or-nothing' (immutable) eating behaviours may increase compulsive eating, negative thoughts and emotions, and/or inadequate compensatory strategies. 25 Consequently, this can incite guideline abandonment. ...
Cognitive flexibility (CF) is a fundamental skill for behavioural regulation and adaptation during the weight-loss process. Research suggests that bariatric surgery (BS) candidates underperform consistently in the Wisconsin Card Sorting Test (WCST), which is a neuropsychological instrument that measures this ability. The current study explored the predictive value of preoperative performance in WCST CF dimensions alongside relevant psychological factors on weight loss after BS. The sample comprised 100 female patients who underwent BS in a public hospital in Lisbon, Portugal. We collected data using the WCST, the Hopkins Symptom Checklist-90-Revised (SCL-90-R), and the Binge Eating Scale (BES). Multiple linear regression (MLR) analyses were performed to obtain explanatory models of total weight loss at 12- and 24-postoperative months (TWL1 and TWL2, respectively). MLR identified the number of preservative responses as a highly significant predictor of TWL1 (p < 0.01), and the SCL-90-R obsession–compulsion and anxiety indices as highly significant predictors of TWL1 and TWL2 (p < 0.01). The number of preservative responses was a relevant predictor of weight loss at 12 months. Persisting in maladaptive cognitive strategies was associated with a lesser weight loss during the important period after BS that requires the adoption new lifestyle habits.
... 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. ...
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). ...
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 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]. ...
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.
... That study's researchers concluded that to prevent obesity over the long term, behavioral treatment approaches will need to effectively address emotional eating (Koenders & van Strien, 2011). That conclusion was suggested to be especially true for women (Teixeira et al., 2010). ...
... This is a limitation because timeseries findings are needed to inform researchers and practitioners of the dynamic processes occurring within obesity treatments, which evolve over months. One study that addressed changes in emotional eating and body satisfaction over 12 and 24 months of behavioral treatment indicated their significant bivariate relationship with weight loss; however, their interrelationship was not assessed (Teixeira et al., 2010). This was possibly due to the high number of related psychological variables included in that study that could have co-varied and/or induced a Type I error. ...
Because of social pressures for thinness in women, body image/body satisfaction is often problematic. Although associations between body satisfaction, emotional eating, and changes in both have been proposed, they are not well-understood and might have implications for weight loss treatments. Women participants of a community-based obesity treatment (Mage = 41.4 years) with either high (n = 65) or normal (n = 79) propensities for emotional eating at baseline were measured on body satisfaction, eating-related self-regulation, dimensions of negative mood and emotional eating, exercise and eating behaviors, and weight at baseline and Months 3 and 6. The high emotional eating group had significantly higher scores on the negative mood and emotional eating measures, and significantly lower body satisfaction. However, that group demonstrated significantly greater improvements on those measures, and on the intake of fruits/vegetables and sweets, than the normal emotional eating group. Body satisfaction change was significantly predicted by exercise, weight, and eating measure changes, unaffected by group. Changes in body satisfaction significantly predicted changes in emotional eating. However, when changes in self- regulation and the mood measures were entered as sequential mediators, the overall mediation models were significant but not those relationships. Findings will inform obesity treatment targets and improve potentials for reductions in the health risks of participants.
... 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. ...
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. ...
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]. ...
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]. ...
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]. ...
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). ...
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). ...
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 ...
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. ...
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. ...
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.
... Research shows that flexible and rigid controls of dietary intake have differential relationships to disordered eating and BMI [25]. Flexible control of dietary intake was negatively associated with BMI, whereas rigid control was positively associated with BMI [26][27][28]. ...
Valid and reliable measures are needed to identify individuals at risk of dietary restraint, emotional and external eating, and to customize weight loss education for more effective weight management. This study aimed to develop and validate a Chinese version of the Weight-Related Eating Behavior Questionnaire (WREQ-C) for assessing dietary restraint, emotional eating, and external eating. In stage one, the linguistic validation of the original English version of the WREQ (WREQ-E) was conducted. In stage two, the psychometric properties of the WREQ-C were first evaluated by item response theory-based (IRT) analyses. The reduced scale was then examined for convergent validity, structural validity (using a confirmatory factor analysis), population invariance, and test–retest reliability. The study included 1007 adults aged between 18 and 71 years. The IRT analysis optimally shortened the original WREQ-E from 16 to 13 items. A convergent validity analysis showed significant correlations between the WREQ-C subscales and the Chinese version of the Dutch Eating Behavior Questionnaire subscales (r = 0.63–0.82). The 13-item WREQ-C demonstrated good reliability (Cronbach’s α = 0.74–0.89) and validity for assessing the psychological aspects of eating behavior, including routine restraint, compensatory restraint, susceptibility to external cues, and emotional eating in Chinese adults.
... To sum up, our results point towards a self-focused, de cit-oriented exploration of one's own body in women with overweight and obesity without an eating disorder that might contribute to the maintenance of body dissatisfaction. As body dissatisfaction negatively in uences psychological well-being and weight loss success [39], targeting these attentional biases might help to enhance obesity treatment outcomes. ...
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.
... Studies suggest that strong restraint can be a protective factor, because it attenuates the associations between disinhibition of eating and weight among women and especially those with a very disinhibited diet (8,33). Other studies have also shown that the relation between weight control and cognitive restraint of eating might be positive but only effective in the short term, or, at least, not necessarily in the long term (34). Cognitive restraint is therefore necessary at the start of obesity management, and the protocol of hypnosis used in the present study may be useful to obtain prolonged weight loss. ...
Background:
The obesogenic environment of Western countries raises questions about its current management. Some clinical studies explore hypnosis, although the current state of knowledge does not lead to definitive conclusions about its efficacy.
Objective:
We assessed the impact of Ericksonian hypnosis and self-hypnosis on disinhibition of eating in adults with obesity and high food impulsivity levels compared to standard nutritional education.
Design:
From September 2014 to July 2015, adults with body mass index of 30-40 kg/m2 and a high disinhibition score (>8 on the Three Factor Eating Questionnaire, TFEQ-51) were included in a randomized controlled trial. The control and hypnosis groups received the same standard nutrition education in eight workshops. In the hypnosis group, subjects had eight sessions of hypnosis combined with training in self-hypnosis. Disinhibition (primary outcome) and other scores from the TFEQ-51 as well as anthropometric, food intake, cardiometabolic, and physical activity variables were collected at inclusion and at 8 months.
Results:
Of 82 randomized adults, 70 participated in all session, 80 participated in at least one session and were included in the main analysis (hypnosis group n=41; control group n=39). After 8 months of follow-up, disinhibition scores adjusted for baseline values were lower in the hypnosis group with a mean between-group difference of 4.2; 95% CI: 2.8, 5.5; p<0.001; 67.7% of adults in the hypnosis group had normalized their disinhibition (versus 11.1%; p<0.0001). Differences for weight (1.8 kg; 95% CI: -0.1, 3.7; p=0.052), body mass index (0.8 kg/m²; 95% CI: 0.1, 1.4; p=0.028), susceptibility to hunger score (2.2; 95% CI: 1.0, 3.3; p<0.001) and its two subscales also favored the hypnosis group.
Conclusions:
In the management of adults with obesity and high disinhibition score, hypnosis and self-hypnosis can significantly improve the deep mechanisms of eating behaviors and seems to have a beneficial effect on weight loss. Clinical Trial Registry: This trial was registered at clinicaltrials.gov as NCT02292108.
... Our results indicate that emotional eating behaviour is especially associated with a high sense of coherence, which could be a coping strategy to regulate emotions (87). Moreover, reducing emotional eating seems to be one of the self-regulation mediators for weight loss in females (103). It should be noted that the coherence scale of the IPQ-R directly assesses the disease and not the general sense of coherence (SOC). ...
Background
Current treatments of obesity often fail to consider gender and psychological aspects, which are essential for weight loss and weight maintenance. The aim of our study was to analyze subjective illness representations (SIRs) of adults with obesity according to the Common-Sense Self-Regulation Model (CSM) by assessing their associations with weight-related variables and gender.
Methods
Data was collected via online self-assessment between April 2017 and March 2018. SIRs were operationalized by the revised Illness Perception Questionnaire (IPQ-R) and illness outcomes according to the CSM were defined as BMI, eating behaviour, physical wellbeing, bodyweight satisfaction, and shape concerns. The sample consisted of 427 adults ( M = 42.2 years, SD = 10.9; 82% female) with obesity (BMI: M = 42.3 kg/m ² , SD = 9.0). Student's t- tests and multiple hierarchical regression analyses were conducted with the control variables (age and BMI) and subjective illness representations and gender as independent variables.
Results
The explanation of outcome variances was moderate to high (21-43%) except for restraint eating behaviour (10%). Subjective illness representations showed several significant associations with weight-related variables, especially timeline and emotional representations. Female gender was significantly associated with more restraint eating behaviour [ F (1, 400) = 4.19, p < 0.001] and females had unfavourable values of the weight-related variables as well as a more cyclic [ t (425) = 3.68, p < 0.001], and more emotional representation [ t (100) = 5.17, p < 0.001] of their obesity.
Conclusion
The results of this study indicate that gender and subjective illness representations, especially the emotional representation, play an important role for weight-related variables. Therefore, the assessment of SIRs may constitute an economic tool to identify specific individual deficits of self-regulation.
... Children's physical self-efficacy is negatively associated with their BMI (Carissimi et al., 2017) and is an important factor in weight management (Chen et al., 2016;Maximova et al., 2015). Researchers have identified that self-efficacy is one of the strongest predictors of a healthy lifestyle, a critical indicator of being physically active and fit, and it can fluctuate in different contexts (e.g., from exercise to eating) (Bektas, 2021;Teixeira et al., 2010). Therefore, self-efficacy is closely related to children's health and development, especially in terms of children's obesity and overweight issues (Annesi et al., 2015;Staiano et al., 2017). ...
This study investigated the relationship between children’s mathematics performance and physical health using data from the Early Childhood Longitudinal Study Kindergarten Class of 2010–2011 (ECLS-K 2011). A two-level hierarchical growth curve model was used to explore the relationships between childhood mathematics performance and childhood health taking moderator effects into consideration. The study results indicate that higher body mass index relates to higher kindergarten mathematics performance, holding all else constant. The results of this study have implications for educators, parents, and health providers in understanding the relationship between mathematics performance and health indicators.
... Despite this, obesity is a growing disease worldwide, being declared a global epidemic (WHO, 2000). Recent reviews and meta-analyses show that psychological interventions have a small to medium effect on weight loss (Comșa et al., 2020;Jacob et al., 2018), and much research showed that changing eating behaviors leads to weight loss (Linde et al., 2006;Teixeira et al., 2010Teixeira et al., , 2015. ...
Recent meta-analyses show that psychological interventions have a small to medium effect on weight loss. We propose here a different approach to changing eating intentions. According to the Free Will literature, people decide to act before they acknowledge it, and they decide based on the reconstruction of previous experiences. The action can thus be inhibited immediately (max 100ms) after awareness. We wanted to test if intervention based on this model, using hypnotic suggestions, can effectively change the intentions of eating. This study aims to identify which format of hypnotic suggestion can be more effective in changing eating intentions regarding high-calorie foods. Therefore, 88 healthy adult participants randomized in four groups received one session of hypnotic induction and suggestions or placebo. We measured the eating intentions through a computer task in which participants could choose pictures of low and high caloric food before, during, and after hypnosis. For the within-subject effect, results showed that two types of hypnotic suggestions significantly impacted the intentions of eating on high-calorie foods with large-effect, namely Cognitive Rehearsal (d=0.81, p<.001) and Memory Substitution (d=0.82, p<.001). After controlling for pre-test ratings, we found a significant between-effect: the Cognitive Rehearsal group differed significantly from the Control in terms of intentions of eating (d=0.85, p<.05). We conclude that hypnosis with Cognitive Rehearsal suggestions can help to positively impact the intentions of eating.
... 20,25 These data highlight the challenges with weight maintenance after weight loss that is common to all weight loss programs. 40 Ultimately, the question of whether the weight loss achieved in weight loss SMAs is superior to other behavioral weight loss interventions in primary care remains unanswered. ...
Purpose:
Shared medical appointments (SMAs) may help mitigate some of the barriers for managing obesity in primary care. The primary aim of this systematic review was to measure the effect of weight loss SMAs.
Methods:
Systematic searches using keywords and Medical Subject Headings for overweight, obesity, and SMAs were conducted in the CENTRAL, Medline Complete, PsycINFO, Scopus, CINAHL, EMBASE, and Web of Science databases with no date limits. Risk of bias was assessed using the Effective Health Practice Project Quality Assessment Tool for Quantitative Studies.
Results:
Fifteen studies involving weight loss SMAs in adults and children were identified. Six studies had controls. Inconsistency in reporting weight loss or weight change in controlled studies meant that data could not be pooled for meta-analysis. Results from individual studies indicated that SMAs can support adult patients to achieve significant weight loss. Women and older adults were more likely to take up SMA invitations. Results from the 5 studies involving children were less conclusive. Studies involving participants of a higher socioeconomic status tended to report lower attrition than studies involving participants who experienced disadvantage. These findings should be interpreted with caution as all but 1 included study was assessed as being weak in quality.
Conclusions:
Overall, SMAs may be of benefit to address obesity in primary care, particularly for women and older adults. Appropriately designed prospective and controlled studies are required to engage their target audience and to assess whether SMAs are superior to other weight loss options in primary care.
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.
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.
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.
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.
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.
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.
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.
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.
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/m ² , 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].
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.
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.
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.
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.
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
Obesity is a chronic disease with increasing prevalence. It affects quality of life and renders those affected at increased risk of mortality. For people living with obesity, weight loss is one of the most important strategies to improve health outcomes and prevent or reverse obesity-related complications. In line with newly released clinical practice guidelines, weight loss targets for people living with obesity should be defined individually based on their clinical profile, and progress measured in the context of improvements in health outcomes, rather than weight loss alone. We outline current treatment options for clinically meaningful weight loss and briefly discuss pharmacological agents and devices under development. Numerous studies have shown that weight loss of ≥5% results in significant improvements in cardiometabolic risk factors associated with obesity; this degree of weight loss is also required for the approval of novel anti-obesity medications by the US Food and Drug Administration. However, some obesity-related comorbidities and complications, such as non-alcoholic steatohepatitis, obstructive sleep apnea, gastroesophageal reflux disease and remission of type 2 diabetes, require a greater magnitude of weight loss to achieve clinically meaningful improvements. In this review, we assessed the available literature describing the effect of categorical weight losses of ≥5%, ≥10%, and ≥15% on obesity-related comorbidities and complications, and challenge the concept of clinically meaningful weight loss to go beyond percentage change in total body weight. We discuss weight-loss interventions including lifestyle interventions and therapeutic options including devices, and pharmacological and surgical approaches as assessed from the available literature.
Zusammenfassung
Hintergründe Gruppenprogramme zur Adipositastherapie unter Alltagsbedingungen sind wenig untersucht. Diese Studie analysiert das interprofessionelle Behandlungsprogramm bei Adipositas mit den Schwerpunkten Ernährungsverhalten und Lebensstiländerung (BASEL) bezüglich Effektivität und betrieblicher Wirtschaftlichkeit.
Material und Methodik Retrospektive Untersuchung der Gewichtsentwicklung von Programmstart bis Programmende sowie bis zum Nachtreffen. Analyse der Zusammenhänge zwischen einer Gewichtsreduktion≥5% und weiteren Faktoren durch eine multivariate logistische Regression. Zusätzlich erfolgte eine Kostenanalyse.
Ergebnisse Die 454 Teilnehmenden hatten ein mittleres Ausgangsgewicht von 114 kg (68–195 kg), BMI 40 kg/m2 (25,2–63,7), waren 46 Jahre (17–75) und mehrheitlich Frauen (72%). Bei Programmende lag die mittlere Gewichtsreduktion bei 4,9% (SD±4,2%) (44,3% erreichten Reduktion≥5%; 11,5% erreichten Reduktion≥10%). Beim Nachtreffen (n=256) betrug die Reduktion 7% (SD±6,4%) (33,5% erreichten Reduktion≥5%; 16,7% erreichten Reduktion≥10%). Personen, die≥75% der Lektionen und das Nachtreffen besuchten, hatten bei Programmende eine 3,8-mal höhere Chance zur erfolgreichen Gewichtsreduktion (≥5%), als Personen, die<75% der Lektionen besuchten und nicht zum Nachtreffen erschienen (p=<0,001). Der Kostendeckungsgrad des Programms lag bei 66%.
Schlussfolgerung Das BASEL ist ein effektives Adipositas-Behandlungsprogramm, wobei die regelmäßige Teilnahme mit einem besseren Therapieerfolg assoziiert war. Über die Hälfte der Personen mit hoher Teilnahmerate erzielten eine klinisch relevante Gewichtsreduktion von≥5%. Das Programm ist aufgrund tiefer Gruppentarife der Krankenversicherer in der Schweiz für Anbieter nicht kostendeckend.
Purpose: This study was conducted to identify influencing factors in a health promotion model that explains and predicts health promoting behavior in obese middle-aged women.Methods: Based on Pender’s health promotion model, a hypothetical model was constructed with nine factors (emotional eating, obesity stress, perceived benefits of action, perceived barriers to action, perceived self-efficacy, activity-related affect, social support, commitment to a plan of action, and health promoting behavior). The participants were 215 obese middle-aged women who visited one of three health check-up centers in Seoul, Incheon, or Gyeonggi Province to receive health check-ups through the National Health Insurance Corporation. Data were collected using a structured questionnaire.Results: In the final research model, the factors that had a direct impact on health promoting behavior of obese middle-aged women were obesity stress (β=-.17, p=.001), perceived self-efficacy (β=.34, p<.001), activity-related affect (β=.22, p<.001), commitment to a plan of action (β=.34, p<.001). The explanatory power was 51.3%.Conclusion: This study found that a higher level of engagement in health promoting behavior was associated with lower obesity stress, higher perceived self-efficacy, better activity-related affect, and a higher commitment to a plan of action. These results may be used as a basis for the development of a nursing intervention program to improve health promoting behavior in obese middle-aged women.
The accurate measurement of university students' motivation to participate in physical activity (PA) is a prerequisite to developing better physical fitness programs. However, motivation driven by government policies, i.e., physical education policies, are often excluded from many existing scales. The purpose of this study was to develop and evaluate a psychometric instrument based on self-determination theory that exclusively measures the motivation of Chinese university students to participate in PA. A total of 1,215 university students who regularly participated in PA at five universities in China constituted the final valid sample. Sample 1 (n = 311) was used to determine the underlying factor structure of the initial Chinese University Students' Physical Activity Motivation Scale (CUSPAMS) through exploratory factor analysis (EFA). Sample 2 (n = 330) was used to test the model fit of the EFA-derived factor structure and data through confirmatory factor analysis (CFA) and to test the internal consistency of each factor and of the whole scale. Sample 3 (n = 574) was used to confirm the model stability and criterion validity. Finally, 177 individuals were randomly selected from Sample 3 to perform test-retest reliability. Preliminary evidence showed that the nine-factor CUSPAMS, consisting of 32 items, yielded good psychometric characteristics. The development of the CUSPAMS provides an opportunity to improve current theories and practices regarding the assessment of PA motivation. The CUSPAMS is recommended for examining factors that influence motives as well as the impact of motives on PA among Chinese university students.
Gamified challenges, one of the most popular features of online weight-loss communities, enable users to set weight-loss goals and compete with other challenge participants via leaderboards. Using the data from a leading online weight-loss community, we study the effect of gamified challenges on the weight-loss outcome. Our findings indicate that participation in gamified challenges has a positive and significant effect on weight loss. We found that, on average, the participants achieved a weight loss of 0.742 kg by participating in at least one challenge a month. We found that effective challenges do not include a numeric weight goal (e.g., lose 5 kg), focus on exercise-only behavioral goals, and have a large active group size. Further, the results show that the absence (presence) of a numeric weight goal benefits users in exercise (diet) challenges. Moreover, a small active group size can help (hurt) users in exercise (diet) challenges. Our results suggest that gamification elements that induce competition should be used with caution in goal-setting environments, especially when gamifying dietary goals. Online weight-loss communities can recommend a useful combination of numeric weight goals, behavioral goals, and an optimal number of participants in each challenge to induce an encouraging level of social comparison.
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)
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.
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.
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.
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.
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)
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)
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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");
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.
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.
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)