Bi-Directional Relationship Between Self-Regulation and Improved Eating: Temporal Associations With Exercise, Reduced Fatigue, and Weight Loss

Abstract

Severely obese men and women (body mass index ≥ 35 ≤ 55 kg/m(2); M(age) = 44.8 years, SD = 9.3) were randomly assigned to a 6-month physical activity support treatment paired with either nutrition education (n = 83) or cognitive-behavioral nutrition (n = 82) methods for weight loss. Both groups had significant improvements in physical activity, fatigue, self-regulation for eating, and fruit and vegetable intake. Compared to those in the nutrition education group, participants in the behavioral group demonstrated greater overall increases in fruit and vegetable intake and physical activity. These group differences were associated with changes that occurred after Month 3. Increased physical activity predicted reduced fatigue, β = -.19, p =.01. A reciprocal relationship between the mediators of that relationship, which were changes in self-regulation and fruit and vegetable intake, was identified. There was significantly greater weight loss over six months in the behavioral nutrition group when contrasted with the nutrition education group. Self-regulation for eating and fruit and vegetable intake were significant predictors of weight loss over both three and six months. Findings enabled a better understanding of psychosocial effects on temporal aspects of weight loss and may lead to more effective behavioral treatments for weight loss.

Behavioral lifestyle interventions for moderate and severe obesity: A systematic review

“…One study 27,29 included mostly men (83%), three studies 22–24 included women only, and the rest 25,26,28,30–35 included 58–88% women. Seven studies 22–25,30,31,34,35 did not report racial/ethnic distribution and one study 26 only reported the percentage of black participants (37%).…”

“…Two studies included primarily white participants (97–100%), 32,33 and two other studies reported samples of non-Hispanic white (34–53%) and black participants (44–62%). 27,28 …”

“…The follow-up durations ranged from six months to five years; 22–35 10 studies had a follow-up for at least 12 months. 22,24–27,29–35 Ten studies 22–25,27,29–35 were conducted in clinic sites and two 26,28 in nonmedical community settings (e.g., YMCA).…”

“…Four interventions (in three studies 24,31,32 ) had distinct intensive (ranging from six weeks to six months) and maintenance phases (ranging from six to 12 months). Four interventions (in two studies 27,29,30 ) utilized in-person group sessions, and the other 21 interventions (in 10 studies 22–26,28,31–35 ) utilized a combination of in-person group and individual sessions. In addition to group and individual sessions, two interventions (in one study 26 ) also utilized phone contacts, and two interventions (in one study 24 ) provided continuous support through telecommunication (email, chat, and phone) during the maintenance phase.…”

“…22–24,27,29–35 In general, the teams consisted of more than one health profession, including physicians (e.g., psychiatrists and internists) and non-physician healthcare providers (e.g., dietitians/nutritionists, psychologists, nurses, physical trainers, and social workers). Of the two community-based studies, one 26 did not report on interventionists and one 28 involved YMCA wellness leaders.…”