title: Lifestyle intervention has a beneficial effect on eating behavior and long-term weight loss in obese adults.
abstract: OBJECTIVE
  To investigate the change in eating behavior and the factors related with the change among successful dieters (maintained a weight loss of ≥5% of original weight).
  
  
  METHODS
  Obese adult subjects (21 male, 55 female) were randomized into three-year lifestyle intervention (n=59) and control groups (n=17). Eating behavior (cognitive restraint of eating, uncontrolled eating and emotional eating) was evaluated by the TFEQ-18 and motivation to lose weight and tolerance to problems by a separate questionnaire. Weight, height and body mass index were measured.
  
  
  RESULTS
  Weight decreased more in the intervention group than in the control group (5.0% vs 0.6%, p=0.027). Cognitive restraint increased twice as much in the intervention group compared to the control group (16.0 vs. 7.0, p=0.044). The increment in cognitive restraint was positively associated with weight loss and high baseline motivation and tolerance to problems. Cognitive restraint increased in both successful (n=27) and unsuccessful dieters (n=32), but only the successful dieters were able to decrease uncontrolled eating in the long term.
  
  
  CONCLUSIONS
  Our results showed that intensive lifestyle counseling improved cognitive restraint which was associated with enhanced weight loss among obese adults. Successful dieters also showed a long-term improvement of uncontrolled eating. Eating behavior should be evaluated and followed before and during lifestyle interventions in order to support the change, e.g. by finding methods to control eating at risk situations and strengthening motivation and tolerance to problems.
authors.affiliation: Department of Sports and Exercise Medicine, Oulu Deaconess Institute, P.O. BOX 365, FI-90101 Oulu, Finland; Institute of Health Sciences, University of Oulu, P.O. BOX 5000, FI-90014 University of Oulu, Finland; MRC Oulu, University Hospital of Oulu and University of Oulu, P.O. BOX 5000, FI-90014 OYS, Finland. Electronic address: marjukka.nurkkala@gmail.com.
authors.forename: Marjukka
authors.initials: M
authors.lastname: Nurkkala
authors.affiliation: Department of Sports and Exercise Medicine, Oulu Deaconess Institute, P.O. BOX 365, FI-90101 Oulu, Finland; Institute of Health Sciences, University of Oulu, P.O. BOX 5000, FI-90014 University of Oulu, Finland; MRC Oulu, University Hospital of Oulu and University of Oulu, P.O. BOX 5000, FI-90014 OYS, Finland. Electronic address: kaisu.kaikkonen@odl.fi.
authors.forename: Kaisu
authors.initials: K
authors.lastname: Kaikkonen
authors.affiliation: Department of Sports and Exercise Medicine, Oulu Deaconess Institute, P.O. BOX 365, FI-90101 Oulu, Finland. Electronic address: marja.vanhala@odl.fi.
authors.forename: Marja L
authors.initials: ML
authors.lastname: Vanhala
authors.affiliation: Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. BOX 1627, FI-70211 Kuopio, Finland; Clinical Nutrition and Obesity Centre, Department of Medicine, Kuopio University Hospital, P.O. BOX 100, FI-70029 KYS, Finland. Electronic address: leila.karhunen@uef.fi.
authors.forename: Leila
authors.initials: L
authors.lastname: Karhunen
authors.affiliation: Department of Sports and Exercise Medicine, Oulu Deaconess Institute, P.O. BOX 365, FI-90101 Oulu, Finland; MRC Oulu, University Hospital of Oulu and University of Oulu, P.O. BOX 5000, FI-90014 OYS, Finland; Clinical Research Center and Medical Research Center, University Hospital of Oulu, P.O. BOX 5000, FI-90014 OYS, Finland. Electronic address: anna-maria.keranen@oulu.fi.
authors.forename: Anna-Maria
authors.initials: AM
authors.lastname: Keränen
authors.affiliation: Department of Sports and Exercise Medicine, Oulu Deaconess Institute, P.O. BOX 365, FI-90101 Oulu, Finland; Institute of Health Sciences, University of Oulu, P.O. BOX 5000, FI-90014 University of Oulu, Finland; MRC Oulu, University Hospital of Oulu and University of Oulu, P.O. BOX 5000, FI-90014 OYS, Finland. Electronic address: raija.korpelainen@odl.fi.
authors.forename: Raija
authors.initials: R
authors.lastname: Korpelainen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003376:Counseling; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009765:Obesity / Q000517:prevention & control* / Q000523:psychology; D020377:Self Efficacy; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult
keywords: Eating behavior; Intervention studies; Obesity; Three-Factor Eating Questionnaire-18; Weight loss