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Annesi JJ, Powell SM. Carry-Over of Exercise-Related Self-Regulation to Eating-Related Self-Regulation in Women Participating in Behavioral Obesity Treatments. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2024; 95:789-794. [PMID: 38324780 DOI: 10.1080/02701367.2024.2311652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 01/16/2024] [Indexed: 02/09/2024]
Abstract
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.
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Annesi JJ, Powell SM. Obesity treatment-associated transfer of exercise-related self-regulation to eating-related self-regulation changes in women. Women Health 2024; 64:513-525. [PMID: 38965035 DOI: 10.1080/03630242.2024.2374783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 06/26/2024] [Indexed: 07/06/2024]
Abstract
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.
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Affiliation(s)
- James J Annesi
- Mind Body Wellbing, LLC, Manahawkin, New Jersey, UK
- Kinesiology Department, California State University, Monterey Bay, California, USA
| | - Sara M Powell
- Kinesiology Department, California State University, Monterey Bay, California, USA
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Annesi JJ, Sevene PG. Short- and Long-Term Weight Loss Among Women Is Unrelated to Completed Exercise Within an Obesity Intervention Focused on Self-Regulation. Perm J 2023; 27:14-24. [PMID: 37718609 PMCID: PMC10723091 DOI: 10.7812/tpp/23.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
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.
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Affiliation(s)
- James J Annesi
- Central Coast YMCA, Monterey, CA, USA
- California State University, Monterey Bay, CA, USA
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Annesi JJ, Stewart FA. Emotional Eating: Psychosocial Bases, Accordingly Directed Treatment Design, and Longitudinal Effects in Women with Obesity. JOURNAL OF PREVENTION (2022) 2023; 44:221-237. [PMID: 36701021 DOI: 10.1007/s10935-023-00723-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/07/2023] [Indexed: 01/27/2023]
Abstract
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.
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Affiliation(s)
- James J Annesi
- College of Health Sciences and Human Services, California State University, Monterey Bay, Seaside, CA, USA. .,Central Coast YMCA, 600 Camino El Estero, Monterey, CA, 93940, USA.
| | - Francine A Stewart
- College of Education, California State University, Monterey Bay, Seaside, CA, USA.,Sanford College of Education, National University, San Diego, CA, USA.,Monterey Peninsula Unified School District, Monterey, CA, USA
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Annesi JJ, Stewart FA. Contrasts of Initial and Gain Scores in Obesity Treatment-Targeted Psychosocial Variables by Women Participants' Weight Change Patterns Over 2 Years. FAMILY & COMMUNITY HEALTH 2023; 46:39-50. [PMID: 36190961 DOI: 10.1097/fch.0000000000000348] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
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.
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Affiliation(s)
- James J Annesi
- The University of Alabama at Birmingham, Alabama, School of Health Professions (Dr Annesi); Central Coast YMCA, Monterey, California (Dr Annesi); Sanford College of Education, National University, San Diego, California (Dr Stewart); and Monterey Peninsula Unified School District, Monterey, California (Dr Stewart)
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Sequential mediation path from moderate exercise to weight loss through social cognitive theory variables. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03503-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Annesi JJ, Eberly AA. 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. FAMILY & COMMUNITY HEALTH 2022; 45:187-194. [PMID: 35639791 DOI: 10.1097/fch.0000000000000331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
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.
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Affiliation(s)
- James J Annesi
- Central Coast YMCA, Monterey, California (Dr Annesi and Ms Eberly); and School of Health Professions, University of Alabama at Birmingham (Dr Annesi)
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Annesi JJ. Psychological Mechanisms of Interactions between Improvements in Exercise and Healthy Eating Behaviors (Coaction) within a Community-Based Obesity Treatment Setting. Behav Med 2022; 48:245-250. [PMID: 34296980 DOI: 10.1080/08964289.2021.1940821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
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.
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Affiliation(s)
- James J Annesi
- School of Health Professions, University of Alabama at Birmingham
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Annesi JJ. 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. Int J Behav Med 2022; 30:334-344. [PMID: 35678951 DOI: 10.1007/s12529-022-10106-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2022] [Indexed: 11/05/2022]
Abstract
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.
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Affiliation(s)
- James J Annesi
- University of Alabama at Birmingham, Birmingham, AB, USA. .,Central Coast YMCA, Monterey, CA, USA.
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Annesi JJ. Effects of mood on self-regulating physical activity and sweets intake within obesity treatments. Nutr Health 2022; 28:143-148. [PMID: 35129001 DOI: 10.1177/02601060221078157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
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.
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Affiliation(s)
- James J Annesi
- 9968University of Alabama, Birmingham.,Central Coast YMCA, Monterey, CA
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Annesi JJ. Additional Effects of Reduced Emotional Eating on Associations of Weight Loss via Changes in Social Cognitive Theory Variables. Int J Behav Med 2021; 29:408-415. [PMID: 34528214 DOI: 10.1007/s12529-021-10025-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2021] [Indexed: 11/29/2022]
Abstract
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.
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Affiliation(s)
- James J Annesi
- University of Alabama at Birmingham, Birmingham, AL, USA. .,Central Coast YMCA, Monterey, CA, USA.
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Annesi JJ. Effects of obesity treatment-associated changes in mood and self-regulation on high emotional eating. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02231-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Annesi JJ. Coaction of Obesity Treatment-Associated Changes in Physical Activity and Emotional Eating: Mediation by Body Satisfaction. HEALTH EDUCATION & BEHAVIOR 2021; 49:35-40. [PMID: 34297645 DOI: 10.1177/10901981211029251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
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.
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Affiliation(s)
- James J Annesi
- University of Alabama at Birmingham, Birmingham, AL, USA
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Annesi JJ, Walsh SM. Evaluation of a new causal chain model for predicting embedded psychosocial and behavioral relationships in a community-based obesity treatment seeking maintained weight loss. Scand J Psychol 2021; 62:574-585. [PMID: 34060091 DOI: 10.1111/sjop.12741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 04/21/2021] [Indexed: 01/08/2023]
Abstract
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.
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Affiliation(s)
- James J Annesi
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Stephanie M Walsh
- Emory University School of Medicine, Atlanta, GA, USA.,Children's Heathcare of Atlanta, Atlanta, GA, USA
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Effects of Behaviorally Supported Exercise and Exercise-Induced Mood Changes on Elevated Blood Pressure and Hypertension in African American Adults with Severe Obesity. J Immigr Minor Health 2021; 24:721-729. [PMID: 34036517 PMCID: PMC8147905 DOI: 10.1007/s10903-021-01220-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2021] [Indexed: 10/29/2022]
Abstract
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.
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