title: Psychosocial changes as correlates of weight regain vs. continued loss within 2-year trials of a self-regulation-focused community-based intervention.
abstract: Although health-enhancing weight reductions are associated with behavioural treatments initially, a trajectory towards full regain typically begins within 6-9 months. Women with obesity (body mass index = 30-40 kg m-2) who lost at least 3% of their baseline weight within two trials of a new cognitive-behavioural treatment incorporating physical activity prior to changes in eating behaviours, and either regained ≥50% of that weight over 2 years (Regain group, n=32) or continued to lose weight (ContinuedLoss group, n = 34), were assessed from months 6 to 24 on changes in weight-loss behaviours and psychosocial predictors of those behaviours derived from established behavioural theories. For the Regain group, significant decreases in physical activity and fruit/vegetable intake during months 12-24, from both months 6 to 24 and 12 to 24 in eating- and physical activity-related self-regulation and from months 6 to 24 in eating-related self-efficacy (i.e. feelings of ability), were found. No significant behavioural or psychosocial changes were found over those times in the ContinuedLoss group. Changes in self-regulation and self-efficacy completely mediated the relationship between changes in fruit/vegetable intake and group (Regain vs. ContinuedLoss) (McFadden's R2= 0.19 and 0.20, respectively), with self-regulation independently contributing to the explained variance. Changes over both months 6-24 and 12-24 in self-regulation significantly mediated the relationship between changes in physical activity and group membership (McFadden's R2= 0.24 and 0.27, respectively). Findings suggested that approximately 6 months after treatment initiation would be a suitable time to intervene with some bolstering methods, while approximately 12 months post-initiation would be most applicable for others.
authors.affiliation: Wellness Department, YMCA of Metro Atlanta, Atlanta, GA, USA.|Department of Health Promotion and Physical Education, Kennesaw State University, Kennesaw, GA, USA.
authors.forename: J J
authors.initials: JJ
authors.lastname: Annesi
authors.affiliation: Wellstar School of Nursing, Kennesaw State University, Kennesaw, GA, USA.
authors.forename: N
authors.initials: N
authors.lastname: Mareno
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy; D015444:Exercise; D005247:Feeding Behavior; D005260:Female; D005638:Fruit; D015438:Health Behavior; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D009765:Obesity / Q000517:prevention & control / Q000523:psychology* / Q000628:therapy*; D020377:Self Efficacy; D014481:United States / Q000453:epidemiology; D014675:Vegetables; D015430:Weight Gain; D015431:Weight Loss; D061217:Weight Reduction Programs
keywords: Behavioural; physical activity; psychosocial; weight-loss