title: Behaviorally supported exercise predicts weight loss in obese adults through improvements in mood, self-efficacy, and self-regulation, rather than by caloric expenditure.
abstract: BACKGROUND
  The relationship of exercise to weight loss, beyond minimal caloric expenditures possible in obese and deconditioned individuals, requires clarification.
  
  
  OBJECTIVE
  We assessed whether changes in theory-based psychological variables associated with participation in an exercise treatment extended to psychologically based predictors of controlled eating and weight and waist-circumference reductions.
  
  
  METHODS
  A group of 137 adults with severe obesity (mean body mass index, 42.2 kg/m(2)) volunteered for an exercise-support and nutrition-education treatment of 26 weeks' duration that was based on social cognitive theory. Exercise- and eating-related measures of mood, self-regulation, and self-efficacy were obtained at baseline and at treatment end, along with weight, waist circumference, and exercise volume. Analyses were also conducted separately for women participants only (n = 102).
  
  
  RESULTS
  Treatment-induced changes in total mood disturbance, self-regulatory skill usage for exercise, and exercise self-efficacy were significantly related to changes in self-efficacy to control emotional eating, self-regulatory skill usage for controlled eating, and overall self-efficacy for controlled eating, respectively (p < 0.001). Changes in the eating-related measures significantly predicted changes in weight and waist circumference with adjusted R(2) values from 0.15 to 0.21 and 0.28 to 0.30, respectively (p < 0.001). Post-hoc testing indicated a strong negative correlation between exercise completed and weight change (r = -0.62); however, only 12.4% of the observed weight change was accounted for through associated caloric expenditures.
  
  
  CONCLUSIONS
  Exercise may support weight loss primarily through psychological rather than physiological pathways. Although the models tested were viable, additional modifiable variables may further strengthen the prediction of weight and waist-circumference change and benefit weight-loss theory and treatment outcomes.
authors.forename: James J
authors.initials: JJ
authors.lastname: Annesi