Response Versus Nonresponse to Self-Regulatory Treatment Targets Is Not Discriminated by Personal Characteristics but Predicts Physical Activity,Eating Behavior,and Weight Changes in Women With Obesity
Restricted accessResearch articleFirst published online January, 2018
Response Versus Nonresponse to Self-Regulatory Treatment Targets Is Not Discriminated by Personal Characteristics but Predicts Physical Activity,Eating Behavior,and Weight Changes in Women With Obesity
Results of behavioral weight-loss treatments vary widely, with mostly unsuccessful outcomes beyond the short term. Women with obesity participating in a new cognitive-behavioral weight-loss treatment were assessed on their responses to psychological targets.
Methods
Groups of responders (n = 43) and nonresponders (n = 48) were established post hoc.
Results
Age, race/ethnicity, education, income, body composition, physical activity, and eating behaviors at baseline were not discriminated between responders and nonresponders. Over both 6 and 24 months, responders improved significantly more in physical activity and fruit/vegetable consumption but not sweets intake. Weight loss over 6 and 24 months was significantly greater for the responder group at 8.1% and 8.6% versus nonresponders at 4.7% and 3.8%, respectively. Self-regulation change significantly predicted all behavioral changes, with mood change improving the predictive strength for only sweets intake.
Discussion
Although further research is required to determine the etiology of, and to maximize, positive responses, findings suggested prospects for treatment improvements.
JamesWPT. WHO recognition of the global obesity epidemic. Int J Obes2008; 32: s120–s126.
2.
LovemanEFramptonGKShepherdJet al.The clinical effectiveness and cost-effectiveness of long-term weight management schemes for adults: a systematic review. Health Technol Assess2011; 5: 1–82.
3.
MannTTomiyamaJWestlingEet al.Medicare’s search for effective obesity treatments: diets are not the answer. Am Psychol2007; 62: 220–233.
4.
BanduraA. Social foundations of thought and action: a social cognitive theory, Englewood Cliffs, NJ: Prentice Hall, 1986.
5.
WingRRHammanRFBrayGAet al.Achieving weight and activity goals among diabetes prevention program lifestyle participants. Obes Res2004; 12: 1426–1434.
6.
CooperZDollHAHawkerDMet al.Testing a new cognitive behavioural treatment for obesity: a randomized controlled trial with three-year follow-up. Behav Res Ther2010; 48: 706–713.
7.
FogelholmMKukkomen-HarjulaK. Does physical activity prevent weight gain – a systematic review. Obes Rev2000; 1: 95–111.
8.
SvetkeyLPStevensVJBrantleyPJet al.Comparison of strategies for sustaining weight loss. J Am Med Assoc2008; 299: 1139–1148.
9.
AnnesiJJ. Supported exercise improves controlled eating and weight through its effects on psychosocial factors: extending a systematic research program toward treatment development. Perm J2012; 16: 7–18.
10.
BakerCWBrownellKDPhysical activity and maintenance of weight loss: physiological and psychological mechanisms. In: BouchardC (ed). Physical activity and obesity, Champaign, IL: Human Kinetics, 2000, pp. 311–328.
11.
MacLeanPSWingRRDavidsonTet al.NIH working group report: innovative research to improve maintenance of weight loss. Obesity2015; 23: 7–15.
12.
Annesi JJ. Physical activity in the treatment of obesity: a marker of psychosocial predictors of controlled eating, or facilitator of their improvements in women with differing body images. Minerva Psychiatr 2017; 53: 144–155.
13.
AnnesiJJMartiCN. Path analysis of exercise treatment-induced changes in psychological factors leading to weight loss. Psychol Health2011; 26: 1081–1098.
14.
McNairDMHeuchertJWP. Profile of mood states technical update, North Tonawanda, NY: Multi-Health Systems, 2009.
15.
GodinG. The Godin-Shephard leisure-time physical activity questionnaire. Health Fitness J Canada2011; 4: 18–22.
16.
PereiraMAFitzGeraldSJGreggEWet al.A collection of physical activity questionnaires for health-related research. Med Sci Sports Exerc1997; 29: s1–s205.
17.
JacobsDRAinsworthBEHartmanTJet al.A simultaneous evaluation of 10 commonly used physical activity questionnaires. Med Sci Sports Exerc1993; 25: 81–91.
18.
Aljadani HM, Patterson A, Sibbritt D, et al. Diet quality, measured by fruit and vegetable intake, predicts weight change in young women. J Obes 2013, Article ID 52161, 10 pages.
19.
U.S. Department of Agriculture. Myplate and historical food pyramid resources. Beltsville, MD: National Agricultural Library, 2017.
20.
U.S. Department of Health and Human Services. Dietary guidelines for Americans 2015–2020. 8th ed. Rockville, MD: Office of Disease Prevention and Health Promotion, 2015.
21.
BlockGHartmanAMDresserCMet al.A data-based approach to diet questionnaire design and testing. Am J Epidemiol1986; 124: 453–469.
22.
Mares-PerlmanJAKleinBEKKleinRet al.A diet history questionnaire ranks nutrient intakes in middle-aged and older men and women similarly to multiple food records. J Nutr1993; 123: 489–501.
23.
AnnesiJJMartiCNUnruhJLet al.Effects of the coach approach intervention on adherence to exercise in obese women: assessing mediation of social cognitive theory factors. Res Q Exerc Sport2011; 82: 99–108.
24.
WhiteIRHortonNJCarpenterJet al.Strategy for intention to treat data in randomized trials with missing outcome data. Br Med J2011; 342: d40.
25.
CohenJCohenPWestSGet al.Applied multiple regression/correlation analysis for the behavioral sciences, 3rd ed. Mahwah, NJ: Erlbaum, 2003.
26.
GlymourMMWeuveJBerkmanLFet al.When is baseline adjustment useful in analyses of change? An example with education and cognitive change. Am J Epidemiol2005; 162: 267–278.
27.
StevensJTruesdaleKPMcClainJEet al.The definition of weight maintenance. Int J Obes2006; 30: 391–399.
28.
JefferyRWDrewnowskiAEpsteinLHet al.Long-term maintenance of weight loss: current status. Health Psychol2000; 19: s5–s16.
29.
RosytonPAltmanDGSauerbreiW. Dichotomizing continuous predictors in multiple regression: a bad idea. Stat Med2006; 25: 127–141.
30.
HaasEHillRDLambertMJet al.Do early responders to psychotherapy maintain treatment gains. J Clin Psychol2002; 58: 1157–1172.
31.
BaranowskiTLinTSWetterDWet al.Theory as mediating variables: why aren’t community interventions working as desired?Ann Epidemiol1997; 7: S89–S95.
32.
TeixeiraPJCarraçaEVMarquesMMet al.Successful behavior change in obesity interventions in adults: a systematic review of self-regulation mediators. BMC Med2015; 13: 84.
33.
KonttinenHMännistöSSarlio-LähteenkorvaSet al.Emotional eating, depressive symptoms and self-reported food consumption. A population-based study. Appetite2010; 54: 473–479.
34.
TrostSGOwenNBaumanAEet al.Correlates of adults’ participation in physical activity: review and update. Med Sci Sports Exerc2002; 34: 1996–2001.
