Treatment-associated Improvements in Self-regulation and Mood as Theory-based Correlates of Increased Self-efficacy for Weight-management Behaviors

Expanded understanding of the psychosocial dynamics of weight-loss treatment processes is required to improve consistently poor results. Women with obesity of ages 40–59 years participated in self-regulation-based (n = 41) and information-based (n = 46) treatments. Improvements in self-regulation and self-efficacy related to exercise and eating, mood, exercise, intake of fruits/vegetables and sweets, and weight were significant, and generally greater in the self-regulation group. Exercise- and eating-behavior changes significantly mediated the prediction of self-efficacy changes by changes in self-regulation, with mood change significantly adding to the prediction strength. Findings suggested the value in supporting exercise for its psychosocial benefits within weight-loss treatment

Comparative Effects of Weight Loss Associated with a Consistent Volume of Exercise Within Education-Focused vs. Self-Regulation-Focused Obesity Treatments in Women

Although exercise is generally included in behavioral weight-management treatments, its association with weight loss cannot be reconciled by its corresponding energy expenditures in formerly low-active adults with obesity. It has been suggested that the self-regulation needed to maintain exercise carries over to more controlled eating (i.e., coaction) and weight loss, with exercise-associated mood improvements also having positive impacts on eating behaviors and weight. To clarify these findings to improve behavioral interventions, women randomly assigned to community-based obesity treatments with either a self-regulation focus (n = 40) or educational focus (n = 25) were included in the present reanalysis of recent data. A requirement for inclusion within the present study was completion of 2 to 5 moderate exercise sessions per week (retrospectively assessed), regardless of treatment condition. Demographic data, weight, self-regulation, and negative mood did not significantly differ, by group, at baseline. Only reduction in weight significantly differed over 6 months, with a more pronounced improvement in the self-regulation-focused group. Changes in both self-regulation and negative mood significantly mediated the relationship between group and weight loss. Further regression analysis indicated that the entry of group significantly added to the prediction of weight change by (a) both self-regulation and mood change, and (b) change in self-regulation alone. For the present adherents to a moderate amount of exercise, improvements in self-regulation and mood explained a considerable amount of the variance (32%–37%) in weight loss over 6 months. However, analyses of effects from additional, possibly related, psychosocial variables based on theory and/or prior research (e.g., self-efficacy, emotional eating) will expand understandings of the value of moderate exercise beyond associated energy expenditures within varied behavioral obesity-treatment foci

Indirect Effect of Self-Regulated Exercise on Mood Through Self-Efficacy Changes

To improve deficient long-term effects, an improved understanding of psychosocial factors occurring within behavioral obesity treatments is required. The aim of this study was to suggest paths from changes in self-regulation toward reduced negative mood to inform the direction of more comprehensive investigations and treatment foci. Initially low active women (N = 87) participated in a theory-driven community-based behavioral obesity program emphasizing self-regulation and exercise. There were significant (ps \u3c .001) improvements in exercise amounts, exercise-related self-regulation and self-efficacy, negative mood, and emotional eating during the weight loss phase of baseline–Month 6, and significant (ps \u3c .01) deteriorations during the weight-loss maintenance phase of Month 6–Month 24. During both phases, significant paths (95% CIs [-0.31, -0.01], [-0.14, -0.01], and [-0.50, -0.01]) from changes in self-regulation toward reduced negative mood were through self-efficacy, but not exercise change itself. The mood change-emotional eating change relationships were significant (95% CIs [0.16, 0.39] and [0.19, 0.48]). Although extensions of this research are required to better understand long-term obesity intervention processes, the present findings suggest importance of treatment foci on identified psychological mechanisms of exercise treatment-mood change relationships

Relation of Changes in Body Satisfaction with Propensities for Emotional Eating Within a Community-delivered Obesity Treatment for Women: Theory-based Mediators

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

Weight-Loss Treatment-induced Physical Activity Associated with Improved Nutrition through Changes in Social Cognitive Theory Variables in Women with Obesity

Behavioral weight-loss treatments have typically been unsuccessful and a theoretical. Even when treatments were scientifically derived, theory has rarely been used to decompose, and understand the bases of, their effects. This 2-year study evaluated mediation of the prediction of nutritional changes by changes in physical activity, through social cognitive theory variables. Data from women with Class 1–2 obesity, classified as “insufficiently active” (N = 50; Mage = 47.6 years), were extracted from 2 initial trials of a new cognitive-behavioral intervention. That treatment sought to improve self-regulation, mood, and self-efficacy through increased physical activity, to then induce improved eating and long-term weight loss. Data showed significant improvements in self-regulation for controlled eating, mood, self-efficacy for eating, physical activity/exercise outputs, and intake of fruits/vegetables and sweets. In the prediction of changes in fruit/vegetable intake over 6, 12, and 24 months by physical activity changes, changes in the 3 psychosocial variables were significant mediators. For each of those significant overall models (R2-values =.31, .30, and .25, respectively), self-regulation and self-efficacy change were independent mediators. When change in sweets was substituted for fruits/vegetable intake in otherwise identical models, although overall significance was not found, change in mood was a significant mediator. Changes in intake of fruits/vegetables and sweets significantly predicted a 2-year mean weight loss of 5.4 kg (-5.7% reduction). Results generally supported the basis for the architecture of the new cognitive-behavioral treatment. Based on findings, much of the effect of physical activity/exercise on weight loss could be explained through its impact on psychosocial correlates of healthier eating

Effects of Body Satisfaction and Emotional Eating on Obesity Treatment-Related Changes in Weight and Waist Circumference Over 2 Years: A Serial Multiple Mediation Analysis

Maintenance of lost weight beyond 6 months in adults with obesity remains problematic. To reliably impact obesity over the long term, an improved understanding of treatment-associated changes in psychosocial factors is required. Women are especially susceptible to body image concerns and emotional eating; however, associations among those variables within weight-management processes have been limited to either cross-sectional or short-term analyses. Women with obesity (Mage = 47.4 years, SD = 8.6) who participated in either a year-long YMCA-based cognitive-behavioral treatment emphasizing self-regulation of exercise and eating (n = 54), or a similar treatment that also included brief phone follow-ups of learned self-regulatory skills monthly during a second treatment year (n = 74), were assessed on weight and waist circumference changes over 6 and 24 months and changes in body satisfaction and emotional eating over 12 months. Improvements on all measures were significant with no time × group interaction. In aggregated analyses, there were significant direct relationships between changes in weight over 6 and 24 months, between changes in body satisfaction and emotional eating, and between those psychosocial changes and weight changes. Within serial multiple mediation models incorporating lagged variable analyses, only the path from changes in weight from baseline–Month 6→body satisfaction from baseline–Month 12→weight from baseline–Month 24 was significant. Results were similar when waist circumference was entered in place of weight. Findings suggest body satisfaction requires an increased focus within behavioral treatments for women with obesity to maximize their maintenance or extension of early reductions in weight and waist circumference

Relationship of Exercise Volume with Change in Depression and Its Association with Self-Efficacy to Control Emotional Eating in Severely Obese Women

Introduction. Exercise may improve one's perceived ability to control overeating related to negative emotions through psychological pathways such as reduced depression; however, the volume required is unclear. Methods. Severely obese women (N = 88) participated in a 24-week exercise and nutrition treatment incorporating self-regulatory skills training, and were assessed on depression, self-efficacy, self-regulatory skills usage, weight, and waist circumference, at baseline and treatment end. Results. Subjects completing low-moderate (40–149.9 minutes/week) and public health (≥150 minutes/week) volumes of exercise had significant and similar reductions in depression scores. No significant changes were found for those completing <40 minutes/week. For all subjects aggregated, depression change was significantly related to change in self-efficacy to control emotional eating; however, this relationship was completely mediated by changes in self-regulatory skill usage. When changes in depression, self-efficacy, and self-regulatory skills usage were entered into multiple regression equations as predictors, only self-regulatory skill changes explained significant unique portions of the overall variance in weight and weight circumference change. Discussion. Exercise of less than half the public health recommendation was associated with depression improvement, with no dose-response effect. Changes in depression, self-efficacy, and self-regulation may be salient variables to account for in behavioral weight-loss treatment research

Early Effects of Improved Mood on Propensity for Emotional Eating During the Physical Activity-only Phase of a Community-Based Behavioral Treatment for Obesity in Women with High Mood Disturbance

Weight loss beyond the short term is problematic for individuals with obesity. Especially for women, emotional eating is one of the greatest barriers and might require attention early in a behavioral weight-loss program. Physical activity-associated mood improvement may be associated with reduced emotional eating. Women with obesity volunteered for a community-based weight-management treatment. Effects associated with the initial 10 weeks, which focused on behavioral support of physical activity (prior to addressing eating behavior change), were assessed. Groups were designated based on whether participants’ high total mood disturbance (TMD) scores reduced to a normal level (n = 45) or remained high (n = 27). Although significant overall improvements in emotional eating were found, F(1, 70) = 22.80, p \u3c .001, its change scores did not significantly differ by group, F(1, 70) = 0.82, p = .370. Using aggregated data, the prediction of reduction in emotional eating by lowered TMD scores was not statistically significant. Adding change in self-efficacy for controlled eating into Step 2 of the regression model significantly increased the explained variance to R2 = .10, p = .014, with group not being a significant contributor when added in Step 3. TMD reduction was significantly predicted by increase in physical activity, β = -.23, p = .028, and completion of at least 3 bouts/week, rpb = -.22, p= .015. Because physical activity-related reductions in negative mood and increases in self-efficacy were associated with reduced emotional eating, viability for those behavioral factors as early treatment targets were signaled

Short- and Long-Term Weight Loss Among Women Is Unrelated to Completed Exercise Within an Obesity Intervention Focused on Self-Regulation

Introduction: The aim of this study was to evaluate 1) if completed exercise amounts were associated with short- and long-term weight loss within a cognitive behavioral intervention and 2) if changes in theory-based psychosocial factors significantly explained weight change. Methods: A total of 110 women with obesity participated in a yearlong treatment focused on self-regulation and were grouped based on their amount of completed exercise and assessed on changes in weight, self-regulation, and self-efficacy. Results: There were significant overall improvements in all study measures from baseline–month 6 and baseline–month 12. Overall weight loss means (–5.8 and –5.3 kg, respectively) did not significantly differ across groups averaging the equivalent of \u3c 2.5; 2.6–4.5; 4.6–7.0; and \u3e 7.0 moderate-intensity exercise sessions per week. Similarly, psychosocial improvements did not significantly differ by exercise amount grouping. Increase in exercise self-regulation significantly predicted eating self-regulation gains over both 6 and 12 months. Over the same time periods, the significant prediction of weight loss by eating self-regulation increase was mediated by change in eating self-efficacy. Conclusion: Results suggest attainment of government-recommended amounts of exercise are not associated with significantly greater weight loss than lower amounts of exercise within an intervention focused on self-regulation. Associations of exercise with psychosocial correlates of weight loss should be a treatment consideration