Physical activity changes during an automated online weight loss program.

Evidence-based online behavioral weight loss (BWL) treatment targets a combination of diet, physical activity, and behavioral skills training. While weight loss outcomes are well documented, little is known about changes in physical activity. This study examined changes in objectively measured physical activity across the energy expenditure spectrum during a fully automated, online BWL program. Adults with overweight or obesity (n = 63) completed a 12-week, online BWL program. Participants wore an accelerometer for 7 days and body weight was measured in-clinic at pre- and post-treatment. At post-treatment, mean daily moderate-to-vigorous physical activity increased by about 4 min (SE = 1.59, p = 0.01). There were no statistically significant changes in light physical activity or time spent sedentary (p's > 0.05). Despite only minimal changes in moderate-to-vigorous physical activity overall, larger increases correlated with greater weight loss (r = - 0.28, p = 0.02), which averaged 6.1% of baseline weight at post-treatment. Though achieving important weight loss outcomes, online programs may fail to produce clinically relevant improvements in physical activity, which can put weight loss maintenance at risk.

Association of Migraine and Blood Pressure-Does Obesity Severity Have a Moderating Role?

BACKGROUND: The relationship between migraine and blood pressure (BP) is equivocal, warranting exploration of potential moderators. Obesity associates with both migraine and BP in a dose-dependent fashion, although its role as a moderator has not been evaluated. We examined the relation between migraine and BP in women with comorbid migraine and obesity, and whether this relation was influenced by obesity severity. METHODS: Women with migraine and obesity (n = 134) completed a 28-day headache diary before randomization to lifestyle intervention or migraine education. BP (systolic (SBP)/diastolic (DBP)), body mass index (BMI), and waist circumference (WC) were measured before diary completion. Hierarchical linear regression assessed associations between BP and migraine characteristics (headache frequency, duration, and pain intensity), and obesity severity (both total (BMI) and abdominal (WC)) as moderators of these associations. RESULTS: Participants (BMI = 35.4 ± 6.5 kg/m2; WC = 105.4 ± 15.6 cm, SBP = 113.1 ± 12.1/DPB = 68.1 ± 8.0 mmHg) reported 8.4 ± 4.5 migraine days that lasted 20.2 ± 15.9 h with mean pain intensity of 5.9 ± 1.6 on a 10-point scale. DBP inversely related to migraine days in both total (ß = - 0.226, p = .010) and abdominal (ß = 0.214, p = .015) obesity severity models. SBP and obesity severity did not relate to migraine characteristics. Obesity severity did not moderate relations between migraine characteristics and BP (p's > .05). CONCLUSION: Among women with comorbid migraine and obesity, DBP inversely related to migraine frequency; however, obesity severity did not affect the strength of this or other examined associations. Future studies including healthy weight controls and men and women with continuous BP measures are needed to confirm these findings and identify mechanisms and moderators.

Ecological momentary assessment of changes in eating behaviors, appetite, and other aspects of eating regulation in Roux-en-Y gastric bypass and sleeve gastrectomy patients.

Bariatric surgery can have profound impacts on eating behaviors and experiences, yet most prior research studying these changes has relied on retrospective self-report measures with limited precision and susceptibility to bias. This study used smartphone-based ecological momentary assessment (EMA) to evaluate the trajectory of change in eating behaviors, appetite, and other aspects of eating regulation in 71 Roux-en-Y gastric bypass and sleeve gastrectomy patients assessed preoperatively and at 3, 6, and 12-months postoperative. For some outcomes, results showed a consistent and similar pattern for SG and RYGB where consumption of sweet and high-fat foods and hunger, desire to eat, ability to eat right now, and satisfaction with amount eaten all improved from pre-to 6-months post-surgery with some degree of deterioration at 12-months post-surgery. By contrast, other variables, largely related to hedonic hunger and craving and desire for specific foods, showed less consistent patterns that differed by surgery type. While the findings suggest an overall pattern of improvement in eating patterns following bariatric surgery, they also highlight how a return to preoperative habits may begin as early as 6 months after surgery. Additional research is needed to understand mechanisms that promote changes in eating behavior after surgery, and how best to intervene to preserve beneficial effects.

Momentary predictors of dietary lapse from a mobile health weight loss intervention.

Identifying factors that influence risk of dietary lapses (i.e., instances of dietary non-adherence) is important because lapses contribute to suboptimal weight loss outcomes. Existing research examining lapse risk factors has had methodological limitations, including retrospective recall biases, subjective operationalizations of lapse, and has investigated lapses among participants in gold-standard behavioral weight loss programs (which are not accessible to most Americans). The current study will address these limitations by being the first to prospectively assess several risk factors of lapse (objectively operationalized) in the context of a commercial mobile health (mHealth) intervention, a highly popular and accessible method of weight loss. N = 159 adults with overweight or obesity enrolled in an mHealth commercial weight loss program completed ecological momentary assessments (EMAs) of 15 risk factors and lapses (defined as exceeding a point target for a meal/snack) over a 2-week period. N = 9 participants were excluded due to low EMA compliance, resulting in a sample of N = 150. Dietary lapses were predicted by momentary increases in urges to deviate from one's eating plan (b = .55, p < .001), cravings (b = .55, p < .001), alcohol consumption (b = .51, p < .001), and tiredness (b = .19, p < .001), and decreases in confidence related to meeting dietary goals (b = -.21, p < .001) and planning food intake (b = -.15, p < .001). This study was among the first to identify prospective predictors of lapse in the context of a commercial mHealth weight loss program. Findings can inform mHealth weight loss programs, including just-in-time interventions that measure these risk factors, calculate when risk of lapse is high, and deliver momentary interventions to prevent lapses.

Persistent, High Levels of Social Jetlag Predict Poor Weight Outcomes in a Weight Gain Prevention Study for Young adults.

INTRODUCTION: Social jetlag (SJL), the discrepancy in sleep timing between weekdays and weekends, is associated with higher BMI and cardiometabolic risk and is common in young adults. We examined whether chronic SJL impacts weight gain in young adults participating in a weight gain prevention trial. METHODS: Young adults (n = 599, age 18-35; BMI: 21.0-30.9 kg/m2) completed assessments at 0, 4, 12, and 24 months. Multilevel mixed growth models were used to examine (1) associations between demographics and longitudinal SJL and (2) longitudinal SJL as a predictor of weight change and cardiometabolic outcomes. SJL was assessed as a continuous and clinically-significant dichotomous (< vs. ≥2 h) variable. RESULTS: 38% of participants had clinically-significant SJL at ≥ 1 timepoints (Baseline M ± SD = 1.3±0.89). Younger (b=-0.05, p < 0.001), female (b = 0.18, p = 0.037) and Black (compared to White, b = 0.23, p = 0.045) participants were more likely to have greater SJL. Individuals with high SJL (≥ 2 h; between-person effect) were more likely to have greater weight gain over 2 years (b = 0.05, p = 0.028). High SJL did not affect the rate of change in waist circumference or cardiometabolic markers over time. CONCLUSIONS: High SJL is associated with greater weight gain over time. Reducing SJL may positively impact weight status in young adults.

Dynamic associations between anxiety, stress, physical activity, and eating regulation over the course of a behavioral weight loss intervention.

Negative emotional experiences are associated with dysregulated eating behaviors that impede weight management. While weight loss interventions promote physical activity and self-regulation of eating, no studies have examined how physical activity may directly influence eating by attenuating associations between negative emotions and eating. OBJECTIVE: The current study examined how momentary negative emotions (stress and anxiety), moderate-to-vigorous intensity physical activity (MVPA), and their interactions predict eating dysregulation (i.e., intensity of eating temptations, inability to resist eating tempting foods, overeating), as well as how these associations change during a weight loss intervention. METHODS: Women with overweight/obesity (N = 55) completed 14-day ecological momentary assessment (EMA) protocols with objective measurement of physical activity (i.e., bout-related MVPA time) before and after a three-month internet-based weight loss program. RESULTS: Three-way interactions emerged predicting overeating and eating tempting foods. When women experienced higher than usual levels of momentary anxiety or stress at end-of-treatment, they were less likely to subsequently overeat or eat tempting foods when they had recently engaged in more MVPA (relative to their usual level). No significant associations were found for ratings of temptation intensity. CONCLUSIONS: Findings suggest MVPA may exert direct effects on eating regulation. Specifically, MVPA appears to increasingly buffer the effect of negative emotional states on dysregulated eating behavior over the course of a weight loss intervention. Future work is needed to develop ways of communicating to patients how activity can have both indirect and direct effects on body weight, and examine whether such knowledge improves outcomes.

Weight-Related Information Avoidance Prospectively Predicts Poorer Self-Monitoring and Engagement in a Behavioral Weight Loss Intervention.

BACKGROUND: Self-monitoring is a key component of behavioral weight loss (BWL) interventions. Past research suggests that individuals may avoid self-monitoring in certain contexts (e.g., skipping self-weighing after higher-than-usual calorie intake). However, no studies have attempted to quantify individuals' inclination to avoid information about their weight control ("weight-related information avoidance"; WIA) or prospectively examined its implications for treatment engagement and outcomes in BWL programs. PURPOSE: Characterize WIA using a validated questionnaire among adults enrolled in BWL treatment and examine whether WIA prospectively predicts self-monitoring adherence, session attendance, treatment discontinuation, or weight loss. METHODS: Participants (N = 87; MBMI = 34.9 kg/m2, 83% female) completed a measure of WIA prior to starting a 12 week, group-based BWL intervention. Participants were given digital self-monitoring tools and instructed to self-monitor their food intake daily, physical activity daily, and body weight weekly (Weeks 1-10) and then daily (Weeks 11-12). Session attendance and treatment discontinuation were recorded. Weight was measured in-clinic pretreatment and posttreatment. RESULTS: While mean WIA was low (M = 2.23, standard deviation [SD] = 0.95; potential scale range: 1-7), greater WIA predicted poorer attendance (r = -.23; p = .03) and poorer self-monitoring of physical activity (r = -.28; p = .009) and body weight (r = -.32; p = .003). WIA did not predict food monitoring (p = .08), treatment discontinuation (p = .09), or 12 week weight loss (p = .91). CONCLUSIONS: Greater WIA, as assessed via a brief questionnaire, may place individuals at risk for poorer self-monitoring and treatment engagement during BWL. Further research on the implications of WIA in the context of weight management is warranted, including evaluation of correlates, moderators, and mechanisms of action of WIA. CLINICAL TRIAL REGISTRATION: NCT03337139.

Social predictors of daily relations between college women's physical activity intentions and behavior.

Women perform less physical activity (PA) than men, and this gap widens during college. This study examined college women's daily PA intentions and behavior, and whether social support or social comparison orientation (SCO) moderated the PA intention-behavior relation. College women (N = 80) completed measures of social support and SCO at baseline. For seven consecutive days, participants completed an electronic survey to assess PA intentions and wore an activity monitor to assess minutes of moderate-to-vigorous intensity physical activity (MVPA). Results indicated that intended and performed MVPA minutes were weakly related (p = 0.17, sr = 0.16). Social support did not moderate the intention-behavior relation, but SCO did (p = 0.04, sr = 0.21). Participants with stronger (vs. weaker) SCO, particularly a tendency to compare downward (i.e., to worse-off others), showed smaller discrepancies between intended and completed MVPA. College women frequently fail to achieve PA goals, but stronger tendencies to make (downward) social comparisons may minimize this gap and be a target for intervention.

Preliminary Evaluation of a 1-Day Acceptance and Commitment Therapy Workshop for Increasing Moderate-to-Vigorous Physical Activity in Adults with Overweight or Obesity.

BACKGROUND: Novel strategies to help adults with overweight/obesity increase motivation for becoming active are needed. This single-arm trial aimed to test the feasibility, acceptability, and preliminary efficacy of a 4-h acceptance and commitment therapy (ACT)-based workshop intervention for increasing moderate-to-vigorous physical activity (MVPA) among insufficiently active adults with overweight/obesity. METHODS: Participants (N = 41) received a 1-day 4-h ACT workshop followed by weekly e-mails and monthly phone calls for 3 months. The primary outcome was change in accelerometer-measured MVPA minutes/day at 3 and 6 months. Process variables (i.e., autonomous motivation, PA acceptance) through which the ACT intervention was hypothesized to increase MVPA were assessed via questionnaires. RESULTS: Participants completed 91% of phone calls and 75% of e-mail surveys. Acceptability ratings were > 4.5 out of 5 for "understandable," "useful," and "intent-to-use" on all intervention components. Participants on average achieved significant increases in bouted and total MVPA at 3 months that were maintained at 6 months. Participants also reported significant increases in physical activity acceptance and autonomous motivation, the latter of which related to MVPA changes. CONCLUSION: Results support the feasibility and acceptability of the ACT workshop intervention for promoting MVPA changes among insufficiently active adults with overweight/obesity. Rigorous testing of this approach as a low-intensity standalone or add-on intervention to increase MVPA is warranted.

Momentary affective response to bouts of moderate-to-vigorous physical activity predicts changes in physical activity and sedentary behavior during behavioral weight loss.

BACKGROUND: Affective responses are posited to be key predictors of the uptake and maintenance of health behaviors. However, few studies have examined how individuals' affective response to physical activity, as well as the degree to which their affect response changes, may predict changes in physical activity and sedentary time during behavioral weight loss treatment. PURPOSE: The current study examined how baseline momentary affective response (i.e., stress and anxiety) to moderate-to-vigorous physical activity (MVPA) and the degree of pre--post intervention change in this response predicted change in daily sedentary, light, and MVPA time during a three-month internet-based weight loss program. METHODS: Women with overweight/obesity (final N=37) completed 14-day ecological momentary assessment (EMA) protocols with objective measurement of physical activity (i.e., bout-related MVPA time) before and after the intervention. RESULTS: Women who had more reinforcing responses to MVPA (i.e., greater reductions in anxiety and stress response following MVPA bouts) at baseline had greater increases in overall MVPA at the end of the intervention. Those who had greater anxiety reductions after MVPA bouts at baseline also evidenced less sedentary time at the end of the intervention. Changes in affective responses across the intervention were not related to changes in physical activity levels. CONCLUSIONS: Findings suggest initial levels of affective reinforcement from MVPA bouts predict future change in MVPA and sedentary time during behavioral weight loss. Future work is needed to examine the utility of more precisely targeting affective responses to physical activity to optimize intervention approaches.

Consistent Morning Exercise May Be Beneficial for Individuals With Obesity.

This review explores the hypothesis that a consistent exercise time, especially consistent morning exercise, improves exercise adherence and weight management for individuals with overweight or obesity. We discuss data supporting this premise, identify limitations of current research, and outline directions for future research on exercise timing to more robustly evaluate our thesis.

Physical Activity Intentions and Behavior Mediate Treatment Response in an Acceptance-Based Weight Loss Intervention.

BACKGROUND: Acceptance-based treatment (ABT) for weight loss has shown promise for improving outcomes relative to standard behavioral treatment (SBT). One way in which ABT may improve outcomes is through increasing physical activity (PA) intentions and behavior but little research has examined these as mediators of ABT on weight change. PURPOSE: This study sought to examine ABT's effects on intentions for PA and several objectively measured PA variables during treatment and analyze PA intentions and behaviors as mediators of ABT's effect on weight loss. METHODS: Participants (N = 189) with overweight/obesity randomized to 1 year of either ABT or SBT completed ecological momentary assessment of PA intentions, accelerometer-based PA assessment, and had weight measured at baseline, mid-treatment, and end of treatment. RESULTS: ABT had a significantly higher increase than SBT in PA intention minutes at mid-treatment and end of treatment (p < 0.001), and both groups had nonlinear increases in moderate-to-vigorous physical activity (MVPA) that were not significantly different. Sequential mediation models found that ABT's effect on weight loss was partially mediated by higher PA intention minutes at mid-treatment leading to increased MVPA minutes per week. Increased MVPA minutes were obtained by participants increasing the number of days with MVPA bouts. CONCLUSIONS: ABT's effect on weight loss throughout treatment resulted, in part, from participants increasing their intentions for PA. Controlling for group, higher PA intentions were associated with more PA obtained through more days with exercise.

Participant and interventionist perceptions of challenges during behavioral weight loss treatment.

No prior studies have examined how interventionists' perceptions of participants' weight control challenges or the agreement between participants and interventionists on these perceptions relate to outcomes during group-based behavioral weight loss treatment. This study characterized participants' and interventionists' perceptions of, and agreement about, weight control challenges and assessed how these factors relate to weight loss. Three months into treatment, participants and interventionists independently selected three weight control challenges believed to be most relevant for each participant. Weight was measured at baseline, 3 months, and 12 months. Interventionists and participants had "no" (κ < 0) or "slight" (0 < κ< .20) agreement on most challenges. Although endorsement of certain challenges by participants and/or interventionists was related to 3- and 12-month weight losses, agreement between participants and interventionists was unrelated to weight loss at either time point. Additional research is needed to better understand the role of perceived challenges and participant/interventionist agreement about challenges on treatment outcomes.

I think therefore I Am? Examining the relationship between exercise identity and exercise behavior during behavioral weight loss treatment.

OBJECTIVES: Identification as an exerciser may promote physical activity. This study examined exercise identity (EI) and its relationship with demographic characteristics and exercise among adults participating in behavioral weight loss treatment, which is a key target population for increasing exercise. DESIGN: Longitudinal. METHOD: Participants (N = 320) completed a measure of EI and exercise was assessed with accelerometers at baseline and 6 months. RESULTS: Baseline EI and exercise were positively related and EI and exercise increased over time. However, change in EI was not meaningfully related to change in exercise, baseline EI did not predict change in exercise, and 6-month EI was not related to 6-month exercise. Participants identifying as non-White reported greater EI but lower exercise. CONCLUSIONS: Although EI and exercise may increase among weight loss participants, the two may not be meaningfully related during active weight loss treatment. The relationship between EI and exercise may also differ based on race.

Pilot Trial of an Acceptance-Based Behavioral Intervention to Promote Physical Activity Among Adolescents.

Prior interventions have shown limited efficacy in increasing the number of adolescents engaging in adequate physical activity (PA). Preliminary evidence suggests acceptance-based behavioral treatments (ABTs) may increase PA; however, this approach has not been tested in adolescents. This was a nonrandomized experimental pilot study that examined feasibility, acceptability, and treatment outcomes of a school-based, acceptance-based behavioral intervention for PA. Adolescents (n = 20) with low activity received a PA tracking device and were allocated to device use only or device use plus 10-weeks of ABT. PA, cardiovascular fitness, and physiological outcomes were measured pre- and postintervention. The intervention was found to be feasible and acceptable. PA, cardiovascular fitness, and physiological outcomes improved over time in the intervention group, but not in the comparison condition. This study demonstrated feasibility, acceptability, and preliminary treatment efficacy based on effect sizes for an acceptance-based behavioral intervention to increase PA in adolescents.

A multimodal investigation of impulsivity as a moderator of the relation between momentary elevations in negative internal states and subsequent dietary lapses.

Suboptimal outcomes from behavioral weight loss (BWL) treatments are partially attributable to accumulated instances of non-adherence to dietary prescriptions (i.e., dietary lapses). Results identifying negative internal triggers for dietary lapses are inconsistent, potentially due to individual differences that impact how individuals respond to cues. Impulsivity is one factor that likely influences reactivity to internal states. We examined three dimensions of impulsivity (delay discounting, inhibitory control, and negative urgency) as moderators of the relation between affective and physical states and subsequent dietary lapses at the beginning of BWL. Overweight/obese adults (n = 189) completed behavioral and self-reported measures of impulsivity at baseline of BWL and an ecological momentary assessment (EMA) protocol across the first two weeks of treatment to report on affective/physical states and instances of dietary lapses. Results indicated that baseline negative urgency, but not delay discounting or inhibitory control, was positively associated with overall lapse risk. Moderation analyses indicated that poorer inhibitory control strengthened the relation between momentary increases in stress and subsequent dietary lapse, and higher negative urgency strengthened the relation between increases in loneliness and dietary lapse. Negative urgency also moderated the impact of momentary hunger on subsequent dietary lapse risk in an unexpected direction, such that higher negative urgency weakened the relation between hunger and subsequent lapse. Results lend partial and tentative support for the moderating role of impulsivity on the relation between internal states and lapse likelihood. With replication, the development and testing of personalized treatment components based on baseline impulsivity level may be warranted.

Using ecological momentary assessment to better understand dietary lapse types.

Frequency of lapsing from a diet predicts weight loss failure, however previous studies have only utilized one definition of dietary lapse. No study has examined different types of lapse behaviors among individuals with overweight/obesity. The current study uses ecological momentary assessment (EMA) to examine predictors of three lapse types-eating a larger portion than intended, eating an unintended type of food, and eating at an unplanned time-in adults (N = 189; MBMI = 36.93 ±â€¯5.83 kg/m2; 82.0% female; Mage = 51.81 ±â€¯9.76 years) enrolled in a 12-month randomized controlled trial of two behavioral weight loss treatments. Participants completed 14 days of EMA at the start of treatment during which they indicated types of lapses that occurred with time and location of the lapse. Participants also responded to questions assessing current physical (e.g., hunger, tiredness), environmental (e.g., presence of "delicious" foods), and affective (e.g., loneliness, sadness) states at each prompt. Weight change was assessed at post-treatment. Separate generalized estimating equations were used to examine whether states prospectively predicted lapse occurrence at the next survey. Results indicated that lapse types differed significantly across time and location. Momentary increases in deprivation, hunger, and boredom increased likelihood of different lapse types. Lastly, we examined the prospective association between lapse type and weight loss. Eating at an unintended time was the only lapse type that predicted worse weight loss outcomes. Results support the theory that distinct lapse types exist, and that lapse types can be predicted by both momentary conditions and individual tendencies toward certain physical and affective states. However, not all lapse types may impact weight outcomes. Future research on behaviors that constitute dietary lapse is warranted and could inform personalized weight loss treatments.

Are individuals with loss-of-control eating more prone to dietary lapse in behavioural weight loss treatment? An ecological momentary assessment study.

OBJECTIVE: Individuals with overweight/obesity and loss-of-control eating (LOC) may experience poorer outcomes from behavioural weight loss due to reactivity to internal (e.g., affective and physical) states that impact treatment adherence (e.g., dietary lapses). This study examined (a) whether the presence of LOC increased risk for dietary lapses and (b) the moderating role of LOC on the relation between internal states and dietary lapses. METHOD: Individuals (n = 189) with overweight and obesity completed ecological momentary assessment early in behavioural weight loss. RESULTS: LOC was positively associated with dietary lapse. LOC did not moderate the relation between momentary changes in internal states and dietary lapses. However, the effect of average levels of internal states on lapses was attenuated for those with LOC. DISCUSSION: Results suggest that those with LOC are at higher risk of dietary lapse, whereas elevated average levels of internal states may contribute to early inadherence for those without LOC.

Ecological Momentary Assessment of Dietary Lapses Across Behavioral Weight Loss Treatment: Characteristics, Predictors, and Relationships with Weight Change.

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. PURPOSE: 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.

Understanding physical activity lapses among women: responses to lapses and the potential buffering effect of social support.

Many women fail to meet recommended levels of physical activity (PA). Limited research has examined women's barriers to PA adoption during attempts to increase PA-in particular, how often they experience PA lapses (i.e., failure to meet PA goals), their cognitive-affective responses to lapses, and the role of social support in preventing or responding to lapses. The present study assessed weekly variability in PA lapses, cognitive-affective responses to lapses, and social support related to PA among women participating in a partner-based PA program (n = 20). Multilevel modeling showed that greater PA self-efficacy and more frequent partner communication predicted fewer lapses during the concurrent or subsequent week (ps < 0.02). Interestingly, greater self-forgiveness for lapsing also predicted more lapses the subsequent week (p = 0.04), though greater perceived partner support appeared to buffer the negative effect of self-forgiveness on future lapses (p = 0.04). These findings demonstrate the importance of cognitive-affective responses to PA lapses for future PA, as well as the potential benefit of social support for preventing PA lapses among women.