title: Internal disinhibition predicts weight regain following weight loss and weight loss maintenance.
abstract: OBJECTIVE
  The disinhibition scale of the Eating Inventory predicts weight loss outcome; however, it may include multiple factors. The purpose of this study was to examine the factor structure of the disinhibition scale and determine how its factors independently relate to long-term weight loss outcomes.
  
  
  METHODS
  Exploratory factor analysis of the disinhibition scale was conducted on 286 participants in a behavioral weight loss trial (TRIM), and confirmatory factor analysis was conducted on 3,345 members of the National Weight Control Registry (NWCR), a registry of successful weight loss maintainers. Multivariate regressions were used to examine the relationships between the disinhibition scale factors and weight over time in both samples.
  
  
  RESULTS
  Using baseline data from TRIM, two factors were extracted from the disinhibition scale: 1) an "internal" factor that described eating in response to internal cues, such as feelings and thoughts; and 2) an "external" factor that described eating in response to external cues, such as social events. This factor structure was confirmed using confirmatory factor analysis in the NWCR. In TRIM, internal disinhibition significantly predicted weight loss at 6 months (p = 0.03) and marginally significantly predicted weight loss at 18 months (p = 0.06), with higher levels of internal disinhibition at baseline predicting less weight loss; external disinhibition did not predict weight loss at any time-point. In NWCR, internal disinhibition significantly predicted one-year weight change (p = 0.001), while external disinhibition did not.
  
  
  CONCLUSIONS
  These results suggest that it is the disinhibition of eating in response to internal cues that is associated with poorer long-term weight loss outcomes.
authors.affiliation: The Warren Alpert Medical School of Brown University/Miriam Hospital, Providence, Rhode Island, USA. heather_niemeier@brown.edu
authors.forename: Heather M
authors.initials: HM
authors.lastname: Niemeier
authors.forename: Suzanne
authors.initials: S
authors.lastname: Phelan
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Fava
authors.forename: Rena R
authors.initials: RR
authors.lastname: Wing
mesh_terms: D000328:Adult; D015992:Body Mass Index; D001835:Body Weight; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000517:prevention & control*; D015430:Weight Gain; D015431:Weight Loss