title: Ecological Momentary Assessment of Dietary Lapses Across Behavioral Weight Loss Treatment: Characteristics, Predictors, and Relationships with Weight Change.
abstract: BACKGROUND
  Adherence to dietary prescriptions is critical for successful weight loss and weight loss maintenance. However, research on specific instances of inadherence (lapses) is limited, and findings regarding the frequency, nature, and causes of lapses are mixed. Additionally, no studies have examined lapses over the course of a weight loss program.
  
  
  OBJECTIVE
  In the context of a reduced calorie diet prescribed as part of a behavioral treatment, we aimed to characterize lapse occurrence, examine lapse frequency across treatment, examine predictors of lapses, and assess the relationship between lapses and weight loss.
  
  
  METHODS
  Adults (n = 189) enrolled in a 12-month behavioral weight loss program completed ecological momentary assessment (EMA) at baseline, mid-treatment, and end of treatment. At each EMA survey, participants indicated whether a lapse had occurred, and responded to questions assessing situational, environmental, and affective states.
  
  
  RESULTS
  Lapse frequency showed a curvilinear relationship over time, such that frequency first decreased and then increased. Lapse frequency at baseline was negatively associated with early and overall weight loss. Lapses most often occurred at home, in the evenings, on the weekends, and entailed eating a forbidden food. Greater overall levels of assessed affective and environmental triggers predicted lapses, and greater momentary hunger and deprivation, and the presence of palatable food, also prospectively predicted lapses.
  
  
  CONCLUSIONS
  In addition to characterizing lapse frequency, the current study identified prospective predictors of lapses across treatment. These findings support the importance of lapses to weight control and provide insight for potential targets of intervention to prevent lapse occurrence.
authors.affiliation: Department of Psychology, Drexel University, 3141 Chestnut St, Suite 119, Philadelphia, PA, 19104, USA. evan.forman@drexel.edu.
authors.forename: Evan M
authors.initials: EM
authors.lastname: Forman
authors.affiliation: Department of Psychology, Drexel University, 3141 Chestnut St, Suite 119, Philadelphia, PA, 19104, USA.
authors.forename: Leah M
authors.initials: LM
authors.lastname: Schumacher
authors.affiliation: Neuropsychiatric Research Institute, Fargo, ND, USA.|Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA.
authors.forename: Ross
authors.initials: R
authors.lastname: Crosby
authors.affiliation: Department of Psychology, Drexel University, 3141 Chestnut St, Suite 119, Philadelphia, PA, 19104, USA.
authors.forename: Stephanie M
authors.initials: SM
authors.lastname: Manasse
authors.affiliation: Department of Psychology, Drexel University, 3141 Chestnut St, Suite 119, Philadelphia, PA, 19104, USA.
authors.forename: Stephanie P
authors.initials: SP
authors.lastname: Goldstein
authors.affiliation: Department of Psychology, Drexel University, 3141 Chestnut St, Suite 119, Philadelphia, PA, 19104, USA.
authors.forename: Meghan L
authors.initials: ML
authors.lastname: Butryn
authors.affiliation: Department of Psychological Sciences, University of Connecticut, Mansfield, CT, USA.
authors.forename: Emily P
authors.initials: EP
authors.lastname: Wyckoff
authors.affiliation: Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA.
authors.forename: J
authors.initials: J
authors.lastname: Graham Thomas
mesh_terms: D000339:Affect; D031204:Caloric Restriction / Q000523:psychology; D000072860:Ecological Momentary Assessment; D004777:Environment; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000523:psychology*; D010349:Patient Compliance / Q000523:psychology* / Q000706:statistics & numerical data; D012307:Risk Factors; D015431:Weight Loss; D061217:Weight Reduction Programs
keywords: Adherence; Behavioral weight loss; Dietary lapses; EMA; Ecological momentary assessment; Overweight