title: Examining behavioral processes through which lifestyle interventions promote weight loss: results from PREMIER.
abstract: OBJECTIVE
  To examine the behavioral processes through which lifestyle interventions impacted weight loss.
  
  
  METHODS
  The analyses were limited to overweight and obese Black and White adults randomized to a PREMIER lifestyle intervention (N = 501). Structural equation modeling was conducted to test the direct and indirect relationships of session attendance, days of self-monitoring diet and exercise, change in diet composition and exercise, and 6-month weight change.
  
  
  RESULTS
  Greater session attendance was associated with increased self-monitoring, which was in turn significantly related to reduction in percent energy from total fat consumed. Change in percent energy from fat and self-monitoring was associated with 6-month percent change in weight. Both a decrease in fat intake and increase in self-monitoring are potential mediators of the relationship between attendance and weight change.
  
  
  CONCLUSIONS
  The findings provide a reasonable model that suggests regular session attendance and use of behavioral strategies like self-monitoring are associated with improved behavioral outcomes that are associated with weight loss.
authors.affiliation: Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: Stephanie L
authors.initials: SL
authors.lastname: Fitzpatrick
authors.forename: Karen
authors.initials: K
authors.lastname: Bandeen-Roche
authors.forename: Victor J
authors.initials: VJ
authors.lastname: Stevens
authors.forename: Janelle W
authors.initials: JW
authors.lastname: Coughlin
authors.forename: Richard R
authors.initials: RR
authors.lastname: Rubin
authors.forename: Phillip J
authors.initials: PJ
authors.lastname: Brantley
authors.forename: Kristine L
authors.initials: KL
authors.lastname: Funk
authors.forename: Laura P
authors.initials: LP
authors.lastname: Svetkey
authors.forename: Gerald J
authors.initials: GJ
authors.lastname: Jerome
authors.forename: Arlene
authors.initials: A
authors.lastname: Dalcin
authors.forename: Jeanne
authors.initials: J
authors.lastname: Charleston
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Appel
mesh_terms: D000328:Adult; D001521:Behavior Therapy / Q000379:methods*; D044383:Black People; D004734:Energy Metabolism / Q000502:physiology; D015444:Exercise / Q000502:physiology; D005247:Feeding Behavior / Q000502:physiology; D005260:Female; D006801:Humans; D008019:Life Style / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009765:Obesity / Q000208:ethnology / Q000503:physiopathology / Q000628:therapy*; D050177:Overweight / Q000208:ethnology / Q000503:physiopathology / Q000628:therapy*; D010358:Patient Participation / Q000706:statistics & numerical data; D012648:Self Care / Q000706:statistics & numerical data; D015431:Weight Loss / Q000502:physiology; D044465:White People