A preliminary investigation of the role of self-control in behavioral weight loss treatment

Self-control and grit: associations with weight management and healthy habits

Weight management requires resisting immediate temptations in one's environment (self-control) as well as the ability to persevere towards one's long-term goals despite minor setbacks (grit). This study sought to establish relationships between self-control, grit, and behavioral and health outcomes in the context of a couples-based weight management intervention. Couples (n = 64 dyads) in a behaviorally based intervention completed measures of self-control and grit at study entry and the end of treatment (6 months). Habit automaticity for self-weighing and exercise as well as objective weights were measured at baseline, 6 months, and 12 months (maintenance). Self-control and grit increased during treatment; these increases were significantly associated with greater self-weighing habit automaticity at 6 months. Baseline self-control, changes in self-control, and baseline grit were also associated with 6-month exercise automaticity. Only baseline grit was associated with weight loss maintenance. No partner effects were observed. Findings suggest that self-control and grit are malleable constructs that may play an important role in health behavior habits associated with weight management.ClinicalTrials.gov: NCT02570009, October, 7, 2015.

Effects of a health versus hedonic mindset on daily-life snacking behaviour

BACKGROUND

In today's obesogenic environment high-caloric palatable foods are omnipresent, making it hard for many to reach and maintain a healthy body weight. This study investigates the effects of a health versus hedonic mindset on daily-life snacking behaviour. The hypothesis is that a health mindset leads to reduced snacking behaviour compared to a hedonic mindset. This effect is expected to be most pronounced with high dietary restraint and least pronounced with high trait self-control.

METHODS

For 3 weeks, degree of craving and amount of snacks that were craved and consumed were assessed four times a day, using smartphone Ecological Momentary Assessment (EMA). A total of 111 female participants (body mass index range: 20-23.5) were randomly assigned to a 1-week health (n = 53) or hedonic (n = 58) mindset, occurring in week 2 of the EMA protocol. The mindset manipulations consisted of text messages, focusing either on the enjoyment of tasty food (hedonic) or on healthy living and eating (health).

RESULTS

contrary to our hypotheses, mindset did not affect snacking behaviour. Instead, degree of craving and intake of snacks reduced significantly over time, not moderated by mindset, dietary restraint (Restraint Scale) or trait self-control (Brief Self-Control Scale). Importantly, this was not due to reduced compliance. Possibly, the reduced craving and snacking behaviour were due to monitoring and/or socially desirable answering tendencies. Additional time point analyses showed that craving was strongest in the late afternoon (3:30-5:00 PM), and-across mindset conditions-degree of craving correlated negatively with trait self-control.

CONCLUSIONS

future studies could manipulate degree of monitoring and design individually tailored manipulations.

Self-Control Measurement Methodologies: An Integrative Approach

The study of self-control occurs in many different types of experimental settings using a wide range of methodologies. In addition, measures of self-control vary in their procedures and operational definitions from simple questionnaires to complex scenarios where individuals must choose to act or not. The present summary draws on trends within the literature using widely accepted measures of self-control. The measures are organized based on established paradigms in the literature and focus on three categories: executive functioning tasks, delay of gratification tasks, and subjective-report surveys. We also include an "additional measures" category to capture measures that do not readily fit in these three categories. Finally, we discuss recent approaches to the scientific exploration of self-control and integrate the categories of measures used here within these approaches. This integration incorporates a wide range of research paradigms and provides direction for future studies.

Psychosocial factors in medication adherence and diabetes self-management: Implications for research and practice

Diabetes is a chronic illness that places a significant self-management burden on affected individuals and families. Given the importance of health behaviors-such as medication adherence, diet, physical activity, blood glucose self-monitoring-in achieving optimal glycemic control in diabetes, interventions designed and delivered by psychologists hold promise in assisting children, adolescents, and adults with diabetes in improving their health status and lowering their risk of serious complications. This article first provides an overview of diabetes self-management and associated challenges and burdens. Socioeconomic status factors that may influence diabetes management and outcomes are briefly highlighted. We then review the evidence base for select psychosocial factors that may be implicated in diabetes self-management. Modifiable targets of psychological intervention are presented across 3 overarching domains: (a) knowledge, beliefs, and related cognitive constructs; (b) emotional distress and well-being; and (c) behavioral skills and coping. Important methodological issues facing future research are discussed, along with opportunities for psychologists in improving the care and treatment outcomes of individuals and families living with diabetes. In conclusion, we advocate for continued research emphasis on improving psychosocial aspects of living with diabetes, with greater attention to the situational context in which the self-regulatory processes underlying self-management occur. Psychologists have important roles to play in reducing emotional distress, improving patient knowledge, and providing training in behavioral skills to promote successful self-management and to support patient-centered diabetes care. (PsycINFO Database Record

The BestFIT trial: A SMART approach to developing individualized weight loss treatments

Behavioral weight loss programs help people achieve clinically meaningful weight losses (8-10% of starting body weight). Despite data showing that only half of participants achieve this goal, a "one size fits all" approach is normative. This weight loss intervention science gap calls for adaptive interventions that provide the "right treatment at the right time for the right person." Sequential Multiple Assignment Randomized Trials (SMART), use experimental design principles to answer questions for building adaptive interventions including whether, how, or when to alter treatment intensity, type, or delivery. This paper describes the rationale and design of the BestFIT study, a SMART designed to evaluate the optimal timing for intervening with sub-optimal responders to weight loss treatment and relative efficacy of two treatments that address self-regulation challenges which impede weight loss: 1) augmenting treatment with portion-controlled meals (PCM) which decrease the need for self-regulation; and 2) switching to acceptance-based behavior treatment (ABT) which boosts capacity for self-regulation. The primary aim is to evaluate the benefit of changing treatment with PCM versus ABT. The secondary aim is to evaluate the best time to intervene with sub-optimal responders. BestFIT results will lead to the empirically-supported construction of an adaptive intervention that will optimize weight loss outcomes and associated health benefits.

Failure to replicate depletion of self-control

The limited resource or strength model of self-control posits that the use of self-regulatory resources leads to depletion and poorer performance on subsequent self-control tasks. We conducted four studies (two with community samples, two with young adult samples) utilizing a frequently used depletion procedure (crossing out letters protocol) and the two most frequently used dependent measures of self-control (handgrip perseverance and modified Stroop). In each study, participants completed a baseline self-control measure, a depletion or control task (randomized), and then the same measure of self-control a second time. There was no evidence for significant depletion effects in any of these four studies. The null results obtained in four attempts to replicate using strong methodological approaches may indicate that depletion has more limited effects than implied by prior publications. We encourage further efforts to replicate depletion (particularly among community samples) with full disclosure of positive and negative results.