Impacts of early psychological changes on correlates of weight‐loss maintenance: Seeking increased precision for sustained behavioural obesity treatment effects

Abstract

AbstractIssue AddressedObesity is an increasing worldwide health issue. In affluent English‐speaking countries, obesity ranges from ~28% (Australia) to ~42% (United States) of the adult population. Enabling weight loss beyond an initial 6 months is an unresolved challenge.MethodsWomen with obesity participated in community‐based obesity treatments incorporating either cognitive‐behavioural methods emphasizing self‐regulatory skills development (n = 106) or typical information/education processes (n = 47). Psychosocial, behavioural, and weight changes were measured.ResultsSignificant overall improvements in exercise‐related self‐regulation and self‐efficacy, mood, physical activity/exercise (PA/exercise), diet, and weight were found from baseline–month 6 (weight‐loss phase) and baseline–month 12, but not from months 6–12 (weight‐loss maintenance phase). Significantly greater improvements were found in the cognitive‐behavioural group. Within the weight‐loss phase, changes in both PA/exercise and diet significantly contributed to the explained variance in weight loss, whereas within the weight‐loss maintenance phase, only change in PA/exercise was a significant predictor. There was no significant relationship of weight loss across phases. Months 6–12 change in PA/exercise significantly mediated relationships of changes in self‐regulation→weight, mood→weight, and self‐efficacy→weight. Earlier scores and score changes in mood and self‐efficacy significantly impacted the subsequent parallel relationships.ConclusionsCognitive‐behavioural methods affect psychosocial changes leading to initial changes in diet, PA/exercise, and weight. Those changes then impact subsequent changes in PA/exercise—a primary malleable correlate of maintained weight loss.So What?This research extended previous findings to better‐inform behavioural obesity‐treatment foci to address the pervasive public health problem of attaining and sustaining weight loss. Findings related to PA/exercise will help impact health‐promotion outcomes.