The role of body image in the context of obesity treatment and associated behaviors in women

Doutoramento em Motricidade Humana na especialidade de Saúde e Condição FísicaThis dissertation sought to investigate the role of body image in the context of obesity treatment. Specifically, it was designed to i) identify correlates of pre-treatment body image (evaluation and investment dimensions) in overweight/obese women, ii) investigate body image changes during and after a lifestyle weight loss intervention, iii) examine how, and by what mechanisms, body image changed over time, and iv) investigate the implications of this change to the process of weight management and associated behaviors. The four studies included in this dissertation were developed in the context of a longitudinal randomized controlled trial, consisting of a 1-year behavior change intervention and a 2-year follow-up, including 239 premenopausal women with overweight or obesity (age: 37.6±7.1yr; BMI: 31.5±4.1kg/m2). The main intervention aimed at increasing physical activity, adopting a moderately restricted diet, and ultimately establishing exercise and eating patterns that would support weight maintenance. A module covering body image contents was also included. The comparison group received a general health education curriculum. Study 1 highlighted the damaging effect of dysfunctional investment in appearance, rather than body dissatisfaction, for psychological well-being, and showed that controlled motivations might be one of the mechanisms behind this detrimental effect. In turn, studies 2 and 3 suggested that body image could be effectively enhanced during obesity treatment, leading to a healthier eating self-regulation, and emphasized that physical activity could play an important role in improving body image in overweight/obese women, and also in preventing its deterioration overtime, mainly by tapping its excessive salience to one’s life and self. Finally, study 4 showed that body image investment and depressive mood (to a lesser extent) mediated the relation between physical activity and critical markers of eating self-regulation, and suggested that these associations are relatively consistent in this population. These findings highlighted the importance of enhancing body image during obesity treatment, especially its investment component, to improve well-being, eating regulation, and ultimately weight-related outcomes. Future weight loss interventions would benefit from performing a more thorough assessment of body image investment features and from proactively addressing them as part of their protocols. Furthermore, regular physical activity participation should be emphasized in these interventions, given its important contribution to long-term weight management, which goes beyond increased energy expenditure. In fact, physical activity can also ameliorate key psychological variables such as body image and even prevent their deterioration overtime, which in the end, might reduce susceptibility to relapse and favor lasting weight maintenance.Esta dissertação investigou o papel da imagem corporal no contexto do tratamento da obesidade. Teve como objetivos específicos: i) identificar correlatos da imagem corporal (dimensões de insatisfação e investimento disfuncional na imagem) à entrada de uma intervenção de controlo do peso, ii) investigar as alterações da imagem corporal durante e após uma intervenção comportamental de controlo do peso, iii) explorar potenciais mecanismos subjacentes às alterações da imagem corporal; e iv) investigar as implicações destas alterações no processo de gestão do peso e comportamentos associados. Os quatro estudos desta tese foram desenvolvidos no âmbito de um estudo experimental, controlado e com distribuição aleatória (RCT), compreendendo uma intervenção de 1 ano e um follow-up de 2 anos. A amostra incluiu 239 mulheres pré-menopáusicas com excesso de peso ou obesidade (idade: 37.6±7.1 anos; IMC: 31.5±4.1kg/m2). A intervenção visou estabelecer padrões saudáveis de atividade física e comportamento alimentar, compatíveis com a manutenção do peso no longo-prazo. Incluiu também um módulo direcionado para as questões da imagem corporal. O grupo de controlo teve acesso a um currículo geral de educação para a saúde. (...

Efeitos psicológicos da música em praticantes de exercício: Uma revisão sistemática

Aim: This systematic review sought to summarize the available evidence on the effect of music presence in gym classes in motivation, vitality, exercise affective response, and perceived exertion, among other psychological factors. Methods: The search of articles published until January 2018 was conducted in three online databases (Pubmed, PsycINFO and SPORTDiscus) following PICO model, and complemented manually. The following information was extracted from the selected articles: type of study, intervention characteristics, music condition and instruments, outcomes and assessment instruments, main results, and study methodological quality. The later was assessed with the Quality Assessment Tool for Quantitative Studies. Results: A total of 32 articles were included, of which 5 reported effects on motivation, 15 on exercise affective response, 23 on perceived exertion, and 4 on the motivational aspects of music. Music presence was positively associated with higher levels of motivation (n=3), a more positive affective response to exercise (n=8), but generally not associated with lower levels of perceived exertion (n=16). Conclusion: Although music presence appears to have a potentially positive effect on motivation levels and exercise affective response, the variability in sample characteristics, research protocols, and assessment instruments prevents drawing conclusions, highlighting the need for more studies on this topic.Objetivo: Esta revisión sistemática tuvo el objetivo de resumir la evidencia existente sobre el efecto de la utilización de música durante la práctica de ejercicio en el gimnasio en la motivación, vitalidad, respuesta afectiva al esfuerzo y percepción subjetiva de esfuerzo, entre otros factores psicológicos. Métodos: La investigación de artículos publicados hasta Enero de 2018 fue hecha en 3 bases de datos (Pubmed, PsycINFO y SPORTDiscus), siguiendo el modelo PICO, y complementada manualmente. La siguiente información fue extraída de los artículos seleccionados: tipo de estudio, características de la intervención, música (condición e instrumentos), outcomes (e instrumentos), resultados y calidad metodológica. Esta última fue evaluada a través de la Quality Assessment Tool for Quantitative Studies. Resultados: Se han incluido 32 artículos. De estos, 5 reportaron efectos en la motivación, 15 en la respuesta afectiva al esfuerzo, 23 en la percepción de esfuerzo y 4 en los componentes motivacionales de la música. La presencia de música se mostró positivamente asociada a mayores niveles de motivación (n = 3), a una respuesta afectiva al esfuerzo más positivo (n = 8), pero en general no se mostró asociada a menores niveles de percepción de esfuerzo (n = 16). Conclusión: A pesar de que la presencia de música parece tener un efecto potencialmente positivo en el nivel de motivación y en la respuesta afectiva al esfuerzo, la variabilidad de las muestras, de los protocolos de investigación y de los instrumentos utilizados en la medición de las variables imposibilitan la retirada de conclusiones, subrayando la necesidad de nuevos estudios sobre esta temática.Objetivo: Esta revisão sistemática teve o objetivo de sumariar a evidência existente sobre o efeito da utilização de música durante a prática de exercício em ginásio na motivação, vitalidade, resposta afetiva ao esforço e perceção subjetiva de esforço, entre outros fatores psicológicos. Métodos: A pesquisa de artigos publicados até Janeiro de 2018 foi feita em 3 bases de dados (Pubmed, PsycINFO e SPORTDiscus), seguindo o modelo PICO, e complementada manualmente. A seguinte informação foi extraída dos artigos selecionados: tipo de estudo, características da intervenção, música (condição e instrumentos), outcomes (e instrumentos), resultados e qualidade metodológica. Esta última foi avaliada através do Quality Assessment Tool for Quantitative Studies. Resultados: Foram incluídos 32 artigos. Destes, 5 reportaram efeitos na motivação, 15 na resposta afetiva ao esforço, 23 na perceção subjetiva de esforço e 4 nas componentes motivacionais da música. A presença de música mostrou-se positivamente associada maiores níveis de motivação (n=3), a uma resposta afetiva ao esforço mais positiva (n=8), mas na generalidade não se mostrou associada a menores níveis de perceção de esforço (n=16). Conclusão: Apesar da presença de música aparentar ter um efeito potencialmente positivo no nível de motivação e na resposta afetiva ao esforço, a variabilidade das amostras, dos protocolos de investigação e dos instrumentos utilizados na aferição das variáveis impossibilitam a retirada de conclusões, sublinhando a necessidade de novos estudos sobre esta temática

Perceived Environmental Supportiveness Scale: Portuguese Translation, Validation and Adaptation to the Physical Education Domain

Aim: Grounded on Self-Determination Theory, this study aimed to translate, adapt and validate the Perceived Environmental Supportiveness Scale (PESS) in a sample of Portuguese physical education students. Methods: The global sample was comprised of 964 students (518 females), divided in two groups: the calibration (n = 469) and the validation one (n = 483), all of them enrolled in two Physical Education (PE) classes/week. Results: The analysis provided support for a one factor and 12 items model, which are in line with the values adopted in the methodology (χ² = 196.123, df = 54, p = <.001, SRMR = .035, NNFI = .943, CFI = .954, RMSEA = .074, 90% CI .063-.085). Results express that the models are invariant in all analysis (i.e., calibration vs. validation, male vs. female,and 3rd vs. secondary cycle; three and single factor models). Conclusion: The present study suggests that the PESS with one factor and 12 items has good psychometric properties and can be used to assess perceived need supportive motivational environments provided by PE teachers. Additionally, invariance analysis showed support for the use of the scale in both genders and in the 3rd and secondary cycles.info:eu-repo/semantics/publishedVersio

Systematic Review of Psychological and Behavioral Correlates of Recreational Running

Introduction: The aim of this review was to systematically synthesize the published literature describing the psychological and behavioral correlates of recreational running in adults, defined as running for leisure, with or without a competitive component. Methods: Quantitative research published in peer-reviewed journals until January 2021 were included. Studies were identified through MEDLINE, PsycINFO, SPORTDiscus, and Web of Science and were included in this review if they (1) were aimed at recreational running, (2) included general adult samples (18 years or older, without a diagnosed medical condition or metabolic disorder), and (3) assessed psychological or behavioral correlates of recreational running. Results: Fifty-six articles reporting 58 studies met the eligibility criteria and were included. There were 27 cross-sectional studies, 12 longitudinal studies, and 19 trials (8 non-controlled trials, 5 controlled trials, and 6 randomized controlled trials) (n = 37,501, 1877 years old, 43% women). Twenty-eight studies assessed antecedents of running behavior, and 25 studies used running behavior as treatment or predictor of a given effect or outcome. Four studies examined both predictors and outcomes of running. Thirty-one studies showed poor quality, while 20 had fair and 7 good quality. Motives were the most frequently studied antecedent of running behavior (k = 19), and results suggest that the highest-ranked or more prevalent motives were physical health, psychological motives, and personal achievement. Additionally, perceived control, attitude toward running, intention and subjective norms, self-efficacy, and social support may have also played a role in the adoption of recreational running. Moreover, improvements in mood (k = 10) and well-being (k = 10) were the most frequently reported positive outcomes of running. Reductions in depression, anxiety, and stress were also reported in included studies. Discussion: To our knowledge, this is the first systematic review on this topic. The identification of behavioral and psychological correlates of recreational running across populations can contribute to inform and guide a public policy agenda, focused on helping people sustain regular physical activity, through a modality they have chosen and appear to enjoy. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=68954, identifier: CRD42017068954.info:eu-repo/semantics/publishedVersio

a systematic review

Funding Information: This research received no external funding. C.S.S. is supported by the Portuguese Foundation for Science and Technology (SFRH/BD/139603/2018). The funder had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. Publisher Copyright: © 2023, BioMed Central Ltd., part of Springer Nature.Background: Translation into practice of effective physical activity interventions in primary care is difficult, due to a complex interaction of implementation determinants. We aimed to identify implementation barriers and facilitators of four primary care interventions: physical activity assessment, counselling, prescription, and referral. Methods: A systematic review of qualitative, quantitative and mixed-methods studies published since 2016 was conducted. The “Tailored Implementation for Chronic Diseases” (TICD) framework was adapted to extract and synthesize barriers and facilitators. Results: Sixty-two studies met the inclusion criteria. Barriers (n = 56) and facilitators (n = 55) were identified across seven domains, related to characteristics of the intervention, individual factors of the implementers and receivers, organizational factors, and political and social determinants. The five most frequently reported determinants were: professionals’ knowledge and skills; intervention feasibility/compatibility with primary health care routine; interventions’ cost and financial incentives; tools and materials; and professionals’ cognitions and attitudes. “Social, political and legal factors” domain was the least reported. Physical activity counselling, prescription, and referral were influenced by determinants belonging to all the seven domains. Conclusion: The implementation of physical activity interventions in primary care is influenced by a broader range of determinants. Barriers and facilitators related with health professionals, intervention characteristics, and available resources were the most frequently reported. A deep understanding of the local context, with particularly emphasis on these determinants, should be considered when preparing an intervention implementation, in order to contribute for designing tailored implementation strategies and optimize the interventions’ effectiveness.publishersversionpublishe

Body image change and improved eating self-regulation in a weight management intervention in women

<p>Abstract</p> <p>Background</p> <p>Successful weight management involves the regulation of eating behavior. However, the specific mechanisms underlying its successful regulation remain unclear. This study examined one potential mechanism by testing a model in which improved body image mediated the effects of obesity treatment on eating self-regulation. Further, this study explored the role of different body image components.</p> <p>Methods</p> <p>Participants were 239 overweight women (age: 37.6 ± 7.1 yr; BMI: 31.5 ± 4.1 kg/m²) engaged in a 12-month behavioral weight management program, which included a body image module. Self-reported measures were used to assess evaluative and investment body image, and eating behavior. Measurements occurred at baseline and at 12 months. Baseline-residualized scores were calculated to report change in the dependent variables. The model was tested using partial least squares analysis.</p> <p>Results</p> <p>The model explained 18-44% of the variance in the dependent variables. Treatment significantly improved both body image components, particularly by decreasing its investment component (<it>f²</it>= .32 vs. <it>f²</it>= .22). Eating behavior was positively predicted by investment body image change (p < .001) and to a lesser extent by evaluative body image (p < .05). Treatment had significant effects on 12-month eating behavior change, which were fully mediated by investment and partially mediated by evaluative body image (effect ratios: .68 and .22, respectively).</p> <p>Conclusions</p> <p>Results suggest that improving body image, particularly by reducing its salience in one's personal life, might play a role in enhancing eating self-regulation during weight control. Accordingly, future weight loss interventions could benefit from proactively addressing body image-related issues as part of their protocols.</p

Successful behavior change in obesity interventions in adults: a systematic review of self-regulation mediators

International audienceBackground: Relapse is high in lifestyle obesity interventions involving behavior and weight change. Identifying mediators of successful outcomes in these interventions is critical to improve effectiveness and to guide approaches to obesity treatment, including resource allocation. This article reviews the most consistent self-regulation mediators of medium-and long-term weight control, physical activity, and dietary intake in clinical and community behavior change interventions targeting overweight/obese adults. Methods: A comprehensive search of peer-reviewed articles, published since 2000, was conducted on electronic databases (for example, MEDLINE) and journal reference lists. Experimental studies were eligible if they reported intervention effects on hypothesized mediators (self-regulatory and psychological mechanisms) and the association between these and the outcomes of interest (weight change, physical activity, and dietary intake). Quality and content of selected studies were analyzed and findings summarized. Studies with formal mediation analyses were reported separately. Results: Thirty-five studies were included testing 42 putative mediators. Ten studies used formal mediation analyses. Twenty-eight studies were randomized controlled trials, mainly aiming at weight loss or maintenance (n = 21). Targeted participants were obese (n = 26) or overweight individuals, aged between 25 to 44 years (n = 23), and 13 studies targeted women only. In terms of study quality, 13 trials were rated as " strong " , 15 as " moderate " , and 7 studies as " weak ". In addition, methodological quality of formal mediation analyses was " medium ". Identified mediators for medium-/long-term weight control were higher levels of autonomous motivation, self-efficacy/barriers, self-regulation skills (such as self-monitoring), flexible eating restraint, and positive body image. For physical activity, significant putative mediators were high autonomous motivation, self-efficacy, and use of self-regulation skills. For dietary intake, the evidence was much less clear, and no consistent mediators were identified. Conclusions: This is the first systematic review of mediational psychological mechanisms of successful outcomes in obesity-related lifestyle change interventions. Despite limited evidence, higher autonomous motivation, self-efficacy, and self-regulation skills emerged as the best predictors of beneficial weight and physical activity outcomes; for weight control, positive body image and flexible eating restraint may additionally improve outcomes. These variables represent possible targets for future lifestyle interventions in overweight/obese populations

Keep on running – a randomized controlled trial to test a digital evidence-based intervention for sustained adoption of recreational running: rationale, design and pilot feasibility study

Background: This paper describes the rationale, intervention development, study design and results from the pilot feasibility study of the Keep On Running (KOR) trial. KOR aims to test a web-based brief theory-based intervention, targeting maintenance of recreational running behavior over time (i.e. relapse preventing). Methods: Intervention development was based both on Self- Determination Theory and on Self-Regulation Theory. As part of it, a pilot study was implemented (n=18) to measure intervention adherence and participant satisfaction in order to establish the feasibility and acceptability of the intervention toolkit. Furthermore, this pilot study was also used to test the feasibility and acceptability of the questionnaires selected to be part of the later RCT. Results: Pilot intervention acceptability was good, but overall adherence was low. Features such as feedback and social sharing should be added to the toolkit. The main trial should lessen questionnaire length and include data from usual monitoring gadgets and apps (APIs). The protocol of the RCT was adjusted to test the efficacy of the refined final version of the intervention, and the RCT that will test it, contributing to the understanding of recreational running sustainability, allowing the optimization of future interventions aimed at physical activity promotion.Fundação para a Ciência e Tecnologia - FCTinfo:eu-repo/semantics/acceptedVersio

Questionnaires measuring movement behaviours in adults and older adults: content description and measurement properties. A systematic review

Background Sleep, sedentary behaviour and physical activity are constituent parts of a 24h period and there are several questionnaires to measure these movement behaviours, the objective was to systematically review the literature on content and measurement properties of self- and proxy-reported questionnaires measuring movement behaviours in adults and older adults. Methods The databases PubMed, CINAHL, PsycINFO and SPORTDiscus were systematically searched until April 2021. Articles were included if: the questionnaires were design for adults and older adults; the sample size for validity studies had at least 50 participants; at least, both validity and test-retest reliability results of questionnaire that were developed specifically to measure the amount of sleep, sedentary behaviour or physical activity, or their combination were reported; and articles had to be written in English, Spanish, French, Portuguese, German, Italian or Chinese. Findings and conclusions Data extraction, results, studies’ quality, and risk of bias were evaluated using the Consensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines. Fifty-five articles were included in this review, describing 60 questionnaires. None of the questionnaires showed adequate criterion validity and adequate reliability, simultaneously; 68.3% showed adequate content validity. The risk of bias for criterion validity and reliability were very low in 72.2% and 23.6% of the studies, respectively. Existing questionnaires have insufficient measurement properties and frequent methodologic limitations, and none was developed considering the 24h movement behaviour paradigm. The lack of valid and reliable questionnaires assessing 24h movement behaviours in an integrated way, precludes accurate monitoring and surveillance systems of 24h movement behaviours.info:eu-repo/semantics/publishedVersio