Self-regulatory and self-efficacy mechanisms of weight loss in women within a community-based behavioral obesity treatment.

Given the traditional methods of treating obesity through education on controlling eating and increasing exercise have largely failed beyond the very short term, a more intensive focus on psychosocial correlates of those weight-loss behaviors has been suggested. Multiple behavioral theories incorporate self-regulation, self-efficacy, and mood; however, their interrelations and effects over both the short and long term within cognitive-behavioral obesity treatments remain unclear. Within a novel community-based program with women with obesity who had either low (n = 29) or high (n = 71) mood disturbance scores, there were significant improvements in exercise- and eating-related self-regulation and eating-related self-efficacy-primary targets of that intervention-with no significant difference in those changes by mood disturbance grouping. Changes in the summed exercise- and eating-related self-regulation scores significantly mediated relationships between changes in eating-related self-efficacy and weight (over both 6 and 12 months). There were similar results with mediation assessed via the extent exercise-related self-regulation carried over to eating-related self-regulation. In both of those models a reciprocal relationship between self-regulation and self-efficacy changes was indicated. In serial multiple mediation equations, paths of changes in exercise-related self-regulation → eating-related self-regulation → eating-related self-efficacy → weight were significant. However, paths were not significant when change in self-efficacy was entered as the predictor (initial) variable. Findings suggest viability in first focusing on exercise-related self-regulation, then eating-related self-regulation, in the course of increasing self-efficacy and probabilities for inducing enough sustained weight loss to improve obesity-associated health risks. Benefits of field-based research findings generalizing to weight-management applications were suggested.

The Role of Change in Self-efficacy in Maintaining Exercise-Associated Improvements in Mood Beyond the Initial 6 Months of Expected Weight Loss in Women with Obesity.

BACKGROUND: Although mechanisms are unclear, there is a robust association between exercise and mood improvements. However, beyond ~ 6 months of expected weight loss, weight-management behaviors such as exercise wane as weight gradually regains in most adults. The amount of exercise required to maintain mood improvement is unknown, as is the possible role of theory-based psychosocial changes associated with treatment such as in self-efficacy. METHODS: Women who volunteered for a community-based cognitive-behavioral obesity treatment emphasizing exercise and building self-efficacy via self-regulating through lifestyle challenges/barriers, and were of the 86% who reduced their negative mood during its initial 6 months, were allocated into groups who either maintained their negative mood reduction (Sustain group, n = 43) or reverted toward initial levels of negative mood (Revert group, n = 73) during months 6-24. A binary stepwise logistic regression analysis assessed whether exercise amount and/or change in self-efficacy significantly classified Sustain vs. Revert group membership. RESULTS: Change in exercise amount was not significantly associated with group membership. However, after additional entry of change in exercise self-efficacy, a significant association was found - successfully classifying 70% and 42% of the Revert and Sustain group participants, respectively. When self-efficacy change was entered as the sole independent variable, group membership was classified with 62% accuracy, overall (96% in the Revert group). CONCLUSIONS: Consistent with behavioral explanations of the exercise-mood change relationship, it was interpreted that self-efficacy, rather than exercise amount, was an important correlate of mood change beyond month 6. Suggestions for bolstering self-efficacy later in behavioral obesity treatments were provided.

Psychosocial Predictors of Maintained Weight Loss in Women: Informing Behavioral Obesity Treatment Foci.

BACKGROUND: Behavioral obesity treatments are typically unable to facilitate meaningful weight loss beyond the short term. Implications of malleable psychosocial factors are unclear, which limits behavioral intervention contents. The current aim was to inform obesity treatments to improve their foci on psychosocial factors leading to resilient behavioral changes and maintained weight loss. METHOD: Based on pre-planned analyses, women participating in a community-based obesity treatment emphasizing self-regulation and exercise, and who lost at least 3% of their initial weight (N = 89), were measured on eating-related self-efficacy, negative mood, emotional eating, body satisfaction, and self-regulating eating at baseline, Month 3, and Month 6; and on weight change over 12 months. RESULTS: From baseline to Month 6, there was a significant overall improvement in each psychosocial variable. In separate multiple regression equations, scores at (1) Month 6, (2) change from baseline to Month 6, and (3) change from Month 3 to Month 6 were entered as predictors of maintained weight loss from Month 6 to Month 12. Using a backward elimination process, only negative mood was retained in the final Month 6 model, and significantly predicted maintained weight loss (R2adjusted = .03, p = .050). Changes in self-efficacy, mood, emotional eating, and self-regulation were retained in the final baseline to Month 6 model, and significantly predicted weight loss maintained over 12 months (R2adjusted = .30, p < .001). CONCLUSION: Findings add to research on obesity treatment development by suggesting an enhanced focus on facilitating changes in self-efficacy, mood, emotional eating, and self-regulation may enhance maintenance of lost weight (or increase weight loss).

Early Effects of Body Satisfaction on Emotional Eating: Tailored Treatment Impacts via Psychosocial Mediators in Women with Obesity.

It was proposed that emotional eating is a critical factor to address early in a behavioral obesity treatment for women to improve their long-term weight-loss, which has been problematic. Poor body image/body satisfaction is a likely predictor of emotional eating. Possible social cognitive theory-based mediators of the body satisfaction-emotional eating relationship having treatment implications include disturbed mood and self-efficacy for controlled eating. Women with obesity volunteered for a community-based weight loss program. After confirming salience of disturbed mood and self-efficacy for controlling one's eating as mediators of the body satisfaction-emotional eating relationship at baseline, a 3-month protocol emphasizing exercise and targeting those mediators through a focus on self-regulation was developed and administered to the treatment group (n = 86). The control group (n = 51) received matched time in typical, educationally based weight-loss processes. Improvements in body satisfaction, emotional eating, disturbed mood, and self-efficacy for controlled eating from baseline-month 3 were each significantly greater in the treatment group. Further analysis of the treatment group found that changes in disturbed mood and self-efficacy completely mediated the body satisfaction change-emotional eating change relationship and neither age nor race (White/Black) were significant moderators. Improvement in emotional eating from baseline-month 3 significantly predicted lost weight over both 3 months and with changes incorporating a 6-month follow up. Findings confirmed the importance of addressing the relationship between body satisfaction and emotional eating over the critical initial months of a behavioral obesity treatment for women through targeting improvements in mood and controlled eating-related self-efficacy.

Obesity treatment-associated transfer of exercise-related self-regulation to eating-related self-regulation changes in women.

Obesity in the United States has risen to 42 percent of its adult population and is similarly problematic in many other countries. Although the U.S. government has provided education on healthy eating and the need to exercise regularly, behavioral obesity treatments have largely failed to sustain reductions in weight. Self-regulation, and the incorporation of exercise for its psychological impacts on eating, has sometimes been targeted. While there has been sporadic investigation into the carry-over of exercise-related self-regulation to eating-related self-regulation, the present aim is to further inquiry in that area to inform future treatment content for improved effects. Women enrolled in community-based obesity treatments with either a self-regulation (n = 106) or education (n = 54) focus were assessed on changes in exercise- and eating-related self-regulation, negative mood, completed exercise, and weight. Improvements were significantly greater in the self-regulation-focused group. After controlling for initial change in eating-related self-regulation, change in that measure from Month 3 to 6 was significantly predicted by change in exercise-related self-regulation during the initial 3 treatment months. This suggested a carry-over effect. A stronger predictive relationship was associated with the self-regulation-focused treatment. In further analyses, paths from changes in exercise→negative mood→self-regulation of both exercise and eating were significant. Increase in eating-related self-regulation was significantly associated with weight loss over 6, 12, and 24 months. The self-regulation-focused group had stronger relationships, again. Findings suggested utility in targeting exercise-related self-regulation to impact later change in eating-related self-regulation, and the use of exercise-associated mood improvement to bolster participants' self-regulation capabilities.

Effects of women's age on their emotional eating changes within a self-regulation-focused obesity treatment.

Results of behavioral obesity treatments have generally been unsuccessful. Reduction of participants' emotional eating (EE) might be essential. Women with obesity within age-groups of emerging adult, young adult, and middle-aged adult - participating in a community-based obesity treatment centered around self-regulatory skills to control eating - were evaluated over 6 months. There were significant reductions in participants' EE and eating-related self-regulation. Participants' change in self-regulation significantly predicted their changes in depression-related, anxiety-related, and total EE. Participants' age group did not significantly affect either their degree of improvement or self-regulation-EE change relationships. Emphasizing self-regulatory skills development for the control of EE, regardless of age-group in women, was suggested by the study authors.

Relationship of increased fruit/vegetable intake with reduced consumption of sweets: Psychological mechanisms and associated weight loss in women within behavioral obesity treatments.

Although an increase in fruit and vegetable (FV) consumption in adults might result in reductions in their intake of sweets, there has been minimal direct testing of this. Women participated in 6-month community-based obesity treatment conditions where either their psychological skills development (n = 66) or knowledge regarding healthful eating and exercise (n = 39) was emphasized. Improvements in FV and sweets intake, eating-related self-regulation, self-efficacy for controlled eating, and negative mood were significantly more pronounced in the psychological skills group participants. Together, participants' change in self-regulation, self-efficacy, and mood significantly mediated the relationship of their changes in FV and sweets. Within simple mediation analyses, participants' changes in self-efficacy and negative mood were significant mediators, and their treatment group membership moderated effects on sweets. We provided suggestions for future treatments based on the present findings.

Effects of Increased Physical Activity/Exercise on Long-Term Losses in Weight and Waist Circumference: Serial Mediation from Changes in Exercise-Related to Eating-Related Self-Regulation.

BACKGROUND: Behavioral obesity treatments have generally been unsuccessful at facilitating long-term weight reductions. Increased physical activity/exercise is a strong predictor of maintained weight loss. It has been proposed this is more linked to increases in exercise-related self-regulation carrying-over to eating-related self-regulation than through direct energy expenditures. METHODS: Women with obesity participated in 10-month community-based behavioral treatments that had theory-based foci on either self-regulation skills building (n = 59) or knowledge of weight loss methods (n = 54). Physical activity/exercise, exercise-related self-regulation, and eating-related self-regulation were assessed at baseline and months 3, 6, and 12 in the prediction of weight and waist circumference changes over 24 months. RESULTS: Significant overall improvements on all measures were found, which were significantly greater in the self-regulation-focused group than the knowledge-focused group. Mean reductions in waist circumference/weight were - 4.64 cm/ - 5.17 kg (- 5.5% of baseline weight) and - 0.66 cm/ - 1.19 kg (- 1.2% of baseline weight), respectively. Aggregated data indicated that early increase in physical activity/exercise significantly predicted 24-month reductions in both weight and waist circumference. Serial mediation analyses indicated that a sequential path from exercise-related self-regulation (baseline-month 3) → eating-related self-regulation (baseline-month 6) → eating-related self-regulation (baseline-month 12) fully mediated the physical activity/exercise-weight/waist circumference change relationships. Energy expenditures from physical activity/exercise accounted for 21% of lost weight. CONCLUSIONS: Findings of this field research supported benefits of progressively building self-regulation skills, first for physical activity/exercise then controlled eating, through accordingly focused behavioral treatments. Opportunities for tailoring large-scale community-based interventions grounded in theory were enhanced.

Contrasts of Initial and Gain Scores in Obesity Treatment-Targeted Psychosocial Variables by Women Participants' Weight Change Patterns Over 2 Years.

The typical pattern of weight change associated with behavioral obesity treatments has been some loss in weight through approximately 6 months, followed by near complete regain. However, patterns vary widely across individuals. The objectives are to determine whether recent prediction model-based indications of relations among changes in psychosocial correlates of the weight loss behaviors of physical activity and controlled eating vary by patterns of weight change. Women with obesity enrolled in a community-based behavioral obesity treatment who failed to lose at least 5% of their baseline weight (Minimal Effect group, n = 44), lost 5% or greater and then regained most during months 6 to 24 (Loss/Regain group, n = 42), or lost 5% or greater and then maintained/continued loss (Loss/Loss group n = 42) were evaluated. Improvements in physical activity- and eating-related self-regulation and self-efficacy, mood, and emotional eating over 6 months were significant overall and generally most favorable in the Loss/Loss group and least favorable in the Minimal Effect group. Expected model-based relationships between 6-month changes in the aforementioned psychosocial variables were significant and generally not significantly affected by weight change group. However, group substantially affected the prediction of self-regulation of eating at month 24-a key correlate of long-term weight loss. Findings suggested community-based obesity treatment targets and emphases.

Additional Effects of Reduced Emotional Eating on Associations of Weight Loss via Changes in Social Cognitive Theory Variables.

BACKGROUND: Improvements in the theory-based psychosocial variables of eating self-regulation, mood, and self-efficacy for controlled eating significantly predicted weight loss in community-based obesity treatments. However, in women, additional effects from reductions in emotional eating, and age and race/ethnicity are unclear. METHODS: Women (N = 130) participating in a community-based cognitive-behavioral obesity treatment were assessed on changes in theory-based psychosocial variables and weight. RESULTS: Treatment-associated improvements in self-regulation, mood, and self-efficacy over 3 months significantly predicted 6-month weight loss (R2 = 0.26), with self-regulation change being the strongest individual predictor. Entry of change in emotional eating into the prediction model significantly added to the variance in weight change explained. Age and race/ethnicity did not further improve the predictive strength. CONCLUSIONS: In addition to targeting self-regulation skill development and, to a lesser extent addressing mood and self-efficacy improvements, behavioral obesity treatments should focus on emotional eating to maximize their large-scale effects on excess weight.

Sequential Mediation of the Relation of Increased Physical Activity and Weight Loss by Mood and Emotional Eating Changes: Community-Based Obesity Treatment Development Guided by Behavioral Theory.

Psychological/behavioral correlates of weight loss, including emotional eating, require improved understandings. These might be especially useful in the context of community-based interventions. Women with obesity, enrolled in 6-month community-based weight loss treatments emphasizing either self-regulation (n = 54) or typical educational methods (n = 52), were evaluated on changes in physical activity/exercise, mood, emotional eating, and weight. Significant improvements on each measure were found in both groups, with significantly greater advances made in the self-regulation emphasis group. Using a lagged variable analytic framework, change in emotional eating significantly mediated physical activity → weight change (over both 6 and 12 months) relationships. Group membership moderated only the mood → emotional eating change relationship. Paths from changes in physical activity → mood → emotional eating → weight were significant, with no alternate path reaching significance. Group was not a significant moderator. Identified paths from physical activity to weight loss, through sequential changes in mood and then emotional eating, should be leveraged to guide community-based weight management curricular development and application. Through such large-scale possibilities for dissemination, means for the reversal of the obesity epidemic could be made possible.

Psychological Mechanisms of Interactions between Improvements in Exercise and Healthy Eating Behaviors (Coaction) within a Community-Based Obesity Treatment Setting.

Coaction refers to positive change in one behavior increasing the probability of positive change in a second behavior. Because mechanisms of coaction have not been well studied, and its improved comprehension might optimize architectures of multi-component behavioral obesity interventions, this research aimed to incorporate theory to assess whether treatment-associated changes in self-regulation and self-efficacy sequentially mediate an association between increased exercise and improved eating. Women with obesity (Mean age = 47.9 years) were randomized into community-based obesity treatments with either a self-regulatory skills emphasis (n = 47), or a more equal focus on education and self-management (n = 52). Each treatment aimed to foster weight loss and reductions in health risks. Over 6 months, there were significant improvements in exercise outputs, fruit/vegetable consumption, sweets intake, exercise- and eating-related self-regulation, and exercise- and eating-related self-efficacy that were significantly greater in the high self-regulation group. Using aggregated data, bivariate relationships between changes in exercise, and fruit/vegetable and sweets intake, were significant. Serial mediation analyses indicated that increased exercise outputs were associated with improved eating through the sequential relationships of eating-related self-regulation and self-efficacy, while improved eating was associated with increased exercise more directly through exercise-related self-regulation. Moderation analyses demonstrated stronger associations in the high self-regulation group for relationships between changes in exercise and eating-related self-regulation and self-efficacy only. Results initiated analyses into mechanisms of coaction among exercise and eating behaviors, and reinforced the value of self-regulatory skills enhancement directly and through its effects on domain-specific self-efficacy in behavioral obesity treatments.

Effects of mood on self-regulating physical activity and sweets intake within obesity treatments.

Background: Although emotional eating is associated with obesity in women, psychological correlates of their treatment-based weight-reduction behaviors are unclear. Aim: To test new model-based propositions of effects of mood on self-regulating physical activity and eating to inform interventions. Methods: Women in community-based obesity treatments with emphases on either self-regulation (n = 56) or weight-management education (n = 54) were assessed on psychological and behavioral variables over 12 months. Results: Emotional eating scores were significantly higher than general samples. Overall significant improvements were found in physical activity- and eating-related self-regulation, mood, physical activity, and sweets consumption. Improvements were more pronounced in the self-regulation-emphasis group. Mood significantly moderated self-regulation-behavior change relationships. Increased physical activity predicted improved mood. Discussion: Findings (a) suggested propensities for emotional eating in women with obesity seeking behavioral treatment, (b) clarified treatment effects and the effect of mood in the self-regulation of physical activity and eating behaviors, and (c) supported model-based treatment targets.

Evaluation of a new causal chain model for predicting embedded psychosocial and behavioral relationships in a community-based obesity treatment seeking maintained weight loss.

A new causal chain model positing theory- and research-based interrelationships among psychosocial and behavioral variables leading to weight loss and its maintenance was assessed. Two samples of women participating in community-based cognitive-behavioral obesity treatments were assessed over either 6 months (weight loss phase; N = 103), or additionally including Months 6-12 (weight-loss maintenance phase; N = 101). Analyses first evaluated whether baseline physical, demographic, behavioral (physical activity, fruit/vegetable intake), and/or psychosocial (self-regulation, self-efficacy, negative mood) variables significantly predicted weight change. Further analyses assessed whether changes in model-based behavioral and psychosocial variables significantly differed by groupings of participants based on their short-term weight loss and weight-loss maintenance/further loss. The predictive value of changes in the psychosocial variables on behavioral changes was next assessed, also accounting for group. Finally, mediation, moderation, and moderated mediation analyses tested proposed causal chain-based interrelationships among variables. Of the 12 variables assessed at baseline, only weight was inversely associated with lost weight, and only fruit/vegetable intake was positively associated with effects during the weight-loss maintenance phase. Overall improvements in behavioral and psychosocial variables were significantly greater in participant groupings with better weight loss and weight-loss maintenance results. Changes in self-regulation, self-efficacy, and mood significantly predicted the weight-loss behavior changes, unaffected by group. Results from the five mediation, moderation, and moderated mediation analyses supported hypotheses based on the new causal chain model. The field testing indicated adequacy of the new causal chain model and informed architectures of behavioral obesity treatments concerned with long-term reductions in excess weight.

Emotional eating: A treatment-worthy construct, or artifact of relations between mood and eating behaviors in younger and older women with obesity.

Emotional eating (EE) is considered important for controlling weight, especially in women; however, it might be affected by age. Within a recently proposed model assessing theoretical paths from physical activity to changes in psychological variables and then eating behavior and weight, it was unclear if EE was a construct requiring specific treatment attention or if attending to effects of physical activity-induced mood changes on eating was sufficient. Women with obesity of >35 years-of-age (n = 100) and ≤35 years (n = 44) participated in a behavioral weight loss treatment and were assessed on psychological factors and physical activity and eating behaviors over 6 months. At baseline, the younger group demonstrated significantly higher scores on physical activity and depression, and significantly lower scores on fruit/vegetable intake. Improvements in Tension (i.e., anxiety), Overall Negative Mood, and dimensions of EE from baseline-Month 3 were significantly greater in the younger group. Similar significant improvements in physical activity and the intake of sweets and fruits/vegetables over 6 months were observed in both groups. Incorporating aggregated data, change in physical activity was significantly related to mood improvements. With the exception of EE related to Anger/Frustration, changes in dimensions of EE and Overall EE significantly mediated the prediction of sweets and fruit/vegetable intake by corresponding dimensions of mood and Overall Mood. Age group significantly moderated embedded relationships between changes in Overall EE and EE-Anxiety and change in fruit/vegetable intake, with the older age group having stronger relations. Findings suggest that EE is a construct requiring distinct attention within behavioral obesity treatments.

Mitigation of the effects of emotional eating on sweets consumption by treatment-associated self-regulatory skills usage in emerging adult and middle-age women with obesity.

An urge to eat in response to negative emotions or mood (emotional eating) is associated with an overconsumption of unhealthy foods such as sweets. Propensities for emotional eating is most prevalent in women, but its effects might differ by age. Within behavioral obesity treatments, it is unclear whether learned self-regulatory skills mitigate the effects of emotional eating susceptibilities on sweets intake, or if expected exercise-induced mood improvements affect the emotional eating-sweets intake relationship. Emerging adult (18-25 years-of-age; n = 43) and middle-age (45-65 years-of-age; n = 79) women with obesity participating in the same cognitive-behavioral treatment that emphasized exercise prior to eating-behavior changes were assessed on levels of propensities for emotional eating, self-regulatory skills usage, mood, and intake of sweets. There were overall significant improvements in self-regulation for eating, overall mood, and daily intake of sweets; with a significantly greater reduction in sweets in the emerging adult women. Self-regulation for eating at Month 3 significantly mediated the prediction of sweets intake at Month 6 by overall emotional eating and emotional eating related to depression. When dimensions of mood (i.e., total negative mood, depression, anxiety, anger) at Month 3 were entered into the models as possible moderators of relationships between a corresponding dimension of emotional eating and sweets intake, anxiety was found to be a significant moderator. Because sweets intake was affected by age, it should be considered in behavioral obesity interventions. Findings suggested advantages of fostering self-regulatory skills and reductions in anxiety, possibly through supported exercise, to mitigate unhealthy eating behaviors associated with propensities for emotional eating.

Effects of a naturally occurring stressor on health behaviors and their psychosocial correlates.

Demands of a university semester and approaching final academic examinations could induce increased anxiety and fatigue, which might prompt deteriorations in health behaviors. Female undergraduate nursing and health promotion students (Mage = 23.8 years) with overweight/obesity (n = 30) and without overweight/obesity (n = 62) completed validated measures just prior to final exams, and after recalling behaviors and perceptions at semester start. There were significant increases in tension, fatigue, anxiety-related emotional eating, and sweets; and significant decreases in eating- and exercise-related self-regulation, fruit/vegetable intake, and physical activity. Overweight/obese participants had significantly more reductions in self-regulation, and increases in sweets. Self-regulation significantly mediated relationships between changes in tension and the consumption of both fruits/vegetables and sweets, and change in anxiety-related emotional eating was not a significant moderator of the mood-behavior change relationships. Change in self-regulation significantly mediated the relationship between increase in fatigue and reduction in physical activity. Changes in fruit/vegetable intake, sweets consumption, and physical activity significantly predicted weight change during the semester when participants' initial BMI was entered into the regression equation. Results suggested that the mood-related changes in fruit/vegetable intake, sweets consumption, and physical activity were largely through changes in participants' self-regulatory processes. Possible interventions were suggested.

Predicting 2-year weight loss through temporally specific earlier losses, relevant behaviors, and their psychological correlates: Implications for behavioral treatment architectures.

Maintaining loss of weight beyond an initial 6-9 months remains problematic, with research indicating little recent progress. A poor understanding of how and when prior weight loss, behavioral changes, and psychosocial predictors are associated with long-term weight changes persists. To better-inform behavioral treatments for long-term success with weight loss, women with obesity (N = 86; Mage  = 48.6 years) volunteered for research incorporating community-based weight-management treatments. They were assessed at months 6, 12, and 24 on theory-based psychosocial and behavioral factors, and over 24 months on weight. Considering the included times and temporal ranges, it was found that change in weight from month 6-24 was the strongest predictor of 24-month weight change, and physical activity and fruit/vegetable intake at month 24 best predicted that change in weight. Self-regulation, self-efficacy, and mood at month 24 best predicted both physical activity and fruit/vegetable intake at month 24, with body satisfaction also a significant predictor of physical activity. From these data, mediation analyses found that the predictions of long-term weight loss by scores of self-regulation, self-efficacy, body satisfaction, and mood at month 24 were significantly mediated by fruit/vegetable intake and physical activity in separate equations. Findings indicated both psychosocial and behavioral targets, and timing for those targets, most indicative of long-term success with weight loss.

Self-regulation foci and mood affect healthy and unhealthy eating behaviours differently in successful weight-loss treatment participants.

An increased understanding of how self-regulation and mood affects both healthy and unhealthy eating behaviours is required to improve weight-loss intervention architectures. Women with obesity (N = 54, MBMI  = 34.80 kg/m2 ), who obtained ≥5% weight loss over 12 months (M = -9.01 kg) within a community-based behavioural weight-loss treatment, were assessed. Improvements in exercise- and eating-focused self-regulation (over 3 and 6 months), and the consumption of fruits/vegetables and sweets (over 6 and 12 months), were each significant. Multiple regression analyses indicated that changes in (a) aggregated (exercise-focused + eating-focused) self-regulation, (b) eating-focused self-regulation alone and (c) eating self-regulation that carried over from exercise-focused self-regulation, each significantly predicted fruit/vegetable consumption changes (R2  = .15-.28). Entry of overall mood did not significantly increase those models' predictive strength. Conversely, mood was the most salient predictor of change in sweets intake. There were significant inverse relationships between changes in fruits/vegetables and sweets consumption. Implications for self-regulation theory and treatment improvements were suggested.

Psychosocial Correlates of Emotional Eating and Their Interrelations: Implications for Obesity Treatment Research and Development.

We tested the effects of emotional eating in long-term weight-loss so that both treatment processes and theory could be improved. Women with obesity participated in treatments of either high interpersonal contact and behavioral methods (n = 39) or low interpersonal contact and educational methods (n = 36) through community-based settings. We assessed mood, emotional eating, self-regulation, self-efficacy, and weight. Changes in the psychosocial measures were significantly greater in the high interpersonal contact/behavioral methods group. That group had a mean weight reduction of 6.5% and 6.8% over 6 and 24 months, respectively, which was significantly greater than the 2.9% and 1.8% loss in the low interpersonal contact/educational methods group at the same time points. Using aggregate data, change in eating self-regulation significantly mediated the prediction of reduced anxiety- and depression-related emotional eating over 6 months by improvements in tension and depression, respectively. The emotional eating reductions were significantly associated with weight loss over both 6 and 24 months. Increased physical activity was significantly associated with reduced tension and depression. We also found that the relationship between changes in physical activity and tension was significantly mediated by a change in exercise-related self-efficacy. Increased exercise self-regulation significantly predicted improved eating regulation, with eating-related self-efficacy change being a significant mediator. Our findings suggest an array of psychosocial targets for behavioral weight-management treatments that have large-scale applications.