Cognitive appraisals of dietary transgressions by obese women: associations with self-reported eating behavior, depression, and actual weight loss.
OBJECTIVE
To identify three groups of obese people entering weight loss treatment, who have distinctly different cognitive appraisals of dietary transgressions and to compare these groups on self-report inventories of eating patterns, dieting, and depression, as well as on treatment completion rates and weight loss.


METHODS
Retrospective review of clinical records. Using a measure which evaluates eating-related cognitive appraisals, participants were categorized into one of three cognitive groups (All-or-None, Rationalization, Matter-of-Degree).


METHODS
289 treatment-seeking obese women (age: 40.9 y, body mass index (BMI): 34.7 kg/m2).


METHODS
Self-reported eating and dieting behavior (Three-Factor Eating Questionnaire and Eating Behavior Inventory); depression (Beck Depression Inventory); attendance information and body weight obtained during treatment.


RESULTS
The cognitive group representing objective thinkers (Matter-of-Degree) reported significantly fewer problems with overeating and more personal control over eating than did the rigid, dichotomous thinkers (All-or-None). In addition, the Matter-of-Degree (MAT) group endorsed significantly less subjective hunger and fewer depressive symptoms than the other two cognitive groups. The Rationalization group was more likely to complete a treatment program than was the All-or-None group, with the MAT group not differing from either. Despite these findings, there were no significant differences among cognitive groups on total weight loss.


CONCLUSIONS
Cognitive appraisals of weight-control lapses appear to be associated with self-reported eating behavior, depressive symptoms and treatment completion rates, but not with treatment-induced weight loss. The relationship between long-term weight loss and cognitive appraisals of dieting lapses is yet to be determined. It appears necessary to assess empirically the validity of assumptions regarding factors associated with treatment outcome.
Smith
C F
CF
Weight Management Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston 29425, USA.
O'Neil
P M
PM
Rhodes
S K
SK
D000328:Adult; D003071:Cognition; D003863:Depression; D004032:Diet; D015930:Diet Records; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000523:psychology* / Q000628:therapy; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss