Psychological and behavioral correlates of baseline BMI in the diabetes prevention program (DPP).
OBJECTIVE
To determine psychological and behavioral correlates of baseline BMI in the Diabetes Prevention Program (DPP).


METHODS
Of 1,079 DPP lifestyle intervention participants, 274 completed validated questionnaires at baseline assessing weight loss history, stage of change, self-efficacy, dietary restraint, emotional eating, binge eating, perceived stress, depression, and anxiety.


RESULTS
The mean age of subjects was 52.5 years, 65% were women, and their mean BMI was 33.9 kg/m(2). Higher BMI correlated with more frequent weight cycling (r = 0.50, P < 0.0001) and efforts at weight loss (r = 0.34, P < 0.0001); younger age when first overweight (r = -0.42, P < 0.0001); lower exercise efficacy (r = -0.15, P = 0.015); lower weight loss efficacy (r = -0.21, P < 0.001); a less advanced stage of change for weight loss (r = -0.12, P = 0.04); more perceived stress (r = 0.14, P = 0.02); emotional eating (r = 0.19, P = 0.001); poor dietary restraint (r = -0.14, P = 0.02); binge eating frequency (r = 0.18, P = 0.004) and severity (r = 0.30, P < 0.0001); feeling deprived, angry, or upset while dieting (r = 0.27, P </= 0.0001); and food cravings while dieting (r = 0.31, P < 0.0001). Correlations did not differ as a function of sex; however, correlations of BMI with anxiety and low-fat diet and weight loss self-efficacy differed as a function of ethnicity. In multivariate models, binge eating severity, poor dietary restraint, and food craving were independent correlates of baseline BMI.


CONCLUSIONS
Many psychological and behavioral factors are associated with higher BMI in this ethnically diverse group of men and women. Whether strategies that help patients increase levels of dietary restraint and reduce binge eating and food craving lead to long-term weight loss maintenance needs longitudinal study.
Delahanty
Linda M
LM
Diabetes Center, Massachusetts General Hospital, Boston, Massachusetts 02114, USA. ldelahanty@partners.org
Meigs
James B
JB
Hayden
Doug
D
Williamson
Donald A
DA
Nathan
David M
DM
D015992:Body Mass Index; D002032:Bulimia / Q000523:psychology; D003920:Diabetes Mellitus / Q000517:prevention & control* / Q000523:psychology*; D004038:Diet, Reducing / Q000523:psychology; D005006:Ethnicity; D005247:Feeding Behavior / Q000523:psychology; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009042:Motivation; D044469:Racial Groups; D011795:Surveys and Questionnaires; D015430:Weight Gain; D015431:Weight Loss