Behavioral, psychological, and environmental predictors of weight regain in a group of successful weight losers in a widely available weight‐management program

Abstract

AbstractObjectiveThe aim of this study was to identify predictors of weight regain and continued weight maintenance among individuals already successful at long‐term weight loss in a widely available weight‐management program.MethodsParticipants were 2843 weight‐loss maintainers in WeightWatchers who had maintained weight loss ≥9.1 kg for ≥1 year (average 25.5 kg for 3.5 years; BMI = 26.7 kg/m2). Validated behavioral, psychosocial, and home environmental questionnaires were administered at study entry and 1 year later. Discriminant analysis identified variables that discriminated gainers (≥2.3‐kg gain) from maintainers (±2.3‐kg change).ResultsOver the 1 year of follow‐up, 43% were gainers (mean [SD], 7.2 [5.4] kg), and 57% were maintainers (0.4 [1.2] kg). Compared with maintainers, gainers were younger and had higher initial weight, more recent weight losses, and larger initial weight losses. Standardized canonical coefficients indicated that the 1‐year changes that most discriminated gainers from maintainers were greater decreases in the ability to accept uncomfortable food cravings, urges, and desires to overeat (0.232); self‐monitoring (0.166); body image (0.363); and body satisfaction (0.194) and greater increases in disinhibition (0.309) and bodily pain (0.147). The canonical correlation was 0.505 (p < 0.001).ConclusionsFuture interventions to prevent regain should consider targeting overeating in response to internal and external food cues and declines in self‐monitoring and body image.