title: Effects of treatment differences on psychosocial predictors of exercise and improved eating in obese, middle-age adults.
abstract: BACKGROUND
  Behavioral interventions for weight-loss have been largely unsuccessful. Exercise is the strongest predictor of maintained weight loss and much of its effects may be from associated changes in psychosocial factors.
  
  
  METHODS
  Middle-aged, formerly sedentary adults with severe obesity were randomly selected to 6-month treatments of cognitive-behavioral exercise support paired with either standard nutrition education (n = 99) or nutrition change supported by cognitive-behavioral means with an emphasis on self-regulation (n = 101).
  
  
  RESULTS
  Overall improvements in self-efficacy and self-regulation for both exercise and managed eating, and mood, were found, with significantly greater improvements associated with the cognitive-behavioral nutrition condition in self-regulation for eating and mood. Change scores trended toward being stronger predictors of increased exercise and fruit and vegetable intake than scores at treatment end. Multiple regression analyses indicated that significant portions of the variance in both increased volume of exercise (R2 = 0.45) and fruit and vegetable intake (R2 = 0.21) were explained by changes in self-regulatory skill usage, self-efficacy, and mood.
  
  
  CONCLUSIONS
  Cognitive-behavioral methods for improved eating paired with behavioral support of exercise may improve weight loss through effects on the psychosocial factors of self-regulation, self-efficacy, and overall mood more than when standard nutrition education is incorporated.
authors.affiliation: Dept of Wellness, YMCA of Metro Atlanta, Atlanta, GA, and the Dept of Health Promotion and Physical Education, Kennesaw State University, Kennesaw, GA.
authors.forename: James
authors.initials: J
authors.lastname: Annesi
mesh_terms: D000339:Affect; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D004032:Diet / Q000523:psychology; D004435:Eating / Q000523:psychology*; D015444:Exercise / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009765:Obesity / Q000523:psychology* / Q000628:therapy*; D010353:Patient Education as Topic / Q000379:methods; D020377:Self Efficacy; D012927:Social Control, Informal; D012944:Social Support; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D015431:Weight Loss