Background: Behavioral obesity treatments remain primarily based on nutrition and exercise education, with their minimal effects persisting over many decades. Research suggests benefits of an alternate focus on psychosocial factors. Aim: To evaluate treatment aspects that foster accumulated impacts on weight-loss behaviors via interactions between supported changes in self-efficacy and self-regulation. Methods: Women with obesity participating in a theory-based behavioral weight-loss treatment targeting self-regulation and self-efficacy to foster increases in fruit/vegetable consumption and physical activity (N = 95) were assessed at intervals from baseline through 12 months. Results: The treatment was associated with significant improvements in the tested psychosocial and behavioral variables. Hypothesized paths from baseline self-efficacy → 3-month increases in self-regulation → 6-month increases in self-efficacy → 12-month increases in self-regulation → 12-month behavioral changes were significant in predicting both fruit/vegetable intake and physical activity increases. Most of the variance in weight loss was explained through physical activity change. Conclusion: Targeting self-regulation, self-efficacy, and their over-time interactions enhances behavioral weight-loss treatment outcomes.
AmesGEHeckmanMGGrotheKB, et al. (2012) Eating self-efficacy: Development of a short-form WEL. Eating Behaviors13(4): 375–378.
2.
AnnesiJJ (2020) Relationship between learned self-regulation skills and changes in weight-loss behaviors: Mediation by barriers self-efficacy. Journal of Prevention and Health Promotion1(2): 264–287.
3.
AnnesiJJ (2022) Behavioral weight loss and maintenance: A 25-year research program informing innovative programming. Permanente Journal26(2): 98–117.
4.
AnnesiJJMartiCN (2011) Path analysis of exercise treatment-induced changes in psychological factors leading to weight loss. Psychology and Health26(8): 1081–1098.
5.
AnnesiJJVaughnLL (2011) Relationship of exercise volume with change in depression and its association with self-efficacy to control emotional eating in severely obese women. Advances in Preventive Medicine2011: 514271.
6.
BanduraA (1986) Social Foundations of Thought and Action: A Social Cognitive Theory. Upper Saddle River, NJ: Prentice Hall.
7.
BanduraA (1997) Self-Efficacy: The Exercise of Control. New York, NY: Freeman.
8.
CannonCPKumarA (2009) Treatment of overweight and obesity: Lifestyle, pharmacologic, and surgical options. Clinical Cornerstone9(4): 55–71.
9.
ClarkMMAbramsDBNiauraRS, et al. (1991) Self-efficacy in weight management. Journal of Consulting and Clinical Psychology59(5): 739–744.
10.
CohenJCohenPWestSG, et al. (2003) Applied Multiple Regression/Correlation Analysis for the Behavioral Sciences, 3rd edn. Mahwah, NJ: Erlbaum.
11.
DombrowskiSUKnittleKAvenellA, et al. (2014) Long term maintenance of weight loss with non-surgical interventions in obese adults: Systematic review and meta-analyses of randomised controlled trials. British Medical Journal348: g2646.
12.
DreherMLFordNA (2020) A comprehensive critical assessment of increased fruit and vegetable intake on weight loss in women. Nutrients12(7): 1919.
13.
GodinG (2011) The godin-shephard leisure-time physical activity questionnaire. Health and Fitness Journal of Canada4(1): 18–22.
14.
HayesAF (2022) Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach, 3rd edn. New York, NY: Guilford.
15.
KristalARPetersUPotterJD (2005) Is it time to abandon the food frequency questionnaire? Cancer epidemiology. Biomarkers and Prevention14(12): 2826–2828.
MacLeanPSWingRRDavidsonT, et al. (2015) NIH working group report: Innovative research to improve maintenance of weight loss. Obesity23(1): 7–15.
18.
MarcusBHSelbyVCNiauraRS, et al. (1992) Self-efficacy and the stages of exercise behavior change. Research Quarterly for Exercise and Sport63(1): 60–66.
19.
MichieSAshfordSSniehottaFF, et al. (2011) A refined taxonomy of behaviour change techniques to help people change their physical activity and healthy eating behaviours: The CALO-RE taxonomy. Psychology and Health26(11): 1479–1498.
20.
National Institutes of Health/National Cancer Institute (2020) Dietary Assessment Primer: Validation. Bethesda, MD: National Cancer Institute.
PereiraMAFitzGeraldSJGreggEW, et al. (1997) A collection of physical activity questionnaires for health-related research. Medicine and Science in Sports and Exercise29(Suppl. 6): S1–S205.
23.
PigsborgKKaleaAZDe DominicisS, et al. (2023) Behavioral and psychological factors affecting weight loss success. Current Obesity Reports12(3): 223–230.
24.
PurdieNMcCrindleA (2002) Self-regulation, self-efficacy and health behavior change in older adults. Educational Gerontology28(5): 379–400.
25.
RollsBJEllo-MartinJATohillBC (2004) What can intervention studies tell us about the relationship between fruit and vegetable consumption and weight management?Nutrition Reviews62(1): 1–17.
26.
SaelensBEGehrmanCASallisJF, et al. (2000) Use of self-management strategies in a 2-year cognitive-behavioral intervention to promote physical activity. Behavior Therapy31: 365–379.
27.
SchwarzerRRennerB (2000) Social-cognitive predictors of health behavior: Action self-efficacy and coping self-efficacy. Health Psychology19(5): 487–495.
28.
ShiehCWeaverMTHannaKM, et al. (2015) Association of self-efficacy and self-regulation with nutrition and exercise behaviors in a community sample of adults. Journal of Community Health Nursing32(4): 199–211.
29.
ShresthaN (2020) Detecting multicollinearity in regression analysis. American Journal of Applied Mathematics and Statistics8(2): 39–42.
30.
SmithJMSerierKNBelonKE, et al. (2020) Evaluation of the relationships between dietary restraint, emotional eating, and intuitive eating moderated by sex. Appetite155: 104817.
31.
TeixeiraPJCarraçaEVMarquesMM, et al. (2015) Successful behavior change in obesity interventions in adults: A systematic review of self-regulation mediators. BMC Medicine13: 84.
32.
U.S. Department of Agriculture (2017) MyPlate and Historical Food Pyramid Resources. Beltsville, MD: National Agricultural Library.
33.
U.S. Department of Agriculture/U.S. Department of Health and Human Services (2021) Dietary Guidelines for Americans, 2020-2025. Beltsville, MD: National Agricultural Library.
34.
VohsKDBaumeisterRF (eds) (2017) Handbook of Self-regulation: Research, Theory, and Application, 3rd edn. New York, NY: Guilford.
35.
WarziskiMTSereikaSMStynMA, et al. (2008) Changes in self-efficacy and dietary adherence: The impact on weight loss in the PREFER study. Journal of Behavioral Medicine31(1): 81–92.
36.
WhiteIRHortonNJCarpenterJ, et al. (2011) Strategy for intention to treat data in randomized trials with missing outcome data. British Medical Journal342: 40.
37.
WilliamsonDABrayGARyanDH (2015) Is 5% weight loss a satisfactory criterion to define clinically significant weight loss?Obesity23(12): 2319–2320.
38.
World Health Organization (2000) Obesity: Preventing and Managing the Global Epidemic: Report of a WHO Consultation. Geneva, Switzerland: World Health Organization.
