Psychosocial predictors of decay in healthy eating and physical activity improvements in obese women regaining lost weight: translation of behavioral theory into treatment suggestions

Abstract

Regain of lost weight is a universal problem for behavioral treatments. An increased understanding of theory-based psychosocial predictors of decay in behavioral correlates of weight loss might improve treatments. Data were derived from a previous weight loss investigation of 110 women with obesity. A subsample from the experimental treatment who lost ≥3 % body weight and regained at least one third of that over 24 months (N = 36) was assessed. During months 6 through 24, there were unfavorable changes in behavioral (fruit/vegetable and sweet intake; physical activity) and psychosocial variables. Mood change predicted change in fruit/vegetable and sweet intake, with emotional eating change mediating the latter relationship. Change in self-regulation predicted changes in sweet and fruit/vegetable intake and physical activity, with self-efficacy mediating the self-regulationfruit/vegetable intake and self-regulation-physical activity relationships. Findings suggest that after treatmentinduced weight loss, addressing indicated theory-based psychosocial variables might mitigate decay in behavioral predictors of healthier weight. KEYWORDSWeight loss, Maintenance, Treatment, Self-regulation, Self-efficacy, Physical activity Although behavioral (non-pharmacological/nonsurgical) treatments have consistently been associated with a 5-8 % loss in initial body weight, even more consistent has been a gradual climb toward baseline weight after approximately 6 months [1][2][3]. Although as little as 3 % weight loss can have health benefits [4,5], from one third to two third regain of weight is expected over 2 years [2,6]. Often, regain will continue beyond a participant's initial weight [1]. Repeating a pattern of weight loss and regain might increase individuals' health risks [7]. Researchers suggest that weight loss maintenance differs considerably from weight loss and thus should be distinctly studied and addressed [8]. In a recent trial incorporating a yearlong, state-of-the-science behavioral weight management protocol directed primarily at reductions in energy intake [9], an initial weight loss of 9 % demonstrated a 91 % regain of baseline weight over the subsequent 3 years [10]. Because of the failure of this seemingly comprehensive protocol that was highly focused upon maintaining weight loss from its outset, along with the long history of behavioral treatments' association with weight regain [1-3], its developers questioned the merits of any further pursuits of such weight management interventions [10]. Although other researchers disagreed [11][12][13], it seemed clear that new and different approaches were needed.As a reaction to this and (a) a consensus that exercise is a primary predictor of maintained weight loss [6,14,15], (b) suggestions that the development of self-regulation prior to pursuing reductions in energy intake is advisable [8], (c) proposed behavioral models of the relationship between exercise and weight loss [11,16,17], and (d) indications that physical activity affects weight loss more thr...

Are Adherence to the Mediterranean Diet, Emotional Eating, Alcohol Intake, and Anxiety Related in University Students in Spain?

“…These results show that almost a third of participants exhibit this pattern of eating behavior with a certain frequency. Some authors have related this type of eating behavior with feelings of anxiety [26], while others argue that boredom is a more significant factor than anxiety or depression [25]. An analysis of the differences between men and women in the various subscales shows differences only in the subscale of guilt, where women score higher.…”

“…This type of intake is related to feelings of anxiety and depression among the general population [26], and with certain sex differences: among men emotional eating has been principally associated with symptoms of depression while in women it is primarily associated with anxiety [27]. Contrarily, other authors have argued that, among the non-clinical population, eating is often a response to boredom rather than anxiety or depression [25]. Whatever benefits the strategy of emotional eating may afford in dealing with anxiety, these tend to be short-lived, often followed by other negative emotions such as feelings of guilt [28].…”

“…The concept of emotional eating refers to the tendency to eat as an automatic response to negative emotions [ 24 ] and implies the disproportionate intake of food, regardless of the hunger the person may feel [ 25 ]. This type of intake is related to feelings of anxiety and depression among the general population [ 26 ], and with certain sex differences: among men emotional eating has been principally associated with symptoms of depression while in women it is primarily associated with anxiety [ 27 ].…”

Fatores de risco para recidiva de peso no pós-operatório tardio de cirurgia bariátrica

“…Aproximadamente 50% dos pacientes irão retornar ao seu peso inicial após cinco anos do procedimento cirúrgico [11]. Esses resultados demonstram que o principal desafio do tratamento da obesidade não é a perda de peso, mas a sua manutenção em longo prazo, o que aumenta os riscos à saúde dos indivíduos, principalmente no âmbito emocional, e os custos em saúde [12][13][14].…”

Psychosocial changes as correlates of weight regain vs. continued loss within 2‐year trials of a self‐regulation‐focused community‐based intervention

“…This measure of participants recalling summed fruit and vegetable intake of a typical day over the prior month had strong correspondence with scientifically accepted, lengthier instruments such as the Block Food Frequency Questionnaire (45). It was also previously related to the consumption of sweets (46) and fats (47) (negatively), and the nutritional biomarkers of four serum carotenoids and their total score (48).…”