Carry-Over of Exercise-Related Self-Regulation to Eating-Related Self-Regulation in Women Participating in Behavioral Obesity Treatments.

Purpose: Because obesity has not responded well to instructing affected adults in healthier eating behaviors and increased physical activity/exercise, enhanced research on psychosocial determinants of those behavioral changes is needed. Intervention foci on self-regulation have been suggested, but targeted research is required. Method: Women with obesity participated in community-based treatments that were either self-regulation-focused (self-regulation emphasis group; n = 52) or typical instruction-based (education [treatment-as-usual] group; n = 54). Results: There were overall significant increases in exercise-related self-regulation, physical activity/exercise, exercise-related self-efficacy, and eating-related self-regulation that were each significantly more pronounced in the self-regulation emphasis group. Increase in exercise-related self-regulation over 3 months predicted eating-related self-regulation over 6 months; however, sequential entry of changes in physical activity and exercise-related self-efficacy significantly mediated that relationship. However, only the path from changes in exercise-related self-regulation to exercise self-efficacy to eating-related self-regulation was significant. In a revised model where change in exercise self-efficacy was the sole mediator, treatment group did not significantly moderate the exercise self-regulation to eating self-regulation change relationship, but full mediation of that relationship occurred. Conclusion: Findings indicated salience for perceived ability/self-efficacy for physical activity, over actual physical activity progress, and its role in the transfer of self-regulatory skills from an exercise to eating context. Increased eating self-regulation significantly predicted weight loss over 6, 12, and 24 months. In the self-regulation emphasis group that translated to meaningful weight loss/weight-loss maintenance of greater than 5% of initial weight. Findings contributed to an increased understanding of psychosocial-change processes within obesity treatment research.

Effects of cardiovascular exercise on eating behaviours: Accounting for effects on stress, depression-, and anger-related emotional eating in women with obesity.

Obesity remains a medical issue of great concern. Behavioural methods attempting to induce weight loss have largely failed because of a minimal understanding of stress- and depression-associated psychosocial correlates. This study extended research into the effects of exercise on weight loss through psychological pathways to improve treatments. Women with obesity (N = 108), participating in an original theory-driven cognitive-behavioural treatment within community-based health promotion centres, were evaluated over 24 months. Their mean scores on anxiety, depression, and anger at baseline were significantly higher than normative data from a general sample of United States women. Three serial mediation models were specified assessing mediation of the significant exercise→dietary change relationship. These yielded two significant paths: changes in exercise→anxiety→anxiety-associated emotional eating→self-efficacy→diet, and changes in exercise→depression→depression-associated emotional eating→self-efficacy→diet; and one non-significant path: changes in exercise→anger→anger-associated emotional eating→self-efficacy→diet. In a subsequent moderated moderation model, change in eating-related self-regulation moderated the relationship between changes in anxiety and anxiety-associated emotional eating, where exercise-associated self-regulation moderated effects from eating-related self-regulation. Dietary improvement was significantly related to weight loss over 6 (ß = -0.40), 12 (ß = -0.42), and 24 (ß = -0.33) months. Findings indicated an increased treatment focus on the completion of moderate amounts of exercise for weight loss and, following that, attention to improvements in anxiety, depression, anxiety- and depression-associated emotional eating, self-efficacy for controlled eating, and the transfer of exercise-related self-regulation to eating-related self-regulation. Given the scope of the obesity problem, extensions of this research within field settings are warranted to accelerate application opportunities.

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.

Short- and Long-Term Weight Loss Among Women Is Unrelated to Completed Exercise Within an Obesity Intervention Focused on Self-Regulation.

INTRODUCTION: The aim of this study was to evaluate 1) if completed exercise amounts were associated with short- and long-term weight loss within a cognitive behavioral intervention and 2) if changes in theory-based psychosocial factors significantly explained weight change. METHODS: A total of 110 women with obesity participated in a yearlong treatment focused on self-regulation and were grouped based on their amount of completed exercise and assessed on changes in weight, self-regulation, and self-efficacy. RESULTS: There were significant overall improvements in all study measures from baseline-month 6 and baseline-month 12. Overall weight loss means (-5.8 and -5.3 kg, respectively) did not significantly differ across groups averaging the equivalent of < 2.5; 2.6-4.5; 4.6-7.0; and > 7.0 moderate-intensity exercise sessions per week. Similarly, psychosocial improvements did not significantly differ by exercise amount grouping. Increase in exercise self-regulation significantly predicted eating self-regulation gains over both 6 and 12 months. Over the same time periods, the significant prediction of weight loss by eating self-regulation increase was mediated by change in eating self-efficacy. CONCLUSION: Results suggest attainment of government-recommended amounts of exercise are not associated with significantly greater weight loss than lower amounts of exercise within an intervention focused on self-regulation. Associations of exercise with psychosocial correlates of weight loss should be a treatment consideration.

Effects of Women's Body Satisfaction, Emotional Eating, and Race on Short-, Mid-, and Long-term Weight Loss.

OBJECTIVE: To improve understanding of psychosocial factors, their changes, and racial differences with implications for behavioral obesity treatments. METHODS: Women with obesity of White (n = 64) and Black (n = 33) racial groups participated in cognitive-behavioral community-based obesity treatment and were assessed on body satisfaction, emotional eating, and weight changes over 3, 6, 12, and 24 months via mixed-model repeated-measures analysis of variance and stepwise multiple regression analyses. RESULTS: Baseline body satisfaction scores were significantly higher (P < 0.001) in Black participants. White participants had significantly higher (P = 0.04) emotional eating scores. Significant overall improvements (P < 0.001) in body satisfaction, emotional eating, and weight were found, with weight reduction significantly greater (P = 0.05) among the White women. Weight reductions were significantly predicted by changes in body satisfaction and emotional eating (R2 = 0.12-0.20, P < 0.01). When racial group was entered into the analyses, the explained variance in weight change over 6 and 12 months significantly increased (P < 0.05). CONCLUSIONS AND IMPLICATIONS: Findings suggest addressing body satisfaction, emotional eating, and racial differences by adjusting obesity treatment targets could improve outcomes. Research-to-practice needs include a control group and further identification/elucidation of other psychosocial and economic factors that might affect outcomes.

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.

Theory to treatment to theory: Evolving a community-based obesity intervention.

Within weight-loss treatments, a better understanding of psychosocial correlates of exercise and controlled eating is required to improve lagging outcomes. Within this two-phase study, women with obesity participating in community-based treatments with educational (Phase 1 n = 57, Phase 2 n = 44) and behavioral (Phase 1 n = 80, Phase 2 n = 53) formats were contrasted on psychosocial variables over 3 and 6 months and their interrelations based on the mood-behavior-model and coaction theory. Phase 1 findings informed curricular extensions in Phase 2. In Phase 1, there were significant overall improvements in total mood disturbance, self-regulation of exercise, self-regulation of eating, and weight, which were more pronounced in the behavioral vs. educational format group (-3.5 % vs. -1.4 % weight loss, respectively). Mediation analyses indicated that change in self-regulation of exercise mediated the prediction of change in self-regulation of eating by mood change. Phase 2 findings were similar; however, effect sizes were greater (-6.2 % vs. -2.9 % weight loss, respectively). Within both phases, increased self-regulation of eating significantly predicted weight reduction. Paths from changes in mood→self-regulation of exercise→self-regulation of eating suggested future program attention focus on treatment-associated mood change reinforcing self-regulation, and self-regulation generalizing from an exercise to eating context. Methods of progressing treatment curricula via theory-testing were suggested.

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.

Emotional Eating: Psychosocial Bases, Accordingly Directed Treatment Design, and Longitudinal Effects in Women with Obesity.

Emotional eating (eating triggered by adverse mood) might be an important psychosocial variable to address to improve overwhelmingly deficient obesity treatment outcomes in women. However, emotional eating has rarely been focused upon in a systematic, evidence-based manner. Within Part 1 of this field-based study completed within community health-promotion centers the United States, a treatment protocol was developed targeting negative mood, body satisfaction, and self-efficacy to resist negative emotion-related eating (SE-NegEm), which were the significant psychosocial predictors of emotional eating found at baseline in the women participants with obesity. A comparison condition consisted of matched treatment time, but focused upon typical processes of providing education in healthy eating and exercise. Cluster sampling allocated participants to either the treatment group (n = 100) or comparison group (n = 86). In Part 2, overall improvements in mood, body satisfaction, SE-NegEm, and emotional eating were found to be significant, and significantly more pronounced in the treatment group. In parallel multiple mediation analyses incorporating aggregated data, changes from baseline-Month 3 and baseline-Month 6 in negative mood, body satisfaction, and SE-NegEm significantly mediated relationships between group and changes in emotional eating from baseline-Month 6 and baseline-Month 12, respectively. Changes in body satisfaction and SE-NegEm were significant independent mediators for 6-month change, with negative mood change additionally significant for 12-month change. Reduced emotional eating significantly predicted lost weight, which was greater in the treatment group (- 5.8% vs. - 0.9%). The present process of tailoring and testing treatment content based on earlier-identified predictors of emotional eating was supported.

Coaction of Exercise and Eating Improvements Within a Behavioral Obesity Treatment: Directionality and Psychological Mechanisms.

Purpose: Because coaction (a favorable change in one behavior increasing the probability of a similarly favorable change in another behavior) associated with health behaviors has been identified, directionalities of such relationships within weight-loss behaviors (e.g., exercise, healthy eating) and their theory-based psychological mechanisms requires more investigation. Method: Women with obesity and either disturbed mood (n = 61) or normal mood (n = 58) participated in a cogntive-behavioral weight-management treatment within a community setting. Analyses of both group differences, and mediation models using aggregate data of behavioral and psychological variables, were conducted. Results: Improvements in measures of self-regulation, self-efficacy, mood, exercise, and fruit/vegetable intake were significant overall; with fruit/vegetable increase greater in the disturbed mood group. The prediction of increase in fruits/vegetables from baseline-Month 6 by increase in exercise from bascline-Month 3 (ß = .24) was stronger than effects of change in fruit/vegetabe intake on exercise (ß = .16). Overall mediation models were significant where changes in self-regulation and self-efficacy were entered as serial mediators of predictions of fruit/vegetable change by change in exercise (R2= .35 and .32), and vice versa (R2= .24 and .23). Paths demonstrating effects through self-regulation change and self-efficacy change were significant in the prediction of eating and exercise changes, respectively. Conclusion: Contributions to advancements in behavioral theory and treatment curricula targeting self-regulation and self-efficacy to improve exercse-eating change relationships were suggested.  .

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.

Behavioral Weight Loss and Maintenance: A 25-Year Research Program Informing Innovative Programming.

Introduction Behavioral interventions targeting sustained weight loss have largely failed for decades, with little chance of improvement using prevailing methods. Objective To address treatment limitations, a focused 25-year research program was reviewed through the lens of social cognitive theory, probative investigations, and original predictive models. Innovative, but evidence-based, treatment suggestions were sought. Results Task 1 of the research program addressed adherence to exercise, a well-established requirement for maintained weight loss. A culminating model addressing this treatment aspect suggested that interrelations among changes in self-regulatory skills usage, self-efficacy, and mood should guide exercise-support programming. Task 2 attached an eating-behavior change component and probed for malleable psychosocial variables predictive of success over the weight-loss phase (initial 6 months after treatment initiation). After thorough evaluation of selected theory- and research-driven psychosocial variables, changes in self-regulation, self-efficacy, and mood were again deemed to be the most salient predictors driving eating change. In Task 3, treatment foci related to changes in the 3 psychosocial variables were supported into the weight-loss maintenance phase (beyond 6 months), and the carry-over of changes in self-regulation and self-efficacy from exercise- to eating-related contexts was identified and leveraged. Task 4 suggested value in additionally addressing emotional eating as a distinct factor. Conclusion Suggestions informing principles and extensions of a treatment approach previously demonstrating atypically high degrees of success with maintaining weight loss in field- and community-based settings are provided. Those methods emanate from the reviewed research program, which shaped novel procedures to leverage exercise-induced psychosocial changes for their carry-over benefits for controlling eating.

Cognitive Behavior-Based Programming to Increase Physical Activity and Control Overweight/Obesity in Youth: An 18-Year Research Program Informing Novel Curricula.

IntroductionBecause only 42% of elementary school-aged children and 8% of adolescents complete the recommended amount of physical activity, programs beyond physical education are required to address this inadequacy and the associated rise in overweight/obesity. ObjectiveOur 18-year research program, conducted through the lens of accepted behavioral theory, field-based investigations, and predictive models intended to shape programs to address physical inactivity and high body mass index in youths, was reviewed. ResultsIn research-to-practice task 1, studies evaluated a cognitive-behavioral elementary afterschool treatment developed from principles of social cognitive theory. It provided exercise/physical activity through an individualized goal-setting perspective and training in self-regulatory skills such as restructuring unproductive self-talk. In task 2, the research program focused on favorable associations between treatment-induced improvements in physical self-concept, the overall self, physical appearance, exercise-related self-efficacy, and mood; it also focused on increased physical activity and reductions in excess weight. Program adaptations for preschool and middle school were also found productive. As the treatment model was extended in research-to-practice task 3, a refined focus on self-regulation, self-efficacy, and mood yielded findings of enhanced effects. In task 4, protocol adaptations intended for youths with severe obesity, additional diabetes risks, and candidacies for bariatric surgery were reported. Finally, the reviewed research evaluated treatment adjuncts that incorporate technology. ConclusionOur program of field research yielded progress on physical inactivity and high body mass index in youths via psychosocial pathways. Findings suggested medical professionals more strongly attend to physical inactivity and weight issues in their young patients while seeking evidence-based methods to induce ongoing behavioral progress.

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.

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.

Effects of Behaviorally Supported Exercise and Exercise-Induced Mood Changes on Elevated Blood Pressure and Hypertension in African American Adults with Severe Obesity.

African Americans with obesity have high rates of hypertension. Exercise has been shown to significantly reduce high blood pressure; however, effects through associated reductions in anxiety and depression are unclear. African American adults with either class 2 or 3 obesity (n = 86; Mage = 43.4 years) and either elevated blood pressure (n = 16) or stage 1 (n = 33) or stage 2 (n = 37) hypertension participated in a theoretically driven community-based weight-management program. There were significant increases in exercise outputs; while systolic and diastolic blood pressure, anxiety, and depression significantly decreased from baseline-month 6. Increased exercise significantly predicted reduced anxiety, depression, and diastolic blood pressure. Change in anxiety significantly mediated the relationship between exercise and both systolic and diastolic blood pressure changes. Increasing exercise from the equivalent of 1.5 to 4.5 moderate bouts/week reduced elevated blood pressure/hypertension in African American adults with severe obesity largely through their exercise-associated improvement in anxiety.

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.

Coaction of Obesity Treatment-Associated Changes in Physical Activity and Emotional Eating: Mediation by Body Satisfaction.

BACKGROUND: Research on coaction suggests improvements in physical activity and emotional eating will occur in a reciprocal manner. AIMS: To determine if changes in body satisfaction mediate relations between physical activity and emotional eating changes and if age affects degree of change in those variables. METHOD: Groups of early adult (n = 43) and middle-age (n = 52) women participants of a community-based obesity treatment were assessed on behavioral and psychological variables over 3 and 6 months. RESULTS: Improvements in physical activity, anxiety-related emotional eating, body satisfaction, anxiety, and exercise self-efficacy were significant overall. Early adults demonstrated greater reductions in emotional eating. Physical activity increase over 3 months significantly predicted 6-month reduction in emotional eating but not vice versa. Body satisfaction change significantly mediated the physical activity-emotional eating relationships. Changes in anxiety and exercise self-efficacy moderated activity → emotional eating and body satisfaction → physical activity relationships, respectively. CONCLUSION: Findings can inform both theory and behavioral obesity interventions.

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.