title: Theory-based psychosocial factors that discriminate between weight-loss success and failure over 6 months in women with morbid obesity receiving behavioral treatments.
abstract: OBJECTIVE
  To improve success rates of behavioral weight-loss treatments, a better understanding of psychosocial factors that discriminate between weight-loss success and failure is required. The inclusion of cognitive-behavioral methods and manageable amounts of exercise might induce greater improvements than traditional methods of education in healthy eating practices.
  
  
  METHODS
  Women with morbid obesity [body mass index (BMI) ≥40 kg/m(2)] were recruited for a treatment of supported exercise paired with either a cognitive-behavioral or an educational approach to eating change over 6 months. They were classified as either successful with (i.e., at least 5 % loss; n = 40) or failed at (no loss, or weight gain; n = 43) weight loss. Discriminate function analysis incorporated theory-based models of 1 (self-efficacy), 5 (self-efficacy, self-regulation, mood, physical self-concept, body satisfaction), and 3 (self-efficacy, self-regulation, mood) psychosocial predictors at both month 6, and change from baseline-month 6.
  
  
  RESULTS
  All three models significantly discriminated weight-loss success/failure (66, 88, and 87 % for success; and 81, 87, and 88 % for failure, respectively). Self-regulation had the strongest correlations within the multi-predictor models (0.90-0.96), and all variables entered were above the standard of 0.30 set for relevance. Participants in the cognitive-behavioral nutrition group demonstrated significantly greater improvements in all psychosocial variables and success with weight loss. Completing at least two sessions of exercise per week predicted success/failure with weight loss better than overall volume of exercise.
  
  
  CONCLUSIONS
  New and relevant findings regarding treatment-induced psychosocial changes might be useful in the architecture of more successful behavioral weight-loss interventions.
authors.affiliation: YMCA of Metro Atlanta, 100 Edgewood Avenue NE, Suite 1100, Atlanta, GA, 30303, USA, jamesa@ymcaatlanta.org.
authors.forename: James J
authors.initials: JJ
authors.lastname: Annesi
authors.forename: Ping H
authors.initials: PH
authors.lastname: Johnson
mesh_terms: D000328:Adult; D000339:Affect; D001828:Body Image / Q000523:psychology*; D015928:Cognitive Behavioral Therapy / Q000379:methods; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008875:Middle Aged; D009767:Obesity, Morbid / Q000523:psychology / Q000628:therapy*; D010353:Patient Education as Topic / Q000379:methods; D011582:Psychological Theory; D011584:Psychology; D012649:Self Concept; D020377:Self Efficacy; D000068356:Self-Control / Q000523:psychology*; D016896:Treatment Outcome; D061217:Weight Reduction Programs / Q000379:methods*